77 results on '"Ray-Coquard, Isabelle"'
Search Results
2. Traitements adjuvants du cancer du sein
- Author
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Guastalla, Jean-Paul, primary, Tredan, Olivier, additional, Ray-Coquard, Isabelle, additional, Labidi-Galy, Sana Intidhar, additional, Duret, Aude, additional, Cassier, Philippe, additional, and Bachelot, Thomas, additional
- Published
- 2011
- Full Text
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3. Les auteurs
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Plu-Bureau Geneviève, Raccah-Tebeka Brigitte, Trémollières Florence, Abitbol Vered, André Gabriel, Arnal Jean-François, Bachelot Anne, de Belilovsky Clarence, Beylot Claire, Blom Astrid, Boubli Léon, Bourges Jean-Louis, Bourret Antoine, Boutet Gérard, Bricaire Léopoldine, Christin-Maitre Sophie, Dridi Sophie Myriam, Dubertret Caroline, Fontaine Coralie, Gompel Anne, Gourdy Pierre, Grouthier Virginie, Hamdaoui Naima, Hocké Claude, Hugon-Rodin Justine, Lallam Corinne, Le Guern Véronique, Lenfant Françoise, Letombe Brigitte, Lopes Patrice, Ly Sandra, Madika Anne-Laure, Maitrot-Mantelet Lorraine, Marciceau Ianis, Mares Pierre, Monnet Corti Virginie, Mounier-Vehier Claire, Noirrit-Esclassan Emmanuelle, Pasquier Florence, Pietri Olivia, Ray-Coquard Isabelle, Robin Geoffroy, Rousset-Jablonski Christine, Tebeka Sarah, Touraine Philippe, Tramunt Blandine, and Valéra Marie-Cécile
- Published
- 2019
4. Antitumor activity and safety of the PARP inhibitor rucaparib in patients with high grade ovarian carcinoma and a germline or somatic BRCA1 or BRCA2 mutation: integrated analysis of data from Study 10 and ARIEL2
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Oza, Amit M., Tinker, Anna V., Oaknin, Ana, Shapira-Frommer, Ronnie, Mcneish, Iain A., Swisher, Elizabeth M., Ray-Coquard, Isabelle, Bell-McGuinn, Katherine, Coleman, Robert L., O’Malley, David M., Leary, Alexandra, Chen, Lee-may, Provencher, Diane, Ma, Ling, Brenton, James D., Konecny, Gottfried E., Castro, Cesar M., Giordano, Heidi, Maloney, Lara, Goble, Sandra, Lin, Kevin K., Sun, James, Raponi, Mitch, Rolfe, Lindsey, and Kristeleit, Rebecca S.
- Abstract
Objective:\ud \ud An integrated analysis was undertaken to characterize the antitumor activity and safety profile of the oral poly(ADP-ribose) polymerase inhibitor rucaparib in patients with relapsed high-grade ovarian carcinoma (HGOC).\ud Methods:\ud \ud Eligible patients from Study 10 (NCT01482715) and ARIEL2 (NCT01891344) who received a starting dose of oral rucaparib 600 mg twice daily (BID) with or without food were included in these analyses. The integrated efficacy population included patients with HGOC and a deleterious germline or somatic BRCA1 or BRCA2 (BRCA1/2) mutation who received at least two prior chemotherapies and were sensitive, resistant, or refractory to platinum-based chemotherapy. The primary endpoint was investigator-assessed confirmed objective response rate (ORR). Secondary endpoints included duration of response (DOR) and progression-free survival (PFS). The integrated safety population included patients with HGOC who received at least one dose of rucaparib 600 mg BID, irrespective of BRCA1/2 mutation status and prior treatments.\ud Results:\ud \ud In the efficacy population (n = 106), ORR was 53.8% (95% confidence interval [CI], 43.8–63.5); 8.5% and 45.3% of patients achieved complete and partial responses, respectively. Median DOR was 9.2 months (95% CI, 6.6–11.6). In the safety population (n = 377), the most frequent treatment-emergent adverse events (AEs) were nausea, asthenia/fatigue, vomiting, and anemia/hemoglobin decreased. The most common grade ≥ 3 treatment-emergent AE was anemia/hemoglobin decreased. Treatment-emergent AEs led to treatment interruption, dose reduction, and treatment discontinuation in 58.6%, 45.9%, and 9.8% of patients, respectively. No treatment-related deaths occurred.\ud Conclusions:\ud \ud Rucaparib has antitumor activity in advanced BRCA1/2-mutated HGOC and a manageable safety profile.
- Published
- 2017
5. Clinical trial designs for rare diseases: studies developed and discussed by the International Rare Cancers Initiative
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Bogaerts, Jan, Sydes, Matthew R., Keat, Nicola, McConnell, Andrea, Benson, Al, Ho, Alan, Roth, Arnaud, Fortpied, Catherine, Eng, Cathy, Peckitt, Clare, Coens, Corneel, Pettaway, Curtis, Arnold, Dirk, Hall, Emma, Marshall, Ernie, Sclafani, Francesco, Hatcher, Helen, Earl, Helena, Ray-Coquard, Isabelle, Paul, James, Blay, Jean-Yves, Whelan, Jeremy, Panageas, Kathy, Wheatley, Keith, Harrington, Kevin, Licitra, Lisa, Billingham, Lucinda, Hensley, Martee, McCabe, Martin, Patel, Poulam M., Carvajal, Richard, Wilson, Richard, Glynne-Jones, Rob, McWilliams, Rob, Leyvraz, Serge, Rao, Sheela, Nicholson, Steve, Filiaci, Virginia, Negrouk, Anastassia, Lacombe, Denis, Dupont, Elisabeth, Pauporté, Iris, Welch, John J., Law, Kate, Trimble, Ted, and Seymour, Matthew
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Cancer Research ,International Cooperation ,Methodology ,Randomised controlled trials ,Review ,Bayesian ,Public-Private Sector Partnerships ,Clinical trials ,Rare Diseases ,Oncology ,Research Design ,Neoplasms ,Rare cancers ,Humans ,Frequentist ,Multi-arm ,Randomized Controlled Trials as Topic - Abstract
Background\ud The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research.\ud \ud Settings\ud The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional – usually randomised – clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed.\ud \ud Results\ud The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design.\ud \ud Interpretation\ud Trials can be designed using a wide array of possibilities. There is no ‘one size fits all’ solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.
- Published
- 2014
6. Statement of the AGO Kommission Ovar, AGO Study Group, NOGGO, AGO Austria, Swiss AGO, BGOG, CEEGOG, GEICO, and SFOG regarding the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in epithelial ovarian cancer.
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Harter P, Bogner G, Chiva L, Cibula D, Concin N, Fotopoulou C, Gonzalez-Martin A, Guyon F, Heinzelmann-Schwarz V, Kridelka F, Mahner S, Marmé F, Marth C, Morice P, Novák Z, Papadia A, Ray-Coquard I, Redecha M, Redondo A, Schwameis R, Sehouli J, Undurraga M, Van Gorp T, and Vergote I
- Subjects
- Humans, Female, Carcinoma, Ovarian Epithelial pathology, Hyperthermic Intraperitoneal Chemotherapy, Prospective Studies, Austria, Switzerland, Combined Modality Therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hyperthermia, Induced methods, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology
- Abstract
An international joint statement about the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer was published in 2016, warning about the uncritical use of HIPEC outside controlled studies. This statement has now been updated after the most recent literature was reviewed by the participating study groups and societies. HIPEC became a treatment option in patients with advanced colon cancer after positive results of a randomized trial comparing surgery and HIPEC versus palliative treatment alone. Although this trial did not compare the added value of HIPEC to surgery alone, HIPEC for the treatment of peritoneal metastases was in the subsequent years generalized to many other cancer types associated with peritoneal carcinomatosis including epithelial ovarian cancer (EOC). In the meantime, new evidence from prospective randomized trials specifically for EOC-patients emerged, with however contradicting results and several quality aspects that made the interpretation of their findings critical. Moreover, three additional trials in colorectal cancer failed to confirm the previously presumed survival benefit through the implementation of HIPEC in peritoneally disseminated colorectal cancers. Based on a still unclear and inconsistent landscape, the authors conclude that HIPEC should remain within the remit of clinical trials for EOC-patients. Available evidence is not yet sufficient to justify its broad endorsement into the routine clinical practice., (Copyright © 2023 Société Française du Cancer. All rights reserved.)
- Published
- 2024
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7. Atezolizumab plus bevacizumab and chemotherapy for metastatic, persistent, or recurrent cervical cancer (BEATcc): a randomised, open-label, phase 3 trial.
- Author
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Oaknin A, Gladieff L, Martínez-García J, Villacampa G, Takekuma M, De Giorgi U, Lindemann K, Woelber L, Colombo N, Duska L, Leary A, Godoy-Ortiz A, Nishio S, Angelergues A, Rubio MJ, Fariñas-Madrid L, Yamaguchi S, Lorusso D, Ray-Coquard I, Manso L, Joly F, Alarcón J, Follana P, Romero I, Lebreton C, Pérez-Fidalgo JA, Yunokawa M, Dahlstrand H, D'Hondt V, and Randall LM
- Subjects
- Female, Humans, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bevacizumab therapeutic use, Carboplatin, Chronic Disease, Cisplatin, Platinum therapeutic use, Uterine Cervical Neoplasms drug therapy
- Abstract
Background: The GOG240 trial established bevacizumab with chemotherapy as standard first-line therapy for metastatic or recurrent cervical cancer. In the BEATcc trial (ENGOT-Cx10-GEICO 68-C-JGOG1084-GOG-3030), we aimed to evaluate the addition of an immune checkpoint inhibitor to this standard backbone., Methods: In this investigator-initiated, randomised, open-label, phase 3 trial, patients from 92 sites in Europe, Japan, and the USA with metastatic (stage IVB), persistent, or recurrent cervical cancer that was measurable, previously untreated, and not amenable to curative surgery or radiation were randomly assigned 1:1 to receive standard therapy (cisplatin 50 mg/m
2 or carboplatin area under the curve of 5, paclitaxel 175 mg/m2 , and bevacizumab 15 mg/kg, all on day 1 of every 3-week cycle) with or without atezolizumab 1200 mg. Treatment was continued until disease progression, unacceptable toxicity, patient withdrawal, or death. Stratification factors were previous concomitant chemoradiation (yes vs no), histology (squamous cell carcinoma vs adenocarcinoma including adenosquamous carcinoma), and platinum backbone (cisplatin vs carboplatin). Dual primary endpoints were investigator-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumours version 1.1 and overall survival analysed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT03556839, and is ongoing., Findings: Between Oct 8, 2018, and Aug 20, 2021, 410 of 519 patients assessed for eligibility were enrolled. Median progression-free survival was 13·7 months (95% CI 12·3-16·6) with atezolizumab and 10·4 months (9·7-11·7) with standard therapy (hazard ratio [HR]=0·62 [95% CI 0·49-0·78]; p<0·0001); at the interim overall survival analysis, median overall survival was 32·1 months (95% CI 25·3-36·8) versus 22·8 months (20·3-28·0), respectively (HR 0·68 [95% CI 0·52-0·88]; p=0·0046). Grade 3 or worse adverse events occurred in 79% of patients in the experimental group and in 75% of patients in the standard group. Grade 1-2 diarrhoea, arthralgia, pyrexia, and rash were increased with atezolizumab., Interpretation: Adding atezolizumab to a standard bevacizumab plus platinum regimen for metastatic, persistent, or recurrent cervical cancer significantly improves progression-free and overall survival and should be considered as a new first-line therapy option., Funding: F Hoffmann-La Roche., Competing Interests: Declaration of interests AO reports personal fees for participation in the advisory boards of AstraZeneca, Clovis Oncology, Deciphera, Genmab, GSK, Immunogen, Mersana Therapeutics, PharmaMar, MSD de España, Agenus, Sutro, Corcept Therapeutics, EMD Serono, Novocure, Shattuck Labs, iTeos, and Eisai; travel and accommodation support from AstraZeneca, PharmaMar, and Roche; and funding paid to institution from AbbVie Deutschland, Advaxis, Aeterna Zentaris, Amgen, Aprea Therapeutics AB, Clovis Oncology, Eisai, F Hoffmann-La Roche, Regeneron Pharmaceuticals, Immunogen, MSD de España, Takeda, PharmaMar, Tesaro, and Bristol Myers Squibb. LG reports support for attending meetings or travel from Viatris, GSK, and MSD; consulting fees paid to institution for participation in the advisory boards of Clovis, GSK, AstraZeneca, and Seagen; and speaker honoraria paid to institution from AstraZeneca, GSK, and Eisai. JM-G reports personal fees for participation in the advisory boards of AstraZeneca, Clovis, GSK, and PharmaMar; research grants paid to institution from GSK and Roche; and travel and accommodation expenses from GSK−Tesaro, Pfizer, and PharmaMar. GV reports honoraria for speaker engagements from MSD, Pierre Fabre, GSK, and Pfizer; and consulting fees from Reveal Genomics. UDG reports personal consulting fees from Amgen, AstraZeneca, Pfizer, BMS, Clovis Oncology, Dompé Farmaceutici, Merck, MSD, PharmaMar, Astellas, Bayer, Ipsen, Novartis, Eisai, and Janssen; other funding paid to institution from AstraZeneca, Sanofi, and Roche; and support for attending meetings or travel from Pfizer, Ipsen, and AstraZeneca. KL reports personal honoraria from Eisai; participation on data safety monitoring or advisory boards of Eisai, MSD, Nykode, AstraZeneca, and GSK (honoraria paid to institution); and funding paid to institution from GSK. LW reports personal honoraria for participation in the advisory boards of AstraZeneca, Pfizer, GSK, Roche, MSD–Merck, Eisai, and Seagen; personal honoraria for speaker engagements from AstraZeneca, Eisai, GSK, Pfizer, Roche, MSD–Merck, and Seagen; and support for attending meetings or travel from GSK and MSD. NC reports consultancy or advisory roles for AstraZeneca, Clovis Oncology, Eisai, GSK, Immunogen, Mersana, MSD−Merck, Nuvation Bio, OncXerna, Pfizer, Pieris, and Roche; promotional speaker roles for AstraZeneca, Novartis, Clovis Oncology, MSD−Merck, and GSK; research grants from AstraZeneca, GSK, and Roche; and support for attending meetings or travel from AstraZeneca and GSK. LD reports personal fees for scientific advisory boards from Aadi Bioscience and Regeneron; fees paid to institution for scientific advisory boards from Merck; membership of the British Journal of Obstetrics and Gynaecology Editorial Board; personal royalties for writing expert content for UpToDate, Wiley, and the American Society of Clinical Oncology; personal fees for continuing medical education activities for Advance Medical, CEA Group, and Clinical Care Options; research funding paid to institution for investigator-initiated trials from Merck; clinical trial grants paid to institution from Genentech−Roche, AbbVie (GOG 3005), Acrivon, Advaxis, Aduro BioTech, Alkermes, Blueprint, Constellation, Eisai, GSK–Novartis, Immunogen, Inovio, Iovance, Karyopharm, KSQ Therapeutics, Lycera, Merck, Morab, MorphoTek, Naveris, Nurix, OncoQuest, Pfizer, Syndax, Tesaro, and Zentalis; and fees paid to institution for membership of data and safety monitoring committees for Agenus and Inovio. AL reports personal fees for presentations or educational events from Medscape and PeerVoice; consulting fees paid to institution from Owkin; speaker honoraria paid to institution from MSD, GSK, AstraZeneca, and Eisai; fees paid to institution for participation in the advisory boards of AstraZeneca, MSD, Seagen, GSK, Genmab, Zentalis, and Blueprint; non-remunerated independent data safety monitoring board participation for Clovis and BMS; an educational grant paid to institution from AstraZeneca; and support for attending meetings or travel from OSE Immunotherapeutics. AG-O reports honoraria paid to institution for participation in the advisory board of Novartis; personal honoraria for speaker engagements from AstraZeneca, Pfizer, Novartis, and Lilly; and support for attending meetings or travel from Pfizer and Novartis. MJR reports personal fees for participation in the advisory boards of AstraZeneca, Clovis Oncology, GSK, PharmaMar, MSD de España, Eisai, and Roche; personal fees for speaker engagements from MSD, AstraZeneca, Clovis Oncology, GSK, and PharmaMar; and travel and accommodation from AstraZeneca, PharmaMar, Roche, GSK, and MSD de España. LF-M reports honoraria paid to institution for participation in the advisory boards of GSK; honoraria paid to institution for speaker engagements from GSK, AstraZeneca–MSD, and Eisai; and support for attending meetings or travel from AstraZeneca–MSD and GSK. DL reports personal fees for participation in the advisory boards of AstraZeneca, Clovis Oncology, Corcept, Genmab, GSK, Immunogen, MSD, Oncoinvent, PharmaMar, Seagen, and Sutro; personal fees for consultancy roles from AstraZeneca, Clovis Oncology, Genmab, GSK, Immunogen, MSD, Novartis, PharmaMar, and Seagen; clinical trial or research funding to institution from Clovis Oncology, GSK, MSD, and PharmaMar; other financial or non-financial interests from AstraZeneca, Clovis Oncology, Corcept, Genmab, GSK, Immunogen, Incyte, MSD, Novartis, Oncoinvent, PharmaMar, Roche, Seagen, and Sutro; and travel grants from AstraZeneca, Clovis Oncology, and GSK. IR-C reports personal honoraria for participation in the advisory boards of Adaptimmune, Agenus, Amgen, AstraZeneca, BMS, Clovis, Daiichi Sankyo, Deciphera, Eisai, EQRx, GSK, Merck Serono, MacroGenics, Mersana, Novartis, Onxeo, Roche, and Sutro Biopharma; honoraria paid to institution for participation in the advisory boards of MSD (translational research); and funding paid to institution for translational research from BMS. LM reports participation in the advisory board of Roche; and honoraria for speaker engagements from Roche, GSK, Clovis Oncology, AstraZeneca, Pfizer, Novartis, and Lilly. FJ reports honoraria for lectures, expert boards, and educational events from AstraZeneca, Clovis Oncology, GSK, and Seagen; travel and accommodation support from GSK, Eisai, and MSD; and financial support for national academic GINECO trials from GSK and AstraZeneca. JA reports honoraria for speaker bureaus from GSK, Roche, AstraZeneca, MSD, PharmaMar, and Clovis; and advisory boards for GSK, MSD, AstraZeneca, and Clovis. PF reports personal fees for expert testimony from Daiichi; personal fees for invited speaker engagements from GSK and MSD; and support for attending meetings or travel from Lilly, Novartis, and GSK. IR reports personal fees for advisory boards from AstraZeneca, Clovis Oncology, GSK, PharmaMar, Roche, and MSD; and travel and accommodation from AstraZeneca, PharmaMar, Roche, and GSK. CL reports honoraria for advisory board participation from GSK; personal honoraria for speaker engagements from GSK, Clovis Oncology, Eisai, and MSD; and support for attending meetings or travel from MSD and GSK. JAP-F reports honoraria for speaker engagements from AstraZeneca, PharmaMar, Pharma&, Clovis, and GSK; payment for expert testimony from AstraZeneca, GSK, Roche, and PharmaMar; support for attending meetings or travel from Karyopharm, AstraZeneca, Roche, and PharmaMar; grants paid to institution from GSK and PharmaMar; equipment, materials, drugs, medical writing, gifts, or other services paid to institution from GSK; participation on data safety monitoring or advisory boards for Ability Pharma; and has a patent pending in breast cancer. HD reports personal honoraria for advisory board participation from AstraZeneca. LMR reports honoraria for speaker engagements from Genmab−Seagen, Blueprint Oncology, Curio Science, and Physicians Education Resource; honoraria for participation in the advisory boards of AstraZeneca, Clovis Oncology, GOG Foundation, Aadi Biosciences, Seagen, OnTarget Laboratories, Merck, Mersana, Rubius Therapeutics, Myriad Genetics, Genentech−Roche, Eisai, Novocure, and Immunogen; consulting fees from the GOG Foundation; and funding paid to institution from Genentech−Roche, On Target Laboratories, Pfizer, Aivita Biomedical, Tesaro, AstraZeneca, Merck, Akeso Biopharma, and Grupo Español de Investigación en Cáncer ginecologico. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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8. [Diagnosis of uterine sarcomas and rare uterine mesenchymal tumours with malignant potential. Guidelines of the French Sarcoma Group and Rare Gynaecological Tumours].
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Croce S, Devouassoux-Shisheboran M, Pautier P, Ray-Coquard I, Treilleux I, Neuville A, Arnould L, Just PA, Le Frere Belda MA, Averous G, Leroux A, Bataillon G, Mery E, Loussouarn D, Weinbreck N, Le Guellec S, Mishellany F, Morice P, Guyon F, and Genestie C
- Subjects
- Adult, Child, Female, Humans, Protein-Tyrosine Kinases, Proto-Oncogene Proteins, Receptor Protein-Tyrosine Kinases, DNA Helicases, Nuclear Proteins, Transcription Factors, Leiomyosarcoma diagnosis, Leiomyosarcoma genetics, Leiomyosarcoma therapy, Genital Neoplasms, Female, Rhabdomyosarcoma, Embryonal diagnosis, Rhabdomyosarcoma, Embryonal genetics, Rhabdomyosarcoma, Embryonal therapy, Sarcoma, Endometrial Stromal diagnosis, Sarcoma, Endometrial Stromal genetics, Sarcoma, Endometrial Stromal therapy, Uterine Cervical Neoplasms, Uterine Neoplasms diagnosis, Uterine Neoplasms genetics, Uterine Neoplasms therapy, Soft Tissue Neoplasms, Endometrial Neoplasms, Ribonuclease III, DEAD-box RNA Helicases
- Abstract
The landscape of uterine sarcomas is becoming more complex with the description of new entities associated with recurrent driver molecular alterations. Uterine sarcomas, in analogy with soft tissue sarcomas, are distinguished into complex genomic and simple genomic sarcomas. Leiomyosarcomas and undifferentiated uterine sarcomas belong to complex genomic sarcomas group. Low-grade and high-grade endometrial stromal sarcomas, other rare tumors associated with fusion transcripts (such as NTRK, PDGFB, ALK, RET ROS1) and SMARCA4-deficient uterine sarcoma are considered simple genomic sarcomas. The most common uterine sarcoma are first leiomyosarcoma and secondly endometrial stromal sarcomas. Three different histological subtypes of leiomyosarcoma (fusiform, myxoid, epithelioid) are identified, myxoid and epithelioid leiomyosarcoma being more aggressive than fusiform leiomyosarcoma. The distinction between low-grade and high-grade endometrial stromal sarcoma is primarily morphological and immunohistochemical and the detection of fusion transcripts can help the diagnosis. Uterine PEComa is a rare tumor, which is distinguished into borderline and malignant, according to a risk assessment algorithm. Embryonal rhabdomyosarcoma of the uterine cervix is more common in children but can also occur in adult women. Embryonal rhabdomyosarcoma of the uterine cervix is almost always DICER1 mutated, unlike that of the vagina which is wild-type DICER1, and adenosarcoma which can be DICER1 mutated but with less frequency. Among the emerging entities, sarcomas associated with fusion transcripts involving the NTRK, ALK, PDGFB genes benefit from targeted therapy. The integration of molecular data with histology and clinical data allows better identification of uterine sarcomas in order to better treat them., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2024
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9. Gynecological carcinosarcomas: Overview and future perspectives.
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Collet L, González López AM, Romeo C, Méeus P, Chopin N, Rossi L, Rowinski E, Serre AA, Rannou C, Buisson A, Treilleux I, and Ray-Coquard I
- Subjects
- Female, Humans, Chemotherapy, Adjuvant, Carcinoma, Ovarian Epithelial drug therapy, Uterine Neoplasms epidemiology, Uterine Neoplasms genetics, Uterine Neoplasms therapy, Ovarian Neoplasms pathology, Carcinosarcoma genetics, Carcinosarcoma therapy
- Abstract
Gynecologic carcinosarcoma (CS) are rare and aggressive tumors composed of high-grade carcinoma and sarcoma. Carcinosarcoma account for less than 5% of uterine and ovarian carcinoma and patients have poor outcome with a 5-year overall survival of less than 30%. In early-stage setting, the treatment mainstay is surgery and adjuvant chemoradiotherapy or adjuvant chemotherapy in uterine (UCS) and ovarian CS (OCS), respectively. In metastatic or advanced stage disease, chemotherapy is the rule with a lower response rate and poorer prognosis compared to other high-grade carcinomas. Although very few treatment options are available, CS are often excluded from the clinical trials precluding therapeutic improvement. However, recent molecular advances are paving the way for new therapeutic strategies. In the current proposal, we extensively review the uterine and ovarian carcinosarcomas including epidemiology, pathology, genomic landscape, as well as current therapies and future perspectives., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
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10. Do surgeons overestimate diaphragmatic peritoneal disease in interval debulking surgery of ovarian cancer?
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Turrel E, Chopin N, Meeus P, Blache A, Ray-Coquard I, Tredan O, Treilleux I, Ebring C, Heinemann M, and Rossi L
- Subjects
- Humans, Female, Cytoreduction Surgical Procedures, Retrospective Studies, Neoadjuvant Therapy, Chemotherapy, Adjuvant, Neoplasm Staging, Ovarian Neoplasms pathology, Peritoneal Diseases drug therapy, Peritoneal Diseases pathology, Surgeons
- Abstract
Introduction: Cytoreductive surgery is a key point in ovarian cancer treatment. Substantial morbidity may be consecutive to this major radical surgery. However, the objective of no residual tumor (CC-0) had demonstrated its clear improvement of prognosis. Could macroscopically-driven interval debulking surgery (IDS) overestimate active cancer cells and be unnecessarily morbid?, Materials and Methods: This retrospective cohort study was conducted in Center Leon Berard Cancer Center between 2000 and 2018. We included women with advanced epithelial ovarian cancer who received neoadjuvant chemotherapy and underwent an IDS including resection of peritoneal metastases on the diaphragmatic domes. The primary endpoint was the pathological outcome of peritoneal resections of diaphragmatic domes., Results: Peritoneal resections of diaphragmatic domes consisted of 117 patients. 75 patients required resection of nodules from the right cupola only, 2 patients from the left cupola only, and 40 patients bilaterally. Pathological analysis of the diaphragmatic domes found that 84.6% of samples demonstrated the presence of malignant cells, and only 12.8% found no tumor involvement. Pathology analysis could not be performed for 3 patients (2.6%) (vaporization)., Conclusion: Surgical evaluation after neoadjuvant chemotherapy in ovarian cancer does not often overestimate peritoneal involvement by active carcinomatosis. Potential surgical morbidity due to peritoneal resection in IDS is admissible., Competing Interests: Declaration of competing interest All authors have no conflicts of interests to declare., (Copyright © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Published
- 2023
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11. [Endometrial stromal sarcoma: French Guidelines from the French Sarcoma Group and the Rare Malignant Gynecologic Tumors Group].
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Lebreton C, Meeus P, Genestie C, Croce S, Guyon F, Moscardo CL, Taieb S, Blay JY, Bonvalot S, Bompas E, Chevreau C, Lécuru F, Rossi L, Joly F, Rios M, Chaigneau L, Duffaud F, Pautier P, and Ray-Coquard I
- Subjects
- Female, Humans, Middle Aged, Sarcoma, Endometrial Stromal surgery, Sarcoma, Endometrial Stromal pathology, Endometrial Neoplasms surgery, Endometrial Neoplasms drug therapy, Genital Neoplasms, Female, Uterine Neoplasms surgery, Sarcoma therapy
- Abstract
Low-grade endometrial stromal sarcoma (LG-ESS) accounts for approximately 15% of all uterine sarcomas. Median age of patients is around 50 years and half of the patients are premenopausal. In all, 60% of cases present with FIGO stage I disease. Preoperatively radiologic findings of ESS are not specific. Pathological diagnosis remains essential. This review aimed to present the French guidelines for low grade ESS treatment within the Groupe sarcome français - Groupe d'étude des tumeurs osseuse (GSF-GETO)/NETSARC+ and tumeur maligne rare gynécologique (TMRG) networks. Treatments should be validated in multidisciplinary team involved in sarcomas or rare gynecologic tumors. Hysterectomy is the cornerstone of treatment for localized ESS, and morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome and is not recommended. Leaving the ovaries in situ in stage I tumors could be discussed for young women. Adjuvant hormonal treatment could be considered, for two years for stage I with morcellation or stage II and livelong for stages III or IV. Nevertheless, several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Tamoxifen is contraindicated. Secondary cytoreductive surgery if feasible for recurrent disease, appears to be an acceptable approach. Systemic treatment for recurrent or metastatic disease is mainly hormonal, with or without surgery., (Copyright © 2023. Published by Elsevier Masson SAS.)
- Published
- 2023
- Full Text
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12. [Uterin adenosarcoma: French Guidelines of the French Sarcoma Group and the Rare Gynecologic Tumor Group].
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Karabajakian A, Genestie C, Meeus P, Guyon F, Llacer Moscardo C, Croce S, Taieb S, Duffaud F, Pautier P, Ray-Coquard I, and Blay JY
- Subjects
- Female, Humans, Neoplasm Recurrence, Local therapy, Hormones, Genital Neoplasms, Female therapy, Adenosarcoma surgery, Uterine Neoplasms surgery
- Abstract
Uterine adenosarcoma is a very rare malignancy defined as a biphasic tumor composed of both benign epithelial component and a malignant sarcoma component. The stage of the disease is determined by the presence of myometrial invasion and the extent of extra-uterine disease. The most important histopronostic factors are the existence of a sarcomatous overgrowth defined by a sarcomatous contingent occupying more than 25 % of the volume of the tumor (directly correlated to the grade of the disease), the presence of a heterologous and/or a high-grade component. Stage I adenosarcomas without sarcomatous overgrowth have a good prognosis, with an overall 5-year survival of up to 80 %. In localized disease, complete surgical removal is recommended. The role of hormone therapy, chemotherapy and adjuvant radiotherapy is not established. If possible, relapses should be re-treated surgically, with the aim of achieving complete resection. In the advanced inoperable or metastatic setting, hormone therapy is an option for low-grade adenosarcomas with estrogen receptor (ER) and progesterone receptor (PR) overexpression. For high-grade tumors, the standard chemotherapies are doxorubicin-based combinations, although an integrated approach of surgery and medical treatment should also be considered in this setting., (Copyright © 2023 Société Française du Cancer. All rights reserved.)
- Published
- 2023
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13. [Treatments for rare ovarian tumors: What's new?]
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Lebreton C, Quesada S, Bini M, Babin G, Rossi L, Chopin N, Croce S, Hartog C, Renaud T, Gaillard AL, Petit A, Serre AA, Trédan O, Rowinski E, Cockenpot V, Treilleux I, Rousset-Jablonski C, Méeus P, Guyon F, and Ray-Coquard I
- Subjects
- Female, Humans, Precision Medicine, Incidence, Ovarian Neoplasms therapy, Ovarian Neoplasms pathology
- Abstract
Even if each rare ovarian tumor (ROT) has a low incidence, the sum of all these entities represents almost the half of all ovarian neoplasms. Thus, development of dedicated clinical trial emerged as a prerequisite to improve their managements. Owing to the spreading of dedicated institutional networks and (supra)national collaborations, the number of clinical trials has increased the past few years, with different types of trials; while some focused on specific molecular features, others assessed innovative molecules. Furthermore, relevant randomized clinical trials were designed as a mean to position new treatment options. Currently, innovative molecular-driven trials, based on master protocol trials are emerging and may shed light towards the improvement of personalized medicine regarding ROT., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
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14. [Uterin sarcoma, high-grade stroma, indifferenciated, referential].
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Roussel-Simonin C, Croce S, Guyon F, Llacer C, Ray-Coquard I, Meeus P, Genestie C, Taieb S, Malhaire C, Duffaud F, and Pautier P
- Subjects
- Female, Humans, Middle Aged, Combined Modality Therapy, Hysterectomy, Ovariectomy, Neoplasm Staging, Uterine Neoplasms surgery, Sarcoma surgery, Endometrial Neoplasms therapy, Endometrial Neoplasms pathology
- Abstract
High-grade endometrial stromal sarcoma (HGESS) and uterine undifferentiated sarcoma (UUS) are rare uterine malignancies arising from mesenchymal endometrial cells. They are characterized by aggressive behavior and poor prognosis. Median age of diagnostic is 55years. The most common symptoms are vaginal bleeding, abdominal pain, and pelvic mass. Approximately 65 % are diagnosed witch advance disease stage III or IV according to the International Federation of Gynecology and Obstetrics classification. Median overall survival is around 20months. The management of the disease must be discussed in multidisciplinary staff meetings. The standard management of HGESS and UUS is total hysterectomy with bilateral oophorectomy. Systematic lymphadenectomy is not recommended. Adjuvant therapies, such as chemotherapy and radiotherapy must be discussed. In case of oligo-metastasic disease, surgery of the primary tumor and metastasis must be discussed and if not operable the standard management is doxorubine-based chemotherapy., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
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15. Recommandations pour la pratique clinique Nice/Saint-Paul-de-Vence 2022–2023 : Prise en charge du cancer de l'endomètre métastatique et/ou en rechute.
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Alexandre J, Le Frère-Belda MA, Angelergues A, Ferron G, Treilleux I, Gaillard AL, Frenel JS, You B, Rouleau E, Lortholary A, Ray-Coquard I, and Joly F
- Subjects
- Female, Humans, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carboplatin therapeutic use, Hormones therapeutic use, Paclitaxel, Clinical Trials as Topic, Endometrial Neoplasms drug therapy, Endometrial Neoplasms pathology
- Abstract
Recommendations for clinical practice Nice/Saint-Paul-de-Vence 2022-2023 : Management of advanced/relapsing endometrial cancer Since the first recommendations in 2020 concerning metastatic and/or relapsed endometrial cancer, new treatment options have shown a benefit on patients' life expectancy, justifying their update. In first line, the choice will be made between chemotherapy with carboplatin/paclitaxel or hormone therapy with progestin, depending on tumor characteristics (histological type, grade, expression of hormone receptors, rate of progression). In case of a dMMR tumors, the use of immunotherapy within the framework of a therapeutic trial is an option. Beyond first-line chemotherapy, current standard treatment consists of the combination of pembrolizumab and lenvatinib, regardless of MMR status. Close clinical and biological monitoring is however necessary given the potential toxicity. Chemotherapy retains its place either as monotherapy (paclitaxel or doxorubicin) in the event of failure or contraindication to pembrolizumab-lenvatinib, or in combination with carboplatin in the event of a long free interval and pMMR tumor. The numerous ongoing clinical trials evaluating new therapeutic targets or strategies adapted to molecular or histological types should allow further improvements the prognosis of patients with metastatic endometrial cancer., (Copyright © 2023 Elsevier Masson SAS. Tous droits réservés. All rights reserved.)
- Published
- 2023
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16. Prise en charge des carcinomes ovariens de haut grade séreux et/ou endométrioïdes de stades avancés (III-IV) et testing HRD-BRCA en 2023 : actualisation selon les données publiées et/ou présentées en 2022.
- Author
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Selle F, Joly F, Gladieff L, Prulhière K, Leary A, Kalbacher E, Rouleau E, and Ray-Coquard I
- Subjects
- Female, Humans, Carcinoma, Ovarian Epithelial drug therapy, BRCA2 Protein genetics, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Genomic Instability, Ovarian Neoplasms drug therapy, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology
- Abstract
Management of high grade, serous and/or endometrioid, advanced (stages III-IV) ovarian carcinomas and HRD-BRCA testing in 2023: update according to data published/presented in 2022 Molecular analysis of ovarian carcinomas must be now systematically performed to determine BRCA1 and BRCA2 status as well as genomic instability score. Several types of tests are available. From a clinical perspective, new data from phase III clinical trials presented in 2022 confirm the key role of PARP inhibitors in first-line medical treatment of high-grade serous ovarian cancers. A new algorithm that includes all new evidence is proposed for selection of first-line therapy., (Copyright © 2023 Elsevier Masson SAS. Tous droits réservés. All rights reserved.)
- Published
- 2023
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17. [Uterine leiomyosarcoma - French guidelines from the GSF/NETSARC and TMRG groups].
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Collineau B, Genestie C, Croce S, Meeus P, Floquet A, Guyon F, Llacer-Moscardo C, Lebreton C, Taieb S, Toulmonde M, Blay JY, Bonvalot S, Ray-Coquard I, Pautier P, and Duffaud F
- Subjects
- Female, Humans, Prognosis, Radiotherapy, Adjuvant, Hysterectomy methods, Leiomyosarcoma therapy, Leiomyosarcoma surgery, Uterine Neoplasms diagnosis, Uterine Neoplasms therapy, Sarcoma therapy, Soft Tissue Neoplasms
- Abstract
Uterine leiomyosarcomas represent the most common uterine sarcomas. The prognosis is poor with metastatic recurrence in more than half of the cases. The purpose of this review is to make French recommendations for the management of uterine leiomyosarcomas within the framework of the French Sarcoma Group - Bone Tumor Study Group (GSF-GETO)/NETSARC+ and Malignant Rare Gynecological Tumors (TMRG) networks in order to optimize their therapeutic management. The initial assessment includes a MRI with diffusion perfusion sequence. The diagnosis is histological with a review in an expert center (Reference Network in Sarcoma Pathology (RRePS)). Total hysterectomy with bilateral salpingectomy, en bloc without morcellation, is performed when complete resection is possible, whatever the stage. There is no indication of systematic lymph node dissection. Bilateral oophorectomy is indicated in peri-menopausal or menopausal women. Adjuvant external radiotherapy is not a standard. Adjuvant chemotherapy is not a standard. It can be an option and consists in doxorobucin based protocols. In the event of local recurrence, the therapeutic options are based on revision surgery and/or radiotherapy. Systemic treatment with chemotherapy is most often indicated. In case of metastatic disease, surgical treatment remains indicated when resecable. In cases of oligo-metastatic disease, focal treatment of metastases should be considered. In the case of stage IV, chemotherapy is indicated, and is based on first-line doxorubicin-based protocols. In the event of excessive deterioration in general condition, management by exclusive supportive care is recommended. External palliative radiotherapy can be proposed for symptomatic purposes., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
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18. [Homologous recombination deficiency in epithelial ovarian cancers: from molecular characterization to patient journey].
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Quesada S, Solassol J, Ray-Coquard I, and Fabbro M
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- Female, Humans, Carcinoma, Ovarian Epithelial genetics, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Poly(ADP-ribose) Polymerase Inhibitors pharmacology, Genomic Instability, Homologous Recombination, Ovarian Neoplasms pathology
- Abstract
High-grade serous ovarian carcinoma (HGSOC), the most frequent and aggressive form of epithelial ovarian cancer is characterized in half of cases by homologous recombination deficiency (HRD). This molecular alteration is defined by distinct causes and consequences. The main and most characterized cause is the presence of an alteration affecting BRCA1 and BRCA2 genes. Regarding consequences, a specific genomic instability leads to increased sensitivity to platinum salts and poly (ADP-ribose) polymerase (PARPi) inhibitors. This latter point enabled the advent of PARPi in first and second line maintenance. As such, the initial and rapid evaluation of HRD status with molecular tests is a key step in the management of HGSOC. Until recently, the range of tests offered proved to be very limited and suffered from technical and medical limitations. This has recently led to the development and validation of alternatives, including academic ones. This "state of the art" review will bring a synthesis concerning the assessment of HRD status in HGSOCs. After a brief introduction of HRD (including main causes and consequences) and of its predictive value regarding PARPi, we will discuss the limitations of current molecular tests and the existing alternatives. Finally, we will contextualize this to the situation in France, with special consideration concerning the positioning and the financial coverage of these tests, with the perspective of optimizing patient management ., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2023
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19. Contraception in breast cancer survivors from the FEERIC case-control study (performed on behalf of the Seintinelles research network).
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Sebbag C, Rousset-Jablonski C, Coussy F, Ray-Coquard I, Garin C, Evrevin C, Cessot M, Labrosse J, Laot L, Darrigues L, Bobrie A, Sénéchal-Davin C, Espié M, Giacchetti S, Plu-Bureau G, Maitrot-Mantelet L, Gompel A, Santulli P, Asselain B, Hotton J, Coutant C, Guerin J, Decanter C, Mailliez A, Brain E, Dumas E, Sablone L, Seintinelles RN, Reyal F, and Hamy AS
- Subjects
- Pregnancy, Humans, Female, Case-Control Studies, Prospective Studies, Contraception, Breast Neoplasms, Cancer Survivors
- Abstract
Objective: To compare the prevalence of contraception in breast cancer (BC) patients at risk of unintentional pregnancy (i.e. not currently pregnant or trying to get pregnant) and matched controls., Study Design: The FEERIC study (Fertility, Pregnancy, Contraception after BC in France) is a prospective, multicenter case-control study, including localized BC patients aged 18-43 years, matched for age and parity to cancer-free volunteer controls in a 1:2 ratio. Data were collected through online questionnaires completed on the Seintinelles research platform., Results: In a population of 1278 women at risk of unintentional pregnancy, the prevalence of contraception at study inclusion did not differ significantly between cases (340/431, 78.9%) and controls (666/847, 78.6%, p = 0.97). Contrarily, the contraceptive methods used were significantly different, with a higher proportion of copper IUD use in BC survivors (59.5% versus 25.0% in controls p < 0.001). For patients at risk of unintentional pregnancy, receiving information about chemotherapy-induced ovary damage at BC diagnosis (OR = 2.47 95%CI [ 1.39-4.37] and anti-HER2 treatment (OR = 2.46, 95% CI [ 1.14-6.16]) were significantly associated with the use of a contraception in multivariate analysis., Conclusion: In this large French study, BC survivors had a prevalence of contraception use similar to that for matched controls, though almost one in five women at risk of unintentional pregnancy did not use contraception. Dedicated consultations at cancer care centers could further improve access to information and contraception counseling., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2023
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20. Pregnancy, fertility concerns and fertility preservation procedures in a national study of French breast cancer survivors.
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Mangiardi-Veltin M, Sebbag C, Rousset-Jablonski C, Ray-Coquard I, Berkach C, Laot L, Wang Y, Abdennebi I, Labrosse J, Sautter C, Toussaint A, Sablone L, Laas E, Khallouch S, Coussy F, Santulli P, Chapron C, Bobrie A, Jacot W, Sella N, Dumas E, Sénéchal-Davin C, Espie M, Giacchetti S, Maitrot L, Plu-Bureau G, Coutant C, Guerin J, Asselain B, Fumoleau P, Rodrigues M, Decanter C, Mailliez A, Delrieu L, Lemoine A, Jouannaud C, Houdre D, Reyal F, and Hamy AS
- Subjects
- Cohort Studies, Cryopreservation, Female, Humans, Neoplasm Recurrence, Local, Pregnancy, Breast Neoplasms drug therapy, Cancer Survivors, Fertility Preservation methods
- Abstract
Research Question: What are the real-life oncofertility practices in young women diagnosed with breast cancer?, Design: The FEERIC (FErtility, prEgnancy, contRaceptIon after breast Cancer in France) study is a web-based cohort study launched with the French collaborative research platform Seintinelles. The current work is based on the enrolment self-administered questionnaire of 517 patients with prior breast cancer diagnosis, free from relapse and aged 18 to 43 years at inclusion (from 12 March 2018 to 27 June 2019)., Results: Median age at breast cancer diagnosis was 33.6 years and 424 patients (82.0%) received chemotherapy. Overall, 236 (45.6%) patients were offered specialized oncofertility counselling, 181 patients underwent at least one fertility preservation procedure (FPP); 125 (24.2%) underwent one or more FPP with material preservation (oocytes n = 108, 20.9%; embryos n = 31, 6.0%; ovarian cryopreservation n = 6, 1.2%) and 78 patients received gonadotrophin-releasing hormone agonists (15.1%). With a median follow-up of 26.9 months after the end of treatments, 133 pregnancies had occurred in 85 patients (16.4%), including 20 unplanned pregnancies (15.0%). Most of the pregnancies were natural conceptions (n = 113, 87.6%), while 16 (12.4%) required medical interventions. For the planned pregnancies, median time to the occurrence of an ongoing pregnancy was 3 months. Patients who had an unplanned pregnancy reported lower rates of information on the consequences of the treatments on fertility (P = 0.036) at diagnosis., Conclusions: Most of the patients were not offered proper specialized oncofertility counselling at the time of breast cancer diagnosis. Naturally conceived pregnancies after breast cancer were much more frequent than pregnancies resulting from the use of cryopreserved gametes. Adequate contraceptive counselling seems as important as information about fertility and might prevent unplanned pregnancies., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2022
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21. Mise à jour 2021 des recommandations pour la pratique clinique de Nice/Saint-Paul-de-Vence dans le cancer de l’ovaire épithélial de haut grade: Updated 2021 recommendations for the clinical practice of Nice/Saint-Paul-de-Vence in epithelial high grade ovarian cancer.
- Author
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Joly F and Ray-Coquard I
- Subjects
- Antineoplastic Agents, Immunological therapeutic use, Bevacizumab therapeutic use, Female, Genes, BRCA1, Genes, BRCA2, Humans, Maintenance Chemotherapy, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Progression-Free Survival, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial genetics, Carcinoma, Ovarian Epithelial pathology, Carcinoma, Ovarian Epithelial surgery, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local genetics, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local surgery, Ovarian Neoplasms drug therapy, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery
- Abstract
Since the previous 2013 and 2016 recommendations for clinical practice (RPC) Nice/Saint-Paul-de-Vence for gynecological cancers, the management of ovarian cancer has become more complex with the evolution of the quality criteria recommended for surgery and the integration of molecular biology for the decision of medical treatments, especially for high grade epithelial ovarian cancers. Surgical indications have become more precise both in the first line and in the context of relapse. Treatments with PARP inhibitors is a major advance in medical management with significant efficacy in maintenance after response to platinum-based chemotherapy. The benefit already known in the case of late relapse has also been demonstrated in first-line treatment with progression-free survival never observed in this pathology with patients with very long responses, especially in the case of BRCA gene abnormalities (somatic or constitutional). In 2021, medical and surgical strategies in front line including PARP inhibitors associated or not with bevacizumab as a maintenance complement after platinum chemotherapy are guided by both response to platinum agents and molecular profiling including BRCA (somatic or constitutional) genetic status and homologous recombination pathway (HRD) abnormalities, that should be early tested. On behalf of the GINECO national oncologist group, we have updated the guidelines for high grade ovarian epithelial cancer (excepted rare tumors) in order to allow rapid dissemination of the latest advances to the medical community and improve daily practice., (Copyright © 2021 Société FranÇaise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.)
- Published
- 2021
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22. Traitement médical de première ligne du cancer épithélial de l'ovaire de haut grade: First-line medical treatment of high-grade epithelial ovarian cancer.
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Selle F, Alexandre J, Prulhière K, Kalbacher E, Ray-Coquard I, and Leary A
- Subjects
- Algorithms, Bevacizumab therapeutic use, Carboplatin therapeutic use, Carcinoma, Ovarian Epithelial genetics, Carcinoma, Ovarian Epithelial pathology, Chemotherapy, Adjuvant, Drug Administration Schedule, Female, Genes, BRCA1, Genes, BRCA2, Humans, Indazoles therapeutic use, Maintenance Chemotherapy, Neoadjuvant Therapy, Neoplasm Grading, Neoplasm Staging, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology, Paclitaxel therapeutic use, Phthalazines therapeutic use, Piperazines therapeutic use, Piperidines therapeutic use, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Antineoplastic Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Ovarian Epithelial drug therapy, Ovarian Neoplasms drug therapy
- Abstract
In early stages, standard treatment is adjuvant chemotherapy, consisting of platinum-based combination for 6 cycles, especially in serous and endometrioid high grade carcinomas. In advanced stages, indication of neoadjuvant chemotherapy must be discussed on a case-by-case basis in multidisciplinary meetings (MDM). Bevacizumab can also be considered in the neoadjuvant setting in some circumstances, always after discussion in MDM. Carboplatin plus paclitaxel every 21 days, with or without bevacizumab remains the standard of care for first-line chemotherapy. Inhibitors of poly-(ADP-riboses) polymerases (PARPi) have been approved and are reimbursed as maintenance monotherapy in tumors carrying BRCA1 or BRCA2 mutation after complete or partial response to chemotherapy. Two recent studies demonstrated the efficacy of PARPi on progression free survival, one for niraparib single-agent in patients with high-grade ovarian carcinoma regardless of BRCA status, the other one for the combination of bevacizumab and olaparib in patients with high grade carcinoma, with positive test for homologous recombination DNA repair deficiency (regardless of BRCA status). These two new modalities of maintenance therapy are now available in compassionate use programs or post compassionate use programs. Depending on pending decisions upon reimbursement, these indications might be somewhat modified., (Copyright © 2021 Société FranÇaise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.)
- Published
- 2021
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23. PARP-inhibitors in epithelial ovarian cancer: Actual positioning and future expectations.
- Author
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Vanacker H, Harter P, Labidi-Galy SI, Banerjee S, Oaknin A, Lorusso D, and Ray-Coquard I
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Clinical Trials, Phase I as Topic, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Female, Humans, Maintenance Chemotherapy, Poly(ADP-ribose) Polymerase Inhibitors administration & dosage, Poly(ADP-ribose) Polymerase Inhibitors adverse effects, Progression-Free Survival, Randomized Controlled Trials as Topic, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Ovarian Epithelial drug therapy, Ovarian Neoplasms drug therapy, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use
- Abstract
Poly-(ADP)-ribose polymerase inhibitors (PARPi) are a class of oral anticancer drugs first developed as "synthetically lethal" in cancers harboring BRCA1/BRCA2 inactivating mutations. In high-grade serous or endometrioid ovarian cancers (HGOC), PARPi demonstrated benefit as maintenance therapy in relapsing BRCA-mutated and non-mutated tumors. Recently, they extended their indications to frontline maintenance therapy. This review summarizes the current place of PARPi (i) as maintenance or single agent in recurrent disease and (ii) frontline maintenance with different settings. We reviewed the course of biomarker identification, the challenge of overcoming resistance to PARPi and future combinations with targeted therapies, including anti-angiogenic, immune checkpoint inhibitors and DNA damage response inhibitors., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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24. First results of the EORTC-SPECTA/Arcagen study exploring the genomics of rare cancers in collaboration with the European reference network EURACAN.
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Morfouace M, Stevovic A, Vinches M, Golfinopoulos V, Jin DX, Holmes O, Erlich R, Fayette J, Croce S, Ray-Coquard I, Girard N, and Blay JY
- Subjects
- Adult, Aged, Aged, 80 and over, Europe, Humans, Middle Aged, Retrospective Studies, Genomics, Neoplasms
- Abstract
Purpose: Rare cancers are defined by an incidence of <6 out of 100 000 cases per year. They are under-represented in clinical research including tumour molecular analysis. The aim of Arcagen is to generate a multinational database integrating clinical and molecular information of patients with rare cancers., Patients and Methods: We present the retrospective feasibility cohort of patients with rare cancers, with previously collected tumour samples available from any stage. Molecular analysis was performed using FoundationOne CDx for all histologies except for sarcoma where FoundationOne Heme was used. Clinical data including demographic data, medical history, malignant history, treatment and survival data were collected., Results: Eighty-seven patients from three centres were screened; molecular data were obtained for 77 patients (41 sarcomas, 9 yolk sac tumours, 14 rare head and neck cancers, 13 thymomas). The median age at the time of diagnosis was 48 (range 28-85). Most patients had reportable genomic alterations (89%). The most common alterations were linked to cell cycle regulation (TP53, RB1, CDKN2A/B deletions and MDM2 amplification). Multiple activating single-nucleotide variants (SNVs) could be detected in the RAS/RAF family. The tumour mutational burden status was globally low across all samples with a median of 3 Muts/MB (range 0-52). Only 4 cases (ie, 4.7% of tumours) had direct actionable mutations for a treatment approved in Europe within the patient's tumour type., Conclusion: The Arcagen project aims to bridge the gap and improve knowledge of the molecular landscape of rare cancers by prospectively recruiting up to 1000 patients., Competing Interests: Competing interests: IR-C has Honoraria (self) from AbbVie, Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Roche, GSK, MSD, Deciphera, Mersena, Merck Sereno, Novartis, Amgen, Tesaro and Clovis; honoraria (institution) from GSK, MSD, Roche and BMS; advisory/consulting fees from AbbVie, Agenus, Advaxis, BMS, PharmaMar, Genmab, Pfizer, AstraZeneca, Roche/Genentech, GSK, MSD, Deciphera, Mersena, Merck Sereno, Novartis, Amgen, Tesaro and Clovis; research grant/funding (self) from MSD, Roche and BMS; research grant/funding (institution) from MSD, Roche, BMS, Novartis, AstraZeneca and Merck Sereno and travel support from Roche, AstraZeneca and GSK. JF has Honoraria (self) from BMS, AstraZeneca, Roche, MSD, Merck Sereno; advisory/consulting fees from Servier, BMS, AstraZeneca, Innate Pharma, Roche/Genentech; research grant/funding (self) from AstraZeneca; research grant/funding (institution) from MSD, Roche, BMS, Novartis, AstraZeneca and Merck Sereno and travel support from BMS, MSD, AstraZeneca. J-YB has research support and honoraria from Roche Genentech. DJ, OH and RE are employees of FMI/Roche and Roche shareholders., (© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.)
- Published
- 2020
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25. First-line PARP inhibitors in ovarian cancer: summary of an ESMO Open - Cancer Horizons round-table discussion.
- Author
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Banerjee S, Gonzalez-Martin A, Harter P, Lorusso D, Moore KN, Oaknin A, and Ray-Coquard I
- Subjects
- Bevacizumab therapeutic use, Carcinoma, Ovarian Epithelial drug therapy, Female, Humans, Poly(ADP-ribose) Polymerases therapeutic use, Ovarian Neoplasms drug therapy, Ovarian Neoplasms genetics, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use
- Abstract
Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is the latest breakthrough in the management of newly diagnosed advanced ovarian cancer. The results of the SOLO-1 trial in 2018 led to European Medicines Agency and Food and Drug Administration approval of olaparib as first-line maintenance therapy in patients with BRCA1/2 mutation, establishing a new standard of care. Subsequently, the results of three phase III trials (PRIMA, PAOLA-1, VELIA) evaluating the use of first-line PARP inhibitors beyond patients with BRCA1/2 mutations and as combination strategies were presented in 2019, leading to the recent approval of maintenance niraparib irrespective of biomarker status and olaparib in combination with bevacizumab in homologous recombination deficiency-positive-associated advanced ovarian cancer. An ESMO Open - Cancer Horizons round-table expert panel discussed the four phase III trials of first-line PARP inhibitor therapy and how they are changing the clinical management of advanced ovarian cancer., Competing Interests: Competing interests: SB: Institution research grants: Astrazeneca, Tesaro, GSK. Received honoraria for advisory boards Astrazeneca, Amgen, Clovis Oncology, Genmab, GSK, Immunogen, Merck Sereno, MSD, Mersana, Pfizer, Roche, Seattle Genetics, Tesaro. Support for travel or accommodation: Nucana, Tesaro. AGM: has served on advisory boards for Clovis Oncology, Amgen, AstraZeneca, Genmab/Seattle Genetics, Immunogen, MSD, Mersana, PharmaMar, Roche, and Tesaro/GSK, AMGEN, Merck, Novartis, Oncoinvent, received support for travel or accommodation from AstraZeneca, Pharmamar, GSK and Roche and institutional research funding from Roche and GSK/Tesaro. Lead Investigator PRIMA. PH: has served on advisory boards for Astra Zeneca, Roche, Tesaro, GSK, Lilly, Clovis, Immunogen, MSD/Merck, received honoraria (e.g. for lectures) from Astra Zeneca, Roche, Sotio, Tesaro, Stryker, ASCO, Zai Lab, MSD and institutional research funding from Astra Zeneca, Roche, Tesaro, Genmab, DFG, European Union, DKH, Genmab. DL: has served on advisory boards for Clovis Oncology, AstraZeneca, Genmab/Seattle Genetics, MSD, ImmunoGen, PharmaMar, Roche, MSD, Merck Serono, Amgen and Tesaro/GSK, received support for travel or accommodation from AstraZeneca, GSK and Roche and institutional research funding from Merck, GSK, Clovis, Pharmamar KM: has served on advisory boards for Aravive, Astra Zeneca, Abbvie, Eisai, Genentech/Roche, GSK/Tesaro, Immunogen, Merck, Myriad, Mersana, Tarveda, VBL Therapeutics. Lead Investigator SOLO-1. AO: has served on advisory boards for Clovis Oncology, AstraZeneca, Genmab/Seattle Genetics, MSD, Mersana, PharmaMar, Roche, Deciphera, Merck and Tesaro/GSK, received support for travel or accommodation from AstraZeneca, PharmaMar, Tesaro and Roche. IRC: has served on advisory boards for Clovis Oncology, AstraZeneca, Genmab/Seattle Genetics, MSD, Mersana, PharmaMar, Roche, and Tesaro/GSK, received support for travel or accommodation from AstraZeneca, GSK and Roche and institutional research funding from MSD, GSK. Lead Investigator PAOLA-1., (© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.)
- Published
- 2020
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26. Therapeutic options following second-line platinum-based chemotherapy in patients with recurrent ovarian cancer: Comparison of active surveillance and maintenance treatment.
- Author
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Ray-Coquard I, Mirza MR, Pignata S, Walther A, Romero I, and du Bois A
- Subjects
- Bevacizumab administration & dosage, Carboplatin administration & dosage, Disease Progression, Female, Humans, Maintenance Chemotherapy, Neoplasm Recurrence, Local pathology, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Paclitaxel administration & dosage, Poly(ADP-ribose) Polymerase Inhibitors administration & dosage, Randomized Controlled Trials as Topic, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Neoplasm Recurrence, Local drug therapy, Ovarian Neoplasms drug therapy, Watchful Waiting
- Abstract
Most women with advanced ovarian cancer respond to initial treatment, consisting of surgical resection and ≈6 cycles of platinum-based chemotherapy. However, disease recurrence occurs in most patients, and subsequent therapies become necessary. Historically, close monitoring following treatment (active surveillance) was the only available option, as continued maintenance chemotherapy treatment led to increased toxicity without providing any meaningful clinical benefit. Recently, targeted therapy with the angiogenesis inhibitor bevacizumab and the poly(ADP-ribose) polymerase (PARP) inhibitors olaparib, niraparib, and rucaparib have demonstrated significant clinical benefits as maintenance treatment for recurrent disease. Despite consensus guidelines recommending their use, maintenance treatments are currently underutilized. Here, we review evidence from pivotal clinical trials of approved second-line maintenance treatments demonstrating efficacy in terms of progression-free survival and postprogression efficacy outcomes for patients with recurrent ovarian cancer. Adverse events frequently associated with bevacizumab include hypertension, proteinuria, and non-central nervous system bleeding, whereas PARP inhibitors are associated with nausea, vomiting, fatigue, and anemia. Patient-centered outcomes analyses show that PARP inhibitors provide significant benefits to patient health status, even when accounting for the toxicities associated with treatment. Many factors influence the selection of second-line maintenance treatment for patients with recurrent ovarian cancer, including the maintenance treatment received in the first-line setting. Overall, targeted maintenance treatment represents a new standard of care for patients with ovarian cancer, and we recommend that maintenance treatment should be offered to all eligible patients with recurrent ovarian cancer., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2020
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27. Clinical research disruption in the post-COVID-19 era: will the pandemic lead to change?
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Lorusso D, Ray-Coquard I, Oaknin A, and Banerjee S
- Subjects
- Betacoronavirus immunology, Betacoronavirus pathogenicity, COVID-19, Cancer Care Facilities standards, Cancer Care Facilities trends, Clinical Trials as Topic standards, Coronavirus Infections epidemiology, Coronavirus Infections immunology, Coronavirus Infections transmission, Data Accuracy, Europe epidemiology, Humans, Infection Control standards, Medical Oncology standards, Medical Oncology trends, Neoplasms immunology, Patient Safety, Pneumonia, Viral epidemiology, Pneumonia, Viral immunology, Pneumonia, Viral transmission, Research Design standards, Research Design trends, SARS-CoV-2, Telemedicine organization & administration, Telemedicine standards, Telemedicine trends, Cancer Care Facilities organization & administration, Clinical Trials as Topic organization & administration, Coronavirus Infections prevention & control, Medical Oncology organization & administration, Neoplasms therapy, Pandemics prevention & control, Pneumonia, Viral prevention & control
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2020
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28. Incorporating Parp-inhibitors in Primary and Recurrent Ovarian Cancer: A Meta-analysis of 12 phase II/III randomized controlled trials.
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Ruscito I, Bellati F, Ray-Coquard I, Mirza MR, du Bois A, Gasparri ML, Costanzi F, De Marco MP, Nuti M, Caserta D, Pignata S, Dorigo O, Sehouli J, and Braicu EI
- Subjects
- Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Female, Humans, Randomized Controlled Trials as Topic, Carcinoma, Ovarian Epithelial drug therapy, Ovarian Neoplasms drug therapy, Poly(ADP-ribose) Polymerase Inhibitors administration & dosage
- Abstract
Background: The second decade of 2000s is witnessing a new ovarian cancer (OC) paradigm shift thanks to the results recently obtained by a new class of targeted agents: the Poly(ADP-ribose)polymerase (PARP)-Inhibitors (PARPi). Aim of this meta-analysis is to analyze available results obtained with PARPi, administered alone or in combination with chemo- and/or target-therapies in terms of efficacy and safety for the treatment of recurrent and primary advanced OC., Methods: On December 2019, all published phase II/III randomized clinical studies were systematically searched using the terms "[Parp-Inhibitor] AND [ovar*]". Twelve phase II/III randomized controlled trials were identified, with a total number of 5171 patients included., Results: Results demonstrated that PARPi account for a significant improvement of PFS in both recurrent and primary OC setting, independently from their administration schedule and independently from patients' BRCA mutational status. Moreover, patients harboring a Homologous Recombination Deficiency (HRD) positive testing primary or recurrent OC progress significantly later after PARPi administration/association. Results also reported that PARPi increase the occurrence of severe (G3-G4) anemia. Furthermore, severe fatigue occurred more frequently among patients subjected to PARPi combined with chemotherapy and to PARPi plus Bevacizumab. Finally, a significant increase in severe high blood pressure occurrence was observed when PARPi was added to antiangiogenetics, compared to PARPi alone but a significant decrease in G3-G4 hypertension occurrence was found in PARPi plus bevacizumab users compared to Bevacizumab alone., Conclusions: PARPi are a valid option for the treatment of both primary and relapsed OC patients, with a relative low incidence of severe side effects., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2020
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29. [Current advances in immunotherapy in ovarian cancer].
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Le Saux O, Dubois B, Stern MH, Terme M, Tartour E, Classe JM, Chopin N, Trédan O, Caux C, and Ray-Coquard I
- Subjects
- Antigens, Neoplasm, Antineoplastic Agents, Immunological therapeutic use, B7-H1 Antigen antagonists & inhibitors, CTLA-4 Antigen antagonists & inhibitors, Female, Humans, Immunotherapy trends, Immunotherapy, Adoptive methods, Immunotherapy, Adoptive trends, Ovarian Neoplasms immunology, Immunotherapy methods, Ovarian Neoplasms drug therapy
- Abstract
Ovarian cancers express highly immunogenic tissue-specific antigens. The resulting immune infiltration is a major prognostic factor. There is therefore a strong biological rationale for the development of immunotherapy in ovarian cancer. However, based on Phase I and II clinical trials data, the efficacy of anti-PD-1 and anti-PD-L1 immune checkpoint inhibitors (ICPIs) remains limited in monotherapy in heavily pre-treated patients. Currently, the identification of predictive biomarkers of response and resistance is one of the major areas of research. Identifying effective combination of anti-PD-1 or anti-PD-L1 with other anticancer agents is another clinical need. Several combinations were evaluated. The association of ICPIs with chemotherapy (anthracyclines or carboplatin+paclitaxel) is disappointing (JAVELIN studies). The association with PARP inhibitors, anti-angiogenic agents and CTLA-4 inhibitors seems promising. Other immune therapies such as cell therapies (adoptive transfer of intra-tumor lymphocytes, CAR T cells or vaccines from dendritic cells) could be the future of immunotherapy in ovarian cancer but only early phase studies clinical data is available at this time., (Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
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30. Detailed overview on rare malignant ovarian tumors.
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Aust S, Eberst L, Tredan O, Rousset-Jablonski C, Treilleux I, Méeus P, Chopin N, Beurrier F, Charreton A, Véronique D, Hallouz A, Coulon A, Ricoeur A, Mastier C, Bouhamama A, Racadot S, Devouassoux-Shisheboran M, Haddad V, and Ray-Coquard I
- Subjects
- Adenocarcinoma, Clear Cell pathology, Adenocarcinoma, Clear Cell therapy, Adenocarcinoma, Mucinous pathology, Adenocarcinoma, Mucinous therapy, Brenner Tumor pathology, Brenner Tumor therapy, Carcinoma, Small Cell pathology, Carcinoma, Small Cell therapy, Carcinosarcoma pathology, Carcinosarcoma therapy, Cystadenocarcinoma, Serous pathology, Cystadenocarcinoma, Serous therapy, Female, Humans, Neoplasms, Germ Cell and Embryonal pathology, Neoplasms, Germ Cell and Embryonal therapy, Sex Cord-Gonadal Stromal Tumors pathology, Sex Cord-Gonadal Stromal Tumors therapy, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy, Rare Diseases pathology, Rare Diseases therapy
- Abstract
The group of rare malignant ovarian tumors includes the group of germ cell tumors, sex cords stromal ovarian tumors, small cell carcinoma, malignant Brenner tumors, rare epithelial tumors such as mucinous carcinoma, clear cell carcinoma, or low-grade serous carcinoma, as well as ovarian carcinosarcoma. Together they comprise about 10% of all ovarian tumors. Due to their low prevalence and their heterogeneity, data and treatment recommendations are limited. Even though all ovarian tumors are staged according to the FIGO staging of epithelial ovarian tumors, treatment differs especially in germ cell tumors and sex cords stromal ovarian tumors. Non-epithelial ovarian tumors can arise from a variety of ovarian precursor cells such as germ cells, granulosa cells, theca cells, or stromal fibroblasts. As can be expected already due to their divergent precursor lesions, these malignancies are substantially different but united by their rarity. This overview article gives a comprehensive summary on the pathology and clinical presentation, as well as therapy recommendations of a selection of those rare ovarian tumors, based on the latest national guidelines and related important publications., (Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
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31. [Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa].
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Lavoue V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lecuru F, Lefrere-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Senechal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, and Daraï E
- Subjects
- Antineoplastic Agents therapeutic use, Bevacizumab therapeutic use, Chemotherapy, Adjuvant, Female, France, Humans, Hyperthermia, Induced, Lymph Node Excision, Magnetic Resonance Imaging, Phthalazines therapeutic use, Piperazines therapeutic use, Societies, Medical, Ultrasonography, Carcinoma, Ovarian Epithelial diagnostic imaging, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial pathology, Carcinoma, Ovarian Epithelial surgery, Fallopian Tube Neoplasms diagnostic imaging, Fallopian Tube Neoplasms drug therapy, Fallopian Tube Neoplasms pathology, Fallopian Tube Neoplasms surgery, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Peritoneal Neoplasms diagnostic imaging, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms pathology, Peritoneal Neoplasms surgery
- Abstract
Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). In case of ovarian, Fallopian tube or primitive peritoneal cancer of FIGO III-IV stages, thoraco-abdomino-pelvic CT scan with injection (grade B) is recommended. Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A)., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2019
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32. [Expectation about maintenance therapy among the GINECO French ovarian cancer cohort from the European NOGGO/ENGOT-ov22 Expression IV survey].
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Lorcet M, Lortholary A, Kurtz JE, Berton-Rigaud D, Fabbro M, De La Motte Rouge T, Kaminsky-Forrett MC, Floquet A, Freyer G, Combe P, Dohollou N, Kalbacher E, Despax R, Largillier R, Hardy Bessard AC, Gane N, Sehouli J, Oskay-Oezcelik G, Licaj I, Ray-Coquard I, and Joly Lobbedez F
- Subjects
- Adult, Age Factors, Aged, Cohort Studies, Disease Progression, Disease-Free Survival, Europe, Female, France, Health Surveys, Humans, Life Expectancy, Middle Aged, Neoplasm Recurrence, Local psychology, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy, Quality of Life, Tumor Burden, Health Knowledge, Attitudes, Practice, Maintenance Chemotherapy psychology, Ovarian Neoplasms drug therapy, Ovarian Neoplasms psychology, Patient Preference psychology
- Abstract
Background: Expression IV survey evaluated the patients' expectations to a maintenance therapy., Methods: From January 2015 to March 2016, 401 French patients, in first line or recurrent disease, answered a 24-items anonymous questionnaire. The results were specifically analyzed according to the demographic characteristics and treatment lines., Results: Among the patients, 62% had already been informed about maintenance therapy. Thirty-seven percent of patients received a maintenance treatment: 111 patients during first line and 39 patients in relapse. Expectations of patients were: 1) the chance of cure (73%), 2) the tumor shrinkage (36%), 3) quality of life improvement (35%) and 4) tumor growth reduction (27%). Among the responders, 42% were willing to take the treatment for 6-24 months, 20% for 24-60 months and 38% until tumor progression. 64% of patients expected more than a 6 months progression-free survival. Patients older than 70 years were less informed than their younger counterparts (48% vs 66%) and had lesser hope for cure with maintenance treatment (60% vs 77%). Patients in relapse had more expectation than patients in remission (tumor shrinkage: 47% vs 22%, slowing of tumor growth: 37% vs 15%, improving the progression-free survival of more than 6 months: 71% vs 53%, respectively). Among patients, 48% in relapse consented to take a treatment until progression vs 24% of patients in remission., Conclusion: This sub-analysis in French patients demonstrate a gap between the efficacy of maintenance therapy and the patients' expectations in ovarian cancer, particularly in relapsing disease justifying better information and explanations., (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2018
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33. [Fertility preservation, contraception and menopause hormone therapy in women treated for rare ovarian tumors: Guidelines from the French national network dedicated to rare gynaecological cancer].
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Rousset-Jablonski C, Selle F, Adda-Herzog E, Planchamp F, Selleret L, Pomel C, Chabbert-Buffet N, Daraï E, Pautier P, Trémollières F, Guyon F, Rouzier R, Laurence V, Chopin N, Faure-Conter C, Bentivegna E, Vacher-Lavenu MC, Lhomme C, Floquet A, Treilleux I, Lecuru F, Gouy S, Kalbacher E, Genestie C, de la Motte Rouge T, Ferron G, Devouassoux-Shisheboran M, Kurtz JE, Namer M, Joly F, Pujade-Lauraine E, Grynberg M, Querleu D, Morice P, Gompel A, and Ray-Coquard I
- Subjects
- Carcinoma, Ovarian Epithelial, Contraindications, Drug, Delphi Technique, Female, Humans, Neoplasms, Germ Cell and Embryonal pathology, Neoplasms, Germ Cell and Embryonal therapy, Neoplasms, Glandular and Epithelial pathology, Neoplasms, Glandular and Epithelial therapy, Ovarian Neoplasms pathology, Rare Diseases pathology, Contraception methods, Fertility Preservation methods, Infertility, Female therapy, Menopause, Premature, Ovarian Neoplasms therapy, Rare Diseases therapy
- Abstract
Introduction: Rare ovarian tumors include complex borderline ovarian tumors, sex-cord tumors, germ cell tumors, and rare epithelial tumors. Indications and modalities of fertility preservation, infertility management and contraindications for hormonal contraception or menopause hormone therapy are frequent issues in clinical practice. A panel of experts from the French national network dedicated to rare gynaecological cancers, and of experts in reproductive medicine and gynaecology have worked on guidelines about fertility preservation, contraception and menopause hormone therapy in women treated for ovarian rare tumors., Methods: A panel of 39 experts from different specialties contributed to the preparation of the guidelines, following the DELPHI method (formal consensus method). Statements were drafted after a systematic literature review, and then rated through two successive rounds., Results: Thirty-five recommendations were selected, and concerned indications for fertility preservation, contraindications for ovarian stimulation (in the context of fertility preservation or for infertility management), contraceptive options (especially hormonal ones), and menopause hormone therapy for each tumor type. Overall, prudence has been recommended in the case of potentially hormone-sensitive tumors such as sex cord tumors, serous and endometrioid low-grade adenocarcinomas, as well as for high-risk serous borderline ovarian tumors., Discussion: In the context of a scarce literature, a formal consensus method allowed the elaboration of guidelines, which will help clinicians in the management of these patients., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2018
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34. Cancers de l’ovaire BRCA muté : consultation d’oncogénétique et prescription des inhibiteurs de PARP.
- Author
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Gladieff L, Lyonnet DS, Lortholary A, Leary A, Genestie C, and Ray-Coquard I
- Subjects
- Antineoplastic Agents therapeutic use, Drug Resistance, Neoplasm, Fallopian Tube Neoplasms drug therapy, Fallopian Tube Neoplasms genetics, Female, Hematologic Diseases chemically induced, Humans, Maintenance Chemotherapy, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local genetics, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms genetics, Phthalazines therapeutic use, Piperazines therapeutic use, Poly(ADP-ribose) Polymerase Inhibitors therapeutic use, Adenocarcinoma drug therapy, Adenocarcinoma genetics, Genes, BRCA1, Genes, BRCA2, Mutation, Ovarian Neoplasms drug therapy, Ovarian Neoplasms genetics
- Abstract
Brca Mutated Ovarian Carcinomas: GENETIC COUNSELING AND PARP INHIBITORS PRESCRIPTION: Upon the availability of the PARP inhibitors in relapsed ovarian carcinoma, the pathways of the oncogenetic counseling were modified. Any research for a constitutional alteration of the BRCA1 and BRCA2 genes must be accompanied by an oncogenetic counseling. BRCA testing is recommended from the diagnosis to every woman with an ovarian or fallopian tube or peritoneum of high grade adenocarcinoma, whatever the age at the diagnosis and her family history. In case of sensitive relapse or potential inclusion in a clinical trial and in the absence of preliminary constitutional research, the oncogenetic counseling is organized according to a fast track pathway and a somatic analysis can be realized in parallel. Today, olaparib is indicated for patients with a high grade serous ovarian or fallopian tube or peritoneum adenocarcinoma, with deleterious mutation of BRCA genes (constitutional or somatic), and in sensitive platinum relapse, and in maintenance therapy after a response to chemotherapy including platinum. The indication of a treatment with olaparib can be discussed in multidisciplinary staff for the other non-serous high grade ovarian carcinoma if all other criteria are gathered. Olaparib is prescribed in monotherapy, to start at the latest 8 weeks after the last chemotherapy cycle, under narrow surveillance, because of its gastrointestinal and hematologic toxicities., (© 2017 Elsevier Masson SAS. Tous droits réservés.)
- Published
- 2017
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35. [Innovative anticancer agents reserved to hospital use and not involved in the hospital budget: Creation and evolution].
- Author
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Freyer G, Marty M, Blay JY, Chauffert B, Ganem G, Lotz JP, Marchal F, Medioni J, and Ray-Coquard I
- Subjects
- Economics, Hospital, Humans, Antineoplastic Agents therapeutic use, Budgets, Formularies, Hospital as Topic
- Published
- 2016
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36. [Dualistic classification of epithelial ovarian cancer: Is it clinically relevant?].
- Author
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Devouassoux-Shisheboran M, Genestie C, and Ray-Coquard I
- Subjects
- Adenocarcinoma, Clear Cell pathology, Adenocarcinoma, Mucinous pathology, Brenner Tumor pathology, Carcinoma, Endometrioid pathology, Carcinoma, Ovarian Epithelial, Carcinosarcoma pathology, Cystadenocarcinoma, Serous pathology, Female, Humans, Mutation, Neoplasms, Glandular and Epithelial genetics, Ovarian Neoplasms genetics, Neoplasms, Glandular and Epithelial classification, Neoplasms, Glandular and Epithelial pathology, Ovarian Neoplasms classification, Ovarian Neoplasms pathology
- Abstract
Malignant epithelial tumors (carcinomas) are the most common ovarian cancers and the most lethal gynecological malignancies. Based on their heterogeneous morphology, a dualistic model of carcinogenesis was proposed in 2004. Type I carcinomas, composed of low grade serous, endometrioid, mucinous, clear cell carcinomas and malignant Brenner tumors, were distinct from type II carcinomas (high grade serous, undifferentiated carcinomas and carcinosarcomas). However, clinical studies failed to demonstrate the prognostic value of such a classification. The main reproach to this dualistic model was that it lumped together in type I tumors, heterogeneous lesions such as clear cell and mucinous carcinomas. Recent advances on molecular genetic alterations and precursor lesions favor the classification of ovarian carcinomas as five distinct diseases. The dualistic model of carcinogenesis in type I and II can finally be applied only to serous ovarian carcinomas (low grade and high grade)., (Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2016
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37. [Renovascular safety of bevacizumab in breast cancer patients. The prognostic value of hypertension and proteinuria].
- Author
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Launay-Vacher V, Janus N, Beuzeboc P, Daniel C, Ray-Coquard I, Selle F, Rey JB, Jouannaud C, Spano JP, Thery JC, Morere JF, Goldwasser F, Mir O, Oudard S, Scotté F, Dorent R, Ludwig L, Deray G, and Gligorov J
- Subjects
- Adult, Aged, Analysis of Variance, Angiogenesis Inhibitors adverse effects, Bevacizumab adverse effects, Breast Neoplasms blood supply, Breast Neoplasms mortality, Creatinine blood, Female, France epidemiology, Humans, Hypertension mortality, Incidence, Kidney Function Tests, Middle Aged, Odds Ratio, Prevalence, Prognosis, Prospective Studies, Proteinuria mortality, Survival Analysis, Vascular Endothelial Growth Factors antagonists & inhibitors, Angiogenesis Inhibitors therapeutic use, Bevacizumab therapeutic use, Breast Neoplasms drug therapy, Hypertension epidemiology, Proteinuria epidemiology
- Abstract
Introduction: The potential prognostic value of hypertension and proteinuria of anti-vascular endothelial growth factor (VEGF) drugs has not been assessed in routine clinical practice so far in breast cancer. The objectives of the MARS study were to assess the prevalence of proteinuria and hypertension at baseline, their incidence under anti-VEGF treatment, and to evaluate a possible link with overall survival., Methods: Patients from 8 centres were included between 2009 and 2011 with a follow-up of 1 year. They were naive of any previous anti-VEGF treatment and planned to be started on one. The results of the group of patients with breast cancer receiving bevacizumab are presented., Results: Four hundred and two patients with breast cancer and treated with bevacizumab were included. At inclusion, hypertension prevalence was 12.4%, proteinuria 23.9%. The incidence of de novo proteinuria and hypertension during the follow-up was 61.7% and 16.8%, respectively. Among patients with de novo proteinuria, 62.2% afterwards improved/normalized. No thrombotic microangiopathy was reported. Baseline or de novo proteinuria/hypertension were not associated with overall survival in breast cancer patients treated with bevacizumab., Discussion: These results on the renovascular safety of bevacizumab in breast cancer patients showed that the prevalence of hypertension and proteinuria was high at baseline and, moreover, patients treated with bevacizumab frequently developed de novo hypertension and/or proteinuria. Finally, neither hypertension, nor proteinuria, neither at baseline, nor de novo, were associated with overall survival in our cohort of "real-life'' patients
- Published
- 2015
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38. [Initial management of advanced ovarian cancer: What radiological, pathological and surgical information are important for optimal therapeutic strategy?].
- Author
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Heudel PE, Selle F, Morice P, Rouzier R, Taieb S, Devouassoux-Shisheboran M, Genestie C, Balleyguier C, and Ray-Coquard I
- Subjects
- Biopsy, Chemotherapy, Adjuvant methods, Contrast Media, Female, Humans, Laparoscopy, Laparotomy, Ovary pathology, Tomography, X-Ray Computed methods, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy
- Abstract
Because the majority of patients present advanced disease at diagnosis, the management of epithelial ovarian cancer needs specialist multidisciplinary teamwork. Expertise in surgery, chemotherapy, imaging and histopathology is essential to achieve optimum outcomes. Computed tomography scans are routinely used to determine the extent of disease and to aid in surgical planning. The histologic classification is crucial to plan the best therapeutic strategy and to define the prognosis of disease. Pathological prognostic factors, such as degree of differentiation, FIGO-stage, and histological type have to be described. This report is fundamental to assessing prognosis and selection of appropriate treatment strategy. An adequate staging procedure is an extensive staging by an experienced gynecological oncologist, exploring the entire upper abdomen, and the pelvic and para-aortic lymph node regions to define the Peritoneal Cancer Index (PCI). The final assessment is the completeness of cytoreduction (CC) score, which is an assessment of residual disease after a maximal surgical effort. Initial management of advanced ovarian cancer is best provided by a specialist multidisciplinary team, including a radiologist, a pathologist, a gynecologic oncologist and a medical oncologist., (Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2015
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39. [Quinze questions importantes à se poser en oncologie en 2015].
- Author
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Blay JY, Tredan O, Ray-Coquard I, Rivoire M, Mehlen P, Puisieux A, and Bachelot T
- Subjects
- Health Services Accessibility, Humans, Molecular Targeted Therapy trends, Neoplasms classification, Neoplasms genetics, Precision Medicine trends, Translational Research, Biomedical trends, Forecasting, Medical Oncology trends, Neoplasms therapy
- Abstract
Cancers can now be classified by multidimensional criteria including tumour site, histology, primary - "driver" - molecular alterations, secondary molecular alterations, characteristics of the immune stroma, and genetic profile of the patient. The development of tools for the characterisation of the cancers, as well as novel molecular and immune therapeutics are evolving at an unprecedented pace. In 2012, a list of future challenges was identified at the occasion of the European Organisation for Research and Treatment of Cancer (EORTC) 50(th) anniversary. Three years after, it is interesting to look back at the questions addressed then and to assess the progress of these questions. We propose here a novel set questions which have emerged from the recent publications in this area., (Copyright © 2015 Société Françise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2015
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40. Oral ridaforolimus plus trastuzumab for patients with HER2+ trastuzumab-refractory metastatic breast cancer.
- Author
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Seiler M, Ray-Coquard I, Melichar B, Yardley DA, Wang RX, Dodion PF, and Lee MA
- Subjects
- Administration, Oral, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Humanized adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Breast Neoplasms mortality, Breast Neoplasms pathology, Carcinoma, Ductal, Breast mortality, Carcinoma, Ductal, Breast pathology, Drug Resistance, Neoplasm drug effects, Female, Humans, Middle Aged, Neoplasm Metastasis, Receptor, ErbB-2 metabolism, Sirolimus administration & dosage, Sirolimus adverse effects, Survival Analysis, Trastuzumab, Antibodies, Monoclonal, Humanized administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Breast Neoplasms drug therapy, Carcinoma, Ductal, Breast drug therapy, Sirolimus analogs & derivatives
- Abstract
Background: Although trastuzumab-containing therapies prolong survival in patients with metastatic breast cancer (MBC), most tumors develop trastuzumab resistance, potentially mediated by aberrant phosphatidylinositide 3-kinase (PI3K)/AKT signaling. Ridaforolimus (a mammalian target of rapamycin [mTOR] inhibitor) may overcome trastuzumab resistance by inhibiting PI3K signaling., Methods: A single-arm, phase IIb trial was conducted to evaluate the efficacy and safety of ridaforolimus-trastuzumab in human epidermal growth factor receptor 2-positive (HER2(+)) trastuzumab-refractory MBC (NCT00736970). Ridaforolimus was administered orally (40 mg daily) for 5 d/wk plus weekly trastuzumab. The primary end point was objective response (OR)., Results: Thirty-four patients were enrolled (91% had received 1 or 2 previous trastuzumab-based therapies, whereas 9% had received 3 previous therapies). The most common reasons for discontinuation were disease progression (62%) and adverse events (AEs; 24%). Three patients died; 1 because of bowel perforation, which was possibly ridaforolimus related. Partial response was observed in 5 patients (15%). Median duration of response was 19.1 weeks (range, 15.9-80.1 weeks). Fourteen patients (41%) achieved stable disease (SD); 7 patients (21%) maintained SD for ≥ 24 weeks. The clinical benefit response (CBR) rate was 34.3%. Median progression-free survival (PFS) and overall survival (OS) were 5.4 months (range, 0-20.3 months; 95% confidence interval [CI], 2.0-7.4) and 17.7 months (range, 0-25.9 months; 95% CI, 8.8-20.8), respectively. PFS rate at 6 months was 37%. The most common treatment-related AEs were stomatitis (59%), diarrhea (27%), and rash (27%)., Conclusion: Ridaforolimus-trastuzumab was well tolerated and demonstrated antitumor activity in trastuzumab-resistant HER2(+) MBC., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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41. [Molecular biology of sarcoma and therapeutic choices].
- Author
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Dufresne A, Cassier P, Heudel P, Pissaloux D, Wang Q, Blay JY, and Ray-Coquard I
- Subjects
- Angiogenesis Inhibitors therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Benzamides therapeutic use, Bone Neoplasms genetics, Bone Neoplasms therapy, Crizotinib, Denosumab, Dermatofibrosarcoma genetics, Dermatofibrosarcoma therapy, Gastrointestinal Stromal Tumors genetics, Gastrointestinal Stromal Tumors therapy, Gene Amplification, Gene Deletion, Giant Cell Tumor of Bone genetics, Giant Cell Tumor of Bone therapy, Humans, Imatinib Mesylate, Indoles therapeutic use, Phenylurea Compounds therapeutic use, Piperazines therapeutic use, Point Mutation, Prognosis, Pyrazoles therapeutic use, Pyridines therapeutic use, Pyrimidines therapeutic use, Pyrroles therapeutic use, Sarcoma classification, Sarcoma, Ewing genetics, Sarcoma, Ewing therapy, Sunitinib, Synovitis, Pigmented Villonodular genetics, Synovitis, Pigmented Villonodular therapy, Translocation, Genetic, Molecular Targeted Therapy, Sarcoma genetics, Sarcoma therapy
- Abstract
Soft tissue sarcomas (STS) are a set of very heterogeneous tumors with numerous histological categories. The development of the molecular biology allowed identifying recurring molecular anomalies in certain subgroups of sarcomas, being able to represent diagnostic, prognosis and therapeutic tools. The molecular classification of STS includes until today 5 main groups of abnormalities: sarcomas with "simple genomic profile" showing reciprocal (1) chromosomal translocations, (2) activating mutation, (3) inhibitive mutation or (4) simple amplification; (5) sarcomas with "complex genomic profile" can include several tens of molecular abnormalities. The development of new-targeted therapies is based on the identification of a target, specific of a tumors subgroup and involved in carcinogenesis mechanisms and/or tumoral growth. Then, the aim of clinical research is to establish the proof of the concept through clinical trials, demonstrating the benefit brought to the patient and ending in the marketing of the drug. This proof of the concept was clearly established for imatinib, sunitinib and regorafenib in gastrointestinal stromal tumors, for imatinib in dermatofibrosarcoma protuberans and pigmented vilo-nodular synovitis, for denosumab in giant cell tumors of the bone, ending in the authorization to use these new therapies in these indications. It is in progress and promising for anti-IGF-1R in Ewing sarcomas, for crizotinib in myofibroblastic inflammatory tumors, for mTOR inhibitor in PEComas... The role of molecular abnormalities identified in the mechanisms of tumoral progress for sarcomas and their potential therapeutic impact will be detailed., (Copyright © 2015. Published by Elsevier Masson SAS.)
- Published
- 2015
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42. Emerging treatment strategies in recurrent platinum-sensitive ovarian cancer: focus on trabectedin.
- Author
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Poveda A, Ray-Coquard I, Romero I, Lopez-Guerrero JA, and Colombo N
- Subjects
- Antineoplastic Agents, Alkylating therapeutic use, Female, Humans, Trabectedin, Dioxoles therapeutic use, Neoplasm Recurrence, Local drug therapy, Ovarian Neoplasms drug therapy, Platinum Compounds therapeutic use, Practice Guidelines as Topic, Tetrahydroisoquinolines therapeutic use
- Abstract
Ovarian cancer (OC) is the leading cause of death from gynecological malignancies. In spite of high response rates to the standard front-line treatment for advanced disease with cytoreductive surgical debulking, followed by platinum/taxane-based chemotherapy, most patients eventually relapse developing drug-resistant disease. Owing to the molecular heterogeneity, genetic instability and mutagenicity of OC, increases in survival might be achieved by translating recent insights at the morpho-molecular levels to individual therapeutic strategies. Several emerging treatments have been shown to be active in platinum-sensitive (PS) recurrent OC (ROC), but an optimal strategy still has not been established. Based on the recent results, it is likely that the introduction of novel non-platinum based chemotherapies and molecular targeted therapies will have a major impact on the management of ROC. Some current strategies are focused on the extension of platinum-free interval (PFI) in patients with PS, particularly in those with partially PS disease. Apparently, the PFI extension by an effective non-platinum intervention, such as trabectedin plus pegylated liposomal doxorubicin (PLD), may reduce cumulative platinum-induced toxicities leading to longer survival after the reintroduction of subsequent platinum. The introduction of novel therapies, such as the antiangiogenic monoclonal antibody bevacizumab, opens a new field of targeted therapies in this indication. In this review, we aim to outline the therapeutic potential of new emerging approaches, particularly the role of non-platinum therapy with trabectedin in combination with PLD in patients with PS ROC., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2014
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43. [To answer rare cancer issues. Geographical analysis of EMS sarcoma cohort in the Rhône-Alpes region].
- Author
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Fayet Y, Chasles V, Ducimetière F, Collard O, Berger C, Meeus P, Ranchère-Vince D, Thiesse P, Sunyach MP, Marec-Bérard P, Poncet L, Cousin P, Blay JY, and Ray-Coquard I
- Subjects
- Adult, Aged, France epidemiology, Gastrointestinal Stromal Tumors pathology, Humans, Liposarcoma pathology, Middle Aged, Rare Diseases pathology, Gastrointestinal Stromal Tumors epidemiology, Geography, Medical, Liposarcoma epidemiology, Rare Diseases epidemiology
- Abstract
Rare cancer issues have not been much explored yet because of their low incidence. That is why epidemiological studies have difficulties in identifying indisputable etiological risk factors. An expert opinion, mainly concentrated in some establishments, is required for these cancers' management. However, on account of the potential remoteness of these therapeutic resources, the patients' way of care remains also unstudied. By means of a geographical analysis of a regional exhaustive cohort of sarcoma, diagnosed in 2006 and 2007 and followed during five years at least, we can make progress on these different issues. Gastro-Intestinal and Stromal Tumors (GIST) occur more frequently in privileged territories while liposarcomas arise in more deprived areas. The association between liposarcomas and areas deprivation is significant (P=0.05). Moreover, pre-operative biopsy and some clinical patient characteristics, age, grade or tumor localization, are associated with an increase in the distance covered by patients for the first-line treatment (p ≤ 0,001). In the scope of an interdisciplinary collaboration, the geographical approach develops some hypothesis for rare cancers research, which must be tested by other larger scale studies.
- Published
- 2014
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44. [Care networks in oncology, an evidence for all?].
- Author
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Ray-Coquard I, Ducimetière F, and Farsi F
- Subjects
- Cancer Care Facilities organization & administration, Delivery of Health Care standards, Evidence-Based Practice, France, Humans, Medical Oncology standards, Neoplasms pathology, Pathology, Clinical organization & administration, Rare Diseases pathology, Regional Medical Programs standards, Delivery of Health Care organization & administration, Medical Oncology organization & administration, Neoplasms therapy, Rare Diseases therapy, Regional Medical Programs organization & administration
- Published
- 2013
45. A role for maintenance therapy in managing sarcoma.
- Author
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Ray-Coquard I and Le Cesne A
- Subjects
- Bone Neoplasms drug therapy, Bone Neoplasms mortality, Bone Neoplasms pathology, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung pathology, Disease-Free Survival, Doxorubicin therapeutic use, Female, Humans, Lung Neoplasms drug therapy, Lung Neoplasms pathology, Osteosarcoma drug therapy, Osteosarcoma pathology, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology, Sarcoma mortality, Sarcoma surgery, Sarcoma, Ewing drug therapy, Sarcoma, Ewing mortality, Sarcoma, Ewing pathology, Sirolimus analogs & derivatives, Sirolimus therapeutic use, Soft Tissue Neoplasms drug therapy, Soft Tissue Neoplasms mortality, Soft Tissue Neoplasms pathology, TOR Serine-Threonine Kinases antagonists & inhibitors, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Sarcoma drug therapy, Sarcoma pathology
- Abstract
Despite the use of recommended chemotherapy regimens, patients with metastatic sarcomas have a poor prognosis. To date, the median overall survival for metastatic disease remains less than 18 months. First-line treatment of most metastatic sarcomas consists of chemotherapy with or without surgical excision of residual disease, followed by "watchful waiting" until disease progression or recurrence. According to the current treatment paradigm, recommended by United States and European clinical guidelines, chemotherapy is administered for a fixed number of cycles, and then a watchful waiting approach is taken once a best response is achieved. Single-agent doxorubicin remains the standard for treatment of most soft-tissue sarcomas (STS), as combination and dose-intense regimens have largely failed to improve survival. Combination chemotherapy is the standard treatment approach for osteosarcoma and Ewing's sarcoma, but outcomes are poor for patients with recurrent disease. In order to improve outcomes (in particular, progression-free survival [PFS] and overall survival [OS]), strategies shown to be effective in other solid malignancies, such as maintenance therapy and long-term treatment with targeted therapy, are being investigated in patients with advanced sarcomas. One potential promising approach is the use of mammalian target of rapamycin (mTOR) inhibitors for maintenance therapy. One such mTOR inhibitor, ridaforolimus (AP23573, MK-8669), is currently being evaluated in patients with advanced bone and STS in the ongoing Sarcoma mUlti-Center Clinical Evaluation of the Efficacy of riDaforolimus (SUCCEED) trial., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2012
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46. [Iron deficiency and anemia in oncology].
- Author
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Scotté F, Launay-Vacher V, and Ray-Coquard I
- Subjects
- Anemia blood, Anemia therapy, Antineoplastic Agents adverse effects, Erythropoiesis physiology, Erythropoietin deficiency, Fatigue etiology, Humans, Iron therapeutic use, Iron, Dietary administration & dosage, Kidney Failure, Chronic complications, Neoplasms blood, Neoplasms drug therapy, Practice Guidelines as Topic, Anemia chemically induced, Erythropoietin therapeutic use, Hematinics therapeutic use, Iron Deficiencies, Neoplasms complications
- Abstract
Anemia in oncology is no longer seen only as a side effect of chemotherapies. This comorbidity may be multifactorial, clinically and, for example, may be rather chronic when the patient has chronic renal failure associated, resulting in renal anemia. Similarly, the presence of iron deficiency, which can be solely responsible or contributing factor of anemia, is also a factor to be taken into account in both the diagnosis and exploration of anemia and in its treatment, requiring the use of injectable iron complexes for treatment, if necessary in combination with an erythropoiesis agent stimulating.
- Published
- 2012
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47. [PAIR-gynaecology: multi/interdisciplinary for gynecologic cancer research. Problems needed to be resolved].
- Author
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Ray-Coquard I, Chauvin F, Leblanc E, Caux C, Hoarau H, Bonnetain F, Christophe V, Sastre-Garau X, Lazennec G, Poulain L, Haie-Meder C, Pujade-Lauraine E, Salzet M, Deutsch E, Devouassoux M, Penault Llorca F, Lecuru F, Taieb S, Arveux P, Theillet C, and Joly F
- Subjects
- Biomarkers, Tumor blood, Biomedical Research, DNA, Neoplasm blood, Early Detection of Cancer, Endometrial Neoplasms pathology, Female, Fertility, France epidemiology, Humans, Immunologic Surveillance immunology, MicroRNAs analysis, Ovarian Neoplasms epidemiology, Ovarian Neoplasms genetics, Ovarian Neoplasms immunology, Ovarian Neoplasms pathology, Ovarian Neoplasms psychology, Ovarian Neoplasms therapy, Quality of Life, Risk Factors, Sexuality, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms immunology, Uterine Cervical Neoplasms psychology, Uterine Cervical Neoplasms therapy, Genital Neoplasms, Female diagnosis, Genital Neoplasms, Female epidemiology, Genital Neoplasms, Female genetics, Genital Neoplasms, Female immunology, Genital Neoplasms, Female psychology, Genital Neoplasms, Female therapy
- Abstract
Each year, 13,000 newly gynecologic cancers are diagnosed in France. Gynecologic cancers were specifically heterogeneous (localisations, histologic subgroups, age class, etc). This work was delineated for a national call dedicated to gynecologic cancers. This review reports the major needs in terms of scientific research dedicated to gynecologic cancers in the biologic, epidemiology, human and sociologic fields. For example, medico-economic strategies adapted to ethnosociologic context, specifically for cervix cancer, took important part of the epidemiologic research. Impact of gynecologic cancer in terms of symptoms and late effects, quality of life after treatments and fertility needs to be specifically explored. For fundamental research, molecular characterisation, biologic markers, impact of immunology and genetics represent the major part of the field need to be explored. Finally, therapeutic and diagnosis innovations, optimization of treatments strategies and development of predictive models in order to perform individual prediction taking into account several risk factors (clinical and molecular) to offer help in management of gynecologic cancers are required.
- Published
- 2012
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48. Multidisciplinarity and medical decision, impact for patients with cancer: sociological assessment of two tumour committees' organization.
- Author
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Castel P, Tassy L, Lurkin A, Blay JY, Meeus P, Mignotte H, Faure C, Ranchere-Vince D, Bachelot T, Guastalla JP, Sunyach MP, Guerin N, Treilleux I, Marec-Berard P, Thiesse P, and Ray-Coquard I
- Subjects
- Advisory Committees statistics & numerical data, Breast Neoplasms epidemiology, Breast Neoplasms pathology, Cancer Care Facilities, Consensus, Female, France, General Surgery statistics & numerical data, Group Structure, Humans, Interdisciplinary Communication, Male, Medical Oncology statistics & numerical data, Pathology, Clinical statistics & numerical data, Patient Care Team statistics & numerical data, Radiation Oncology statistics & numerical data, Radiology statistics & numerical data, Sarcoma epidemiology, Sarcoma pathology, Advisory Committees organization & administration, Breast Neoplasms therapy, Decision Making, Medicine, Patient Care Team organization & administration, Sarcoma therapy
- Abstract
Purpose: Medical practices in oncology are expected to be multidisciplinary, yet few articles studied how this may be concretely applied. In the present study, we evaluated the organization of two multidisciplinary committees, one for breast cancer and one for sarcoma, in a French Comprehensive Cancer Centre., Methods: Both tumours were specifically chosen so as to emphasise substantial differences in relation with incidence, histological subtypes, management strategy, and scientific evidence. Between 2003 and 2004, 404 decision processes were observed, 210 for sarcoma (26 meetings) and 194 for breast cancer (10 meetings). The number of physicians who took part in the discussions and their medical specialties were systematically noted as well as the number of contradictory discussions, medical specialties represented in these contradictory discussions and the topics of contradiction. The last measured data was whether the final committee's decision was in conformity with the referent preferences or not. All these measures were related to the referent's medical speciality and working place, to the stage of the disease and to the disease management stage., Results: Committees' specificities concerned their organization, referent's medical specialties, the number of participants in discussions and their medical specialties. Discussions in the sarcoma committee tended to be more multidisciplinary, involving more specialties. Initial strategy proposal for one patient was modified during the discussions for 86 patients out of 210 (41%) and for 62 out of 194 (32%) respectively for sarcoma and breast cancer. However, there was no significant difference in the rate of contradictory discussions between breast cancer and sarcoma committees (32% versus 41% respectively; P = 0.08). The rates of contradictory discussions were similar for localized cancers, local relapse and metastasis disease (37%, 41% and 34% respectively; P = 0.86)., Conclusions: The present study reports more than 30% of changes concerning strategy for patient with cancer due to multidisciplinary discussions. This indicates that, providing tumour committees are adapted to the pathologies' characteristics, they can promote a collective and multidisciplinary approach to oncology.
- Published
- 2012
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49. [Anticancer drugs management in renal insufficiency patients].
- Author
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Zimmer-Rapuch S, Lheureux S, Brocard F, Janus N, Launay-Vacher V, and Ray-Coquard I
- Subjects
- Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Dose-Response Relationship, Drug, Fluid Therapy, Glomerular Filtration Rate, Humans, Neoplasms drug therapy, Renal Insufficiency therapy, Risk Factors, Antineoplastic Agents pharmacokinetics, Kidney drug effects, Renal Insufficiency metabolism
- Abstract
Anticancer drug management is complicated especially in renal insufficiency patients, a frequent situation in oncology. Several aspects need to be taken into account: first, the dosage. In this population, the kidney fails to eliminate drugs. Consequently, dosage adjustment can be necessary for drugs with pharmacokinetic profile altered by renal insufficiency in order to avoid dose-related side effects due to accumulation of the drug. Secondly, renal tolerance is an important aspect of anticancer drug management as renal insufficiency is a risk factor for developing renal side effects. Prevention of renal side effects is essential and means to limit this toxicity should be used, especially with hydration. Finally, it is essential to consider all the treatments prescribed in renal insufficiency patients in order to avoid accumulation of nephrotoxic drugs.
- Published
- 2012
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50. [Renal insufficiency and breast cancer].
- Author
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Beuzeboc P, Le Tourneau C, Gligorov J, Janus N, Spano JP, Ray-Coquard I, Deray G, and Launay-Vacher V
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Antibodies, Monoclonal, Humanized adverse effects, Antineoplastic Agents administration & dosage, Bevacizumab, Bone Neoplasms drug therapy, Bone Neoplasms secondary, Breast Neoplasms complications, Breast Neoplasms metabolism, Creatinine metabolism, Dehydration complications, Diphosphonates adverse effects, Female, Glomerular Filtration Rate, Humans, Imidazoles adverse effects, Middle Aged, Renal Insufficiency metabolism, Young Adult, Zoledronic Acid, Antineoplastic Agents adverse effects, Breast Neoplasms drug therapy, Kidney drug effects, Renal Insufficiency complications
- Abstract
The Renal Insufficiency and Anticancer Medications (IRMA) study is a French national, observational study, which demonstrated the high prevalence of abnormal renal function in a population of 4,684 solid tumour patients, treated in 15 cancer centers. Among them, 7.2% had a SCR level ≥ 110 mmol/L. In the 1,898 patients with breast cancer, only 31 patients (1.63%) had a SCR level ≥ 110 mmol/L. Nevertheless, respectively 51.8 and 50.8% had a creatinine clearance estimated with the Cockcroft-Gault and aMDRD formulae, below 90 mL/min. Even if the most used medications (anthracyclins, taxanes, trastuzumab, hormone therapies) are not nephrotoxic, these results are important because bevacizumab modifies the need for renal management. In case of renal insufficiency, some other treatments such biphosphonates IV, capecitabin and platin salts need drug dosage adjustment or interruption.
- Published
- 2012
- Full Text
- View/download PDF
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