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Identification of tumours harbouring an overall active immune phenotype may help for selecting patients with advanced head and neck squamous cell carcinomas (HNSCC) and non-small cell lung cancer (NSCLC) who may benefit from immunotherapies. Our objective was to develop a reliable and stable scoring system to identify those immunologically active tumours.Using gene expression profiles of 421 HNSCC, we developed a score to identify immunologically active tumours. Validation of the 'HOT' score was done in 40 HNSCC and 992 NSCLC. Stability of the 'HOT' score was tested in paired HNSCC samples from diagnostic biopsies versus surgically resected specimens, untreated versus recurrent samples, and pre-versus post-cetuximab samples in a total of 76 patients. The association between the 'HOT' score with overall survival (OS) and progression-free survival (PFS) was tested in 184 patients with HNSCC or NSCLC treated with PD-1/PD-L1 inhibitors.A 27-gene expression based 'HOT' score was correlated with: (i) PD-L1 and IDO1 expression, (ii) TCD8 infiltrate and (iii) activation of the IFN-γ pathway. The HOT score concordance when comparing diagnostic biopsies and surgically resected specimens was higher than in untreated samples versus recurrent or pre-versus post-cetuximab samples. In 102 and 82 patients with HNSCC or NSCLC treated with PD-1/PD-L1 inhibitors, the HOT score was associated with an improved OS and PFS in multivariate analysis.The 'HOT' score is a simple and robust approach to identify real-world patients with HNSCC and NSCLC immunologically active tumours who may benefit from PD-1/PD-L1 inhibitors.

Rationale: Patients with cancer are at high risk for severe or lethal CoVID-19. The impact of SARS-COV-2 vaccination on the risk of developing COVID-19 was investigated in an exhaustive series of patients from a comprehensive cancer center. Methods: This is a study of the exhaustive population of 2391 cancer patients who were prescribed SARS-COV-2 vaccination until 09/21. Patient characteristics, documented SARS-COV-2 infection with RT-PCR, and survival were collected. The primary endpoint was the rate of COVID-19 after vaccination. Secondary endpoints included risk factors to develop COVID-19 after vaccination, with a comparison with the cohort of vaccinated health care workers (HCW), and risk factors for death. Findings: From Jan to Sept 2021, among 2391 patients with cancer under active treatment prescribed a SARS-COV-2 vaccine, 659 (28%), 1498 (63%) and 139 (6%) received 1, 2 and 3 doses respectively. 95 patients received a single dose of vaccine after a previous COVID-19. 2285 health care workers (HCW) received one (N=17, 0.7%), 2-3 (N=2026, 88.7%) vaccine doses and one dose after COVID-19 (N=242, 10.6%). With a median follow-up of 142 days and 199 for patients and HCW respectively, 39 (1.6%) patients and 35 (1.5%) HCW developed COVID-19 after vaccination. 6 of 39 cancer patients and no HCW died of COVID-19 within 50 days after diagnosis. Independent risk factors for COVID-19 in vaccinated patients were age, single dose of vaccine and anti-CD20 treatment in the last 3 months. Independent risk factors for any cause of death included metastatic disease, gender, cancer type, but also documented COVID-19 before vaccination. Interpretation: Patients receiving two or more doses of COVID-19 vaccine have reduced risk of COVID-19. The risk of death of vaccinated cancer patients presenting COVID-19 remains high. COVID-19 before vaccination is associated with an increased overall risk of death. Funding Information: LYRICAN (INCA-DGOS-INSERM 12563), NetSARC (INCA & DGOS), InterSARC (INCA), LabEx DEvweCAN (ANR-10-LABX 0061), PIA Institut Convergence Francois Rabelais PLAsCAN (PLASCAN, 17-CONV-0002), Fondation ARC contre le Cancer, La Ligue contre le Cancer (Canopee), EURACAN (EC 739521) contributed to fund this study. Declaration of Interests: The authors have declared no conflicts of interest Ethics Approval Statement: The study was approved by the Institutional review board of the Centre Leon Berard on March 2021.

Background Cancer patients presenting with COVID-19 have a high risk of death. In this work, predictive factors for survival in cancer patients with suspected SARS-COV-2 infection were investigated. Methods PRE-COVID-19 is a retrospective study of all 302 cancer patients presenting to this institute with a suspicion of COVID-19 from March 1st to April 25th 2020. Data were collected using a web-based tool within electronic patient record approved by the Institutional Review Board. Patient characteristics symptoms and survival were collected and compared in SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR)–positive and RT-PCR–negative patients. Results Fifty-five of the 302 (18.2%) patients with suspected COVID-19 had detectable SARS-COV-2 with RT-PCR in nasopharyngeal samples. RT-PCR–positive patients were older, had more frequently haematological malignancies, respiratory symptoms and suspected COVID-19 pneumonia of computed tomography (CT) scan. However, respectively, 38% and 20% of SARS-COV-2 RT-PCR–negative patients presented similar respiratory symptoms and CT scan images. Thirty of the 302 (9.9%) patients died during the observation period, including 24 (80%) with advanced disease. At the median follow-up of 25 days after the first symptoms, the death rate in RT-PCR–positive and RT-PCR–negative patients were 21% and 10%, respectively. In both groups, independent risk factors for death were male gender, Karnofsky performance status, Highlights • Cancer patients with SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR have a death rate of 20% at 30 days. • Cancer patients with clinical symptoms of COVID-19 but SARS-COV-2 RT-PCR have high death rate. • 70% cancer patients suspected COVID-19 dying before day 30 have no SARS-COV-2 on RT-PCR or computed tomography. • For both groups, the risk factors of death include "relapsing cancer", Karnofsky performance status

Most head and neck cancers are associated with smoking and alcohol exposure. Smoking and alcohol cessation (ASC) is associated with improved quality of life, cancer therapy efficacy, decreased treatment-related and cardiovascular risks, and is expected to decrease the risk of second primary tumor. It is therefore a high priority in the plan of care. However, results of current ASC programs are disappointing and understanding the reasons of this is critical. We started a qualitative study in 6 academic centers including 3 university hospitals, one regional hospital and one comprehensive cancer center. We first interviewed surgeons and care givers involved in the management of head and neck cancers. Poor communication between stakeholders, absence of alignment of care goals between patients, surgeons and other caregivers, and low level of understanding by patients of the benefits of ASC were felt to represent frequent obstacles to successful outcome. More work is ongoing within the context of our IHNPACT umbrella protocol to identify hurdles associated with successful ASC.

RESUME La comprehension fine des mecanismes biologiques des cancers humains et le developpement de therapeutiques personnalisees basees sur de nouvelles classifications moleculaires et immunologiques de ces cancers progresse a un rythme rapide depuis plusieurs annees. Le developpement clinique des medicaments innovants, curatifs, evolue egalement rapidement dans ses methodologies en s’adaptant aux fragmentations nosologiques qui resulte de ces progres. Cependant le cout de ces therapeutiques qui permettent une amelioration de la survie voire la guerison de maladies incurables met en difficulte financiere les systemes de sante. De nombreux medicaments de ces familles therapeutiques ne font pas l’objet de prise en charge specifique actuellement en France. Cet article discute les consequences et les enjeux de cette situation inedite dans le domaine de la cancerologie clinique.

Resume Objectif evaluer la place de l’ambulatoire dans la realisation des panendoscopies des voies aero-digestives superieures (VADS). Etudier les criteres d’hospitalisation, et les motifs de conversion. Patients et methodes Etude retrospective de janvier 2011 a mai 2013. Criteres d’inclusion panendoscopie des VADS dans le cadre d’un bilan de carcinome. Recueil pour chaque patient : âge, sexe, localisation lesionnelle, type de bilan, stade TNM, antecedent de radiotherapie externe (RTE), distance domicile/centre, score Apfel, Detsky et ASA. Comparaison du groupe ambulatoire et du groupe hospitalisation par test de Fisher pour le score ASA, test de Student pour l’âge, test du Chi2 de Pearson pour les autres variables. Resultats Quatre cent trente-six panendoscopies ont ete realisees : 252 en ambulatoire dont 4 cas de conversion et 184 en hospitalisation. Il n’existe pas de difference statistiquement significative entre les 2 groupes en ce qui concerne l’âge, le sexe, la localisation lesionnelle, le type de bilan, le stade TNM, les antecedents de RTE, la distance domicile/hopital, le score Apfel. Il existe une difference statistiquement significative pour le score ASA (p Conclusion Chez des patients selectionnes, la panendoscopie des VADS peut relever de l’ambulatoire. Les raisons du taux eleve de refus par le patient doivent etre etudiees.

Background: This nationwide prospective cohort reports on the outcome of patients with cancer presenting COVID-19 symptoms with or without detectable SARS-COV2 on RT-PCR and/or specific CT-scan imaging. Methods: This prospective study was conducted in 23 Cancer Centers and hospitals. Inclusion criteria were :1) confirmed diagnosis of solid or hematologic cancer in treatment and 2) clinical symptoms of COVID-19. COVID-19 infection was defined as: 1) detectable SARS-CoV2 on RT-PCR (repeated twice if negative first) and/or specific CT-scan imaging if undocumented SARS-COV-2 on RT-PCR. The primary endpoint was death at day-28 after COVID-19 test, in patients with (COVID-19 positive group) or without (COVID-19 negative group) documented COVID-19. Findings: From March 1st 2020 to May 21st 2020, 1230 cancer patients with suspicion of COVID-19, including 1162 (94·5%) matching inclusion criteria were included. 425 (36·6%) [including 155 [13·3%] with diagnosis on CT-scan only], and 737 (63·4%) were in the COVID-19+ and COVID-19- groups respectively. Deaths within 28 days after COVID-19 diagnosis occurred in 116/425 (27·8%) of COVID-19+ patients, and in 118/737 (16·3%) of COVID-19 negative patients (p 100 mg/L vs 35/203 (17·4%) of other patients died before day 28 (p

But de la presentation Evaluer la faisabilite de la prise en charge des panendoscopies des Voies Aerodigestives Superieures (VADS) en ambulatoire. Materiel et methodes Etude retrospective monocentrique de janvier 2011 a mai 2013 sur les 449 patients ayant beneficie d’une panendoscopie des VADS en dehors d’un contexte d’urgence. Resultats 255 panendoscopies ont ete realisees en ambulatoire (groupe 1) et 194 en hospitalisation conventionnelle (groupe 2). 4 cas de conversion imprevues ambulatoire/hospitalisation conventionnelle ont ete rapportes (1,5 %) : 1 patient seul la nuit suivant la chirurgie, 1 pneumopathie febrile, 1 hyperthermie sans porte d’entree retrouvee et une dyspnee laryngee postoperatoire immediate. La duree de sejour est de 1 nuit dans 10 % des cas et de 2 nuits dans 61 % des cas dans le groupe 2. Il n’existe pas de difference statistiquement significative entre les 2 groupes en ce qui concerne l’âge, le sexe, le stade TNM, la localisation lesionnelle, le stade tumoral, le type de bilan, les antecedents de Radiotherapie, la distance kilometrique entre le domicile et le centre, le score ASA, le score APFEL, le score de Detsky. Le motif ayant pousse a une hospitalisation conventionnelle le plus frequemment retrouve est dans 73 cas (38 %) le refus du patient a la realisation de la chirurgie ambulatoire. Les autres motifs correspondent aux criteres de la Haute Autorite de sante (HAS). Conclusion La panendoscopie des VADS est un examen permettant la prise en charge des patients en ambulatoire avec un taux faible de conversion chez des patients selectionnes selon les criteres HAS. Une meilleure information du patient devrait permettre de diminuer les hospitalisations pour ce geste et de developper l’ambulatoire dans les services de cancerologie ORL, pour repondre aux directives gouvernementales.

But de la presentation Etude de la transition epithelio-mesenchymateuse (TEM) au cours de la tumorigenese des cancers de la cavite orale. Materiel et methodes Evaluation, dans 86 biopsies de leucoplasies orales avec suivi disponible, 76 carcinomes epidermoides de la cavite orale reseques inclus dans le Tumor Cancer Genome Atlas (TCGA) et 60 lignees cellulaires de cancers des voies aerodigestives superieures, d’une signature d’expression de la TEM et du niveau d’expression de ZEB1&2, TWIST1&2 et SNAI1&2, facteurs de transcription impliques dans la TEM, paradigme de la plasticite cellulaire. Le profil d’expression des microRNAs de la famille miR200, puissants regulateurs negatifs de ZEB1&2, a egalement ete analyse dans 20 biopsies de leucoplasie orale, chez des patients ayant ( n = 10) ou n’ayant pas developpe un carcinome epidermoide de la cavite orale. Resultats Les niveaux d’expression des marqueurs epitheliaux et mesenchymateux etaient inversement correles, que ce soit dans les leucoplasies orales, les carcinomes epidermoides de la cavite buccale ou les lignees cellulaires. Etonnamment, l’expression d’une majorite de marqueurs mesenchymateux, en particulier le recepteur tyrosine kinase AXL, etaient generalement associes a un risque diminue de developper un cancer chez des patients atteints de leucoplasie orale. L’expression des genes ZEB1&2 et SNAI1&2 etait inversement correlee. Un niveau eleve d’expression de SNAI2 et faible de ZEB1 au sein de la leucoplasie orale etaient associes a un developpement plus frequent de cancer (log-rank p = 0,0086). L’expression des microRNAs de la famille de miR200 etait en general associee au developpement de cancer. Un total de 10 % des lignees cellulaires et 38 % des carcinomes epidermoides de la cavite orale avaient un profil phenotypique mesenchymateux. Dans les cancers, le profil mesenchymateux etait associe a l’envahissement ganglionnaire ( p = 0,0015). Conclusion En raison de leur accessibilite, les leucoplasies orales representent un modele interessant pour l’etude de la plasticite cellulaire. SNAI2 et ZEB1 pourraient avoir des roles opposes au cours du developpement des cancers de la cavite buccale. L’expression de marqueurs de la TEM pourrait avoir un effet protecteur aux stades precoces de la tumorigenese de la cavite orale. La validation experimentale de ces observations est en cours.