89 results on '"Alina Berriolo-Riedinger"'
Search Results
2. Prognostic value of FDG-PET in patients with mantle cell lymphoma: results from the LyMa-PET Project
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Clément Bailly, Thomas Carlier, Alina Berriolo-Riedinger, Olivier Casasnovas, Emmanuel Gyan, Michel Meignan, Anne Moreau, Barbara Burroni, Loïc Djaileb, Remy Gressin, Anne Devillers, Thierry Lamy, Catherine Thieblemont, Olivier Hermine, Françoise Kraeber-Bodéré, Steven Le Gouill, and Caroline Bodet-Milin
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2020
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3. Total metabolic tumor volume, circulating tumor cells, cell-free DNA: distinct prognostic value in follicular lymphoma
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Marie-Hélène Delfau-Larue, Axel van der Gucht, Jehan Dupuis, Jean-Philippe Jais, Isabelle Nel, Asma Beldi-Ferchiou, Salma Hamdane, Ichrafe Benmaad, Gaelle Laboure, Benjamin Verret, Corinne Haioun, Christiane Copie-Bergman, Alina Berriolo-Riedinger, Philippine Robert, René-Olivier Casasnovas, and Emmanuel Itti
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Specialties of internal medicine ,RC581-951 - Abstract
Abstract: Outcomes for follicular lymphoma (FL) have greatly improved, but most patients will ultimately relapse. High total metabolic tumor volume (TMTV), computed from baseline 18F-fluorodeoxyglucose–positron emission tomography (PET), is associated with shorter progression-free survival (PFS), but circulating tumor cells (CTCs) and cell-free DNA (cfDNA) may also reflect tumor burden and be of prognostic value. The aim of our study was to correlate CTCs and cfDNA with TMTV in FL at diagnosis and to determine their prognostic values. We retrospectively analyzed 133 patients (with previously untreated FL and a baseline PET) from 2 cohorts with either a baseline plasma sample (n = 61) or a bcl2-JH-informative peripheral blood (PB) sample (n = 68). Quantification of circulating bcl2-JH+ cells and cfDNA was performed by droplet digital polymerase chain reaction. A significant correlation was found between TMTV and both CTCs (P < .0001) and cfDNA (P < .0001). With a median 48-month follow-up, 4-year PFS was lower in patients with TMTV > 510 cm3 (P = .0004), CTCs >0.0018 PB cells (P = .03), or cfDNA >2550 equivalent-genome/mL (P = .04). In comparison with TMTV alone, no additional prognostic information was obtained by measuring CTCs. In contrast, Cox multivariate analysis, including cfDNA and TMTV, showed that both cfDNA and TMTV remained predictive of outcome. In conclusion, CTCs and cfDNA correlate with TMTV in FL, and all 3 influence patient outcome. PFS was shorter for patients with high cfDNA and TMTV, suggesting that these parameters provide relevant information for tumor-tailored therapy.
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- 2018
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4. FDG PET/CT for prognostic stratification of patients with metastatic breast cancer treated with first line systemic therapy: Comparison of EORTC criteria and PERCIST.
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Edouard Depardon, Salim Kanoun, Olivier Humbert, Aurélie Bertaut, Jean-Marc Riedinger, Ilan Tal, Jean-Marc Vrigneaud, Maud Lasserre, Michel Toubeau, Alina Berriolo-Riedinger, Inna Dygai-Cochet, Pierre Fumoleau, François Brunotte, and Alexandre Cochet
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Medicine ,Science - Abstract
AIM:Evaluate response and predict prognosis of patients with newly diagnosed metastatic breast cancer treated with first line systemic therapy using European Organization for Research and Treatment of Cancer (EORTC) criteria and PET Response Criteria in solid Tumours (PERCIST). METHODS:From December 2006 to August 2013, 57 women with newly diagnosed metastatic breast cancer were retrospectively evaluated. FDG-PET/CT was performed within one month before treatment and repeated after at least 3 cycles of treatment. Metabolic response evaluation was evaluated by two readers according to both EORTC criteria and PERCIST, classifying the patients into 4 response groups: complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD). RESULTS:With EORTC criteria, 22 patients had CMR, 17 PMR, 6 SMD and 12 PMD. With PERCIST, 20 patients had CMR, 15 PMR, 10 SMD and 12 PMD. There was agreement between EORTC and PERCIST in 84% of the patients. By log-rank analysis, metabolic response evaluated with both EORTC criteria and PERCIST was able to predict overall survival (p = 0.028 and 0.002 respectively). CMR patient group had longer median OS than patients in the combined PMR+SMD+PMD group (60 vs 26 months both with EORTC and PERCIST; p = 0.009 and 0.006 respectively). By multivariate analysis, CMR either with EORTC or PERCIST remained an independent predictor of survival. CONCLUSION:Metabolic response evaluation with EORTC criteria and PERCIST gave similar prognostic stratification for metastatic breast cancer treated with a first line of systemic therapy.
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- 2018
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5. Influence of Software Tool and Methodological Aspects of Total Metabolic Tumor Volume Calculation on Baseline [18F]FDG PET to Predict Survival in Hodgkin Lymphoma.
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Salim Kanoun, Ilan Tal, Alina Berriolo-Riedinger, Cédric Rossi, Jean-Marc Riedinger, Jean-Marc Vrigneaud, Louis Legrand, Olivier Humbert, Olivier Casasnovas, François Brunotte, and Alexandre Cochet
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Medicine ,Science - Abstract
To investigate the respective influence of software tool and total metabolic tumor volume (TMTV0) calculation method on prognostic stratification of baseline 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) in newly diagnosed Hodgkin lymphoma (HL).59 patients with newly diagnosed HL were retrospectively included. [18F]FDG-PET was performed before any treatment. Four sets of TMTV0 were calculated with Beth Israel (BI) software: based on an absolute threshold selecting voxel with standardized uptake value (SUV) >2.5 (TMTV02.5), applying a per-lesion threshold of 41% of the SUV max (TMTV041) and using a per-patient adapted threshold based on SUV max of the liver (>125% and >140% of SUV max of the liver background; TMTV0125 and TMTV0140). TMTV041 was also determined with commercial software for comparison of software tools. ROC curves were used to determine the optimal threshold for each TMTV0 to predict treatment failure.Median follow-up was 39 months. There was an excellent correlation between TMTV041 determined with BI and with the commercial software (r = 0.96, p
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- 2015
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6. Final results of brentuximab vedotin combined with ifosfamide-carboplatin-etoposide in first refractory/relapsed Hodgkin lymphoma: a lymphoma study association phase I/II study
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Aspasia Stamatoullas, Hervé Ghesquières, Pierre Feugier, Marc André, Fabien Le Bras, Anne-Claire Gac, Cécile Borel, Thomas Gastinne, Philippe Quittet, Franck Morschhauser, Vincent Ribrag, Stephanie Guidez, Emmanuelle Nicolas-Virelizier, Alina Berriolo-Riedinger, Thierry Vander Borght, Véronique Edeline, Pauline Brice, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service d'hématologie, Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), and Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
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relapse ,refractory ,Cancer Research ,autologous stem cell transplantation ,Oncology ,brentuximab vedotin ,[SDV]Life Sciences [q-bio] ,salvage chemotherapy ,ICE regimen ,Hematology ,Hodgkin lymphoma - Abstract
This phase I/II study assessed the combination of brentuximab vedotin (BV) with ifosfamide-carboplatin-etoposide (ICE) as a second-line therapy in refractory/relapsed (R/R) classical Hodgkin lymphoma (cHL) patients. Phase I study was designed to determine the maximum tolerated dose (MTD) of BV (10 patients) and phase II evaluated the rate of complete metabolic response (CMR) after 2 cycles of BV-ICE (42 patients). There were no dose-limiting toxicities (DLT) during phase I recommending BV 1.8 mg/kg for phase II. Twenty-six patients (61.9%) achieved CMR after 2 cycles of BV-ICE and 37 patients (88%) were transplanted. With a median follow-up of 38 months, the 3-year progression free survival (PFS) and overall survival (OS) rate were 64.3% and 100%, respectively. Hematological toxicities (81%) and infections (21%) were the most frequent adverse event encountered BV-ICE regimen is feasible with manageable toxicities and could be an alternative to other salvage treatments. : ClinicalTrials.gov identifier: NCT02686346.
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- 2022
7. Data from Identification of Biomarkers Including 18FDG-PET/CT for Early Prediction of Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer
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François Brunotte, Alexandre Cochet, Pierre Fumoleau, Charles Coutant, Salim Kanoun, Véronique Lorgis, Isabelle Desmoulins, Alina Berriolo-Riedinger, Céline Charon-Barra, Jean-Marc Riedinger, and Olivier Humbert
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Purpose: To investigate the value of the metabolic tumor response assessed with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinicobiologic markers to predict pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in women with triple-negative breast cancer (TNBC).Experimental Design: Fifty consecutive women with TNBC and an indication for NAC were prospectively included. Different pretreatment clinical, biologic, and pathologic biomarkers, including SBR grade, the Ki-67 proliferation index, androgen receptor expression, EGF receptor (EGFR), and cytokeratin 5/6 staining, were assessed. Tumor glucose metabolism at baseline and its change after the first cycle of NAC (ΔSUVmax) were assessed using FDG-PET.Results: The pCR rate was 42%. High Ki-67 proliferation index (P = 0.016), negative EGFR status (P = 0.042), and high ΔSUVmax (P = 0.002) were significantly associated with pCR. In multivariate logistic regression, both negative EGFR status (OR, 6.4; P = 0.043) and high ΔSUVmax (OR, 7.1; P = 0.014) were independent predictors of pCR. Using a threshold at −50%, tumor ΔSUVmax predicted pCR with a negative, a positive predictive value, and an accuracy of 79%, 70%, and 75%, respectively. Combining a low ΔSUVmax and positive EGFR status could predict non-pCR with an accuracy of 92%.Conclusions: It is important to define the chemosensitivity of TNBC to NAC early. Combining EGFR status and the metabolic response assessed with FDG-PET can help the physician to early predict the probability of achieving pCR or not. Given these results, the interest of response-guided tailoring of the chemotherapy might be tested in multicenter trials. Clin Cancer Res; 21(24); 5460–8. ©2015 AACR.
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- 2023
8. Supplementary Figure 1 from Identification of Biomarkers Including 18FDG-PET/CT for Early Prediction of Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer
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François Brunotte, Alexandre Cochet, Pierre Fumoleau, Charles Coutant, Salim Kanoun, Véronique Lorgis, Isabelle Desmoulins, Alina Berriolo-Riedinger, Céline Charon-Barra, Jean-Marc Riedinger, and Olivier Humbert
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Supplementary Figure 1: Graphical display of changes in primary tumor SUVmax between baseline and interim 18F-FDG PET exams.
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- 2023
9. Positron Emission Tomography–Driven Strategy in Advanced Hodgkin Lymphoma: Prolonged Follow-Up of the AHL2011 Phase III Lymphoma Study Association Study
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René-Olivier Casasnovas, Reda Bouabdallah, Pauline Brice, Julien Lazarovici, Hervé Ghesquieres, Aspasia Stamatoullas, Jehan Dupuis, Anne-Claire Gac, Thomas Gastinne, Bertrand Joly, Krimo Bouabdallah, Emmanuelle Nicolas-Virelizier, Pierre Feugier, Franck Morschhauser, David Sibon, Christophe Bonnet, Alina Berriolo-Riedinger, Véronique Edeline, Marie Parrens, Diane Damotte, Diane Coso, Marc André, Michel Meignan, Cédric Rossi, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'hématologie
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Adult ,Cancer Research ,Adolescent ,Neoplasms, Second Primary ,Middle Aged ,Vinblastine ,Hodgkin Disease ,Dacarbazine ,Bleomycin ,Young Adult ,Oncology ,Doxorubicin ,Vincristine ,Positron-Emission Tomography ,Procarbazine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Prednisone ,Cyclophosphamide ,Etoposide ,Follow-Up Studies ,Neoplasm Staging - Abstract
PURPOSE The AHL2011 study (ClinicalTrials.gov identifier: NCT01358747 ) demonstrated that a positron emission tomography (PET)-driven de-escalation strategy after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) provides similar progression-free survival (PFS) and overall survival (OS) and reduces early toxicity compared with a nonmonitored standard treatment. Here, we report, with a prolonged follow-up, the final study results. METHODS Patients with advanced Hodgkin lymphoma (stage III, IV, or IIB with mediastinum/thorax ratio > 0.33 or extranodal involvement) age 16-60 years were prospectively randomly assigned between 6 × BEACOPP and a PET-driven arm after 2 × BEACOPP delivering 4 × ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in PET2– and 4 × BEACOPP in PET2+ patients. PET performed after four cycles of chemotherapy had to be negative to complete the planned treatment. RESULTS In total, 823 patients were enrolled including 413 in the standard arm and 410 in the PET-driven arm. With a 67.2-month median follow-up, 5-year PFS (87.5% v 86.7%; hazard ratio [HR] = 1.07; 95% CI, 0.74 to 1.57; P = .67) and OS (97.7% in both arms; HR = 1.012; 95% CI, 0.50 to 2.10; P = .53) were similar in both randomization arms. In the whole cohort, full interim PET assessment predicted patients' 5-year PFS (92.3% in PET2–/PET4–, 75.4% [HR = 3.26; 95% CI, 18.3 to 5.77] in PET2+/PET4– and 46.5% [HR = 12.4; 95% CI, 7.31 to 19.51] in PET4+ patients, respectively; P < .0001) independent of international prognosis score. Five-year OS was also affected by interim PET results, and PET2+/PET4– patients (93.5%; HR = 3.3; 95% CI, 1.07 to 10.1; P = .036) and PET4+ patients (91.9%; HR = 3.756; 95% CI, 1.07 to 13.18; P = .038) had a significant lower OS than PET2–/PET4– patients (98.2%). Twenty-two patients (2.7%) developed a second primary malignancy, 13 (3.2%) and 9 (2.2%) in the standard and experimental arms, respectively. CONCLUSION The extended follow-up confirms the continued efficacy and favorable safety of AHL2011 PET-driven strategy, which is noninferior to standard six cycles of BEACOPP. PET4 provides additional prognostic information to PET2 and allows identifying patients with particularly poor prognosis.
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- 2022
10. A tumor volume and performance status model to predict outcome before treatment in diffuse large B-cell lymphoma
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Catherine Thieblemont, Loic Chartier, Ulrich Dührsen, Umberto Vitolo, Sally F. Barrington, Jan M. Zaucha, Laetitia Vercellino, Maria Gomes Silva, Ines Patrocinio-Carvalho, Pierre Decazes, Pierre-Julien Viailly, Herve Tilly, Alina Berriolo-Riedinger, Oliver Casasnovas, Andreas Hüttmann, Hajira Ilyas, N. George Mikhaeel, Joel Dunn, Anne-Ségolène Cottereau, Christine Schmitz, Lale Kostakoglu, Joseph N. Paulson, Tina Nielsen, Michael Meignan, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), The Lymphoma Academic Research Organisation [Lyon] (LYSARC), Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), King‘s College London, Guy's and St Thomas' Hospital [London], Medical University of Gdańsk, Service de Médecine Nucléaire [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Instituto Português de Oncologia do Porto / Portuguese Oncology Institute of Porto (IPO Porto), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratoire d'Imagerie Translationnelle en Oncologie (LITO ), Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], University of Virginia, Genentech, Inc. [San Francisco], F. Hoffmann-La Roche [Basel], CHU Henri Mondor, and leboeuf, Christophe
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Clinical Trials as Topic ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Medizin ,Humans ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Hematology ,Lymphoma, Large B-Cell, Diffuse ,Neoplasm Recurrence, Local ,Tumor Burden - Abstract
Aggressive large B-cell lymphoma (LBCL) has variable outcomes. Current prognostic tools use factors for risk stratification that inadequately identify patients at high risk of refractory disease or relapse before initial treatment. A model associating 2 risk factors, total metabolic tumor volume (TMTV) >220 cm3 (determined by fluorine-18 fluorodeoxyglucose positron emission tomography coupled with computed tomography) and performance status (PS) ≥2, identified as prognostic in 301 older patients in the REMARC trial (#NCT01122472), was validated in 2174 patients of all ages treated in 2 clinical trials, PETAL (Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas; N = 510) and GOYA (N = 1315), and in real-world clinics (N = 349) across Europe and the United States. Three risk categories, low (no factors), intermediate (1 risk factor), and high (2 risk factors), significantly discriminated outcome in most of the series. Patients with 2 risk factors had worse outcomes than patients with no risk factors in the PETAL, GOYA, and real-world series. Patients with intermediate risk also had significantly worse outcomes than patients with no risk factors. The TMTV/Eastern Cooperative Oncology Group-PS combination outperformed the International Prognostic Index with a positive C-index for progression-free survival and overall survival in most series. The combination of high TMTV > 220 cm3 and ECOG-PS ≥ 2 is a simple clinical model to identify aggressive LBCL risk categories before treatment. This combination addresses the unmet need to better predict before treatment initiation for aggressive LBCL the patients likely to benefit the most or not at all from therapy.
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- 2022
11. Obinutuzumab vs rituximab for advanced DLBCL: a PET-guided and randomized phase 3 study by LYSA
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Gandhi Damaj, Steven Le Gouill, Christophe Bonnet, Hervé Ghesquières, David Sibon, Marc André, Emmanuel Itti, Loïc Chartier, Françoise Kraeber-Bodéré, Luc Fornecker, Hervé Tilly, Vincent Ribrag, Franck Morschhauser, Jean-Philippe Jais, Caroline Bodet-Milin, Alina Berriolo-Riedinger, Krimo Bouhabdallah, Philippe Ruminy, Guillaume Cartron, Catherine Thieblemont, Remy Gressin, Reda Bouhabdallah, Corinne Haioun, Lucie Oberic, Thierry Jo Molina, René-Olivier Casasnovas, Pierre Feugier, Josette Brière, Thierry Lamy, and Hervé Maisonneuve
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medicine.medical_specialty ,Immunology ,CHOP ,Antibodies, Monoclonal, Humanized ,Biochemistry ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,International Prognostic Index ,Obinutuzumab ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Cyclophosphamide ,business.industry ,Cell Biology ,Hematology ,medicine.disease ,Chemotherapy regimen ,3. Good health ,Transplantation ,chemistry ,Doxorubicin ,Vincristine ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Prednisone ,Vindesine ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma ,030215 immunology ,medicine.drug - Abstract
Rituximab plus polychemotherapy is the standard of care in diffuse large B-cell lymphoma (DLBCL). GAINED, a randomized phase 3 trial, compared obinutuzumab to rituximab. Transplant-eligible patients (18-60 years) with an untreated age-adjusted International Prognostic Index (aaIPI) score ≥1 DLBCL were randomized (1:1) between obinutuzumab or rituximab and stratified by aaIPI (1; 2-3) and chemotherapy regimen (doxorubicin, cyclophosphamide, prednisone plus vindesine, bleomycin [ACVBP] or vincristine [CHOP]). Consolidation treatment was determined according to response to interim positron emission tomography (PET). Responders after cycle 2 and 4 (PET2−/PET4−) received immunochemotherapy. Responders after only cycle 4 (PET2+/4−) received transplantation. The primary objective was an 8% improvement (hazard ratio [HR] = 0.73; 80% power; α risk, 2.5%; 1-sided) in 2-year event-free survival (EFS) in the obinutuzumab arm. From September 2012, 670 patients were enrolled (obinutuzumab, n = 336; rituximab, n = 334). A total of 383 (57.2%) were aaIPI 2-3, 339 (50.6%) received CHOP. Median follow-up was 38.7 months. The 2-year EFS was similar in both groups (59.8% vs 56.6%; P = .123; HR = 0.88). The 2-year PFS in the whole cohort was 83.1% (95% confidence interval, 80% to 85.8%). PET2−/4− and PET2+/4− had similar 2-year progression-free survival (PFS) and overall survival (OS): 89.9% vs 83.9% and 94.8% vs 92.8%. The 2-year PFS and OS for PET4+ patients were 62% and 83.1%. Grade 3-5 infections were more frequent in the obinutuzumab arm (21% vs 12%). Obinutuzumab is not superior to rituximab in aaIPI ≥1 DLBCL transplant-eligible patients. This trial was registered at www.clinicaltrials.gov as #NCT01659099.
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- 2021
12. Predictive factors of early progression after CAR T-cell therapy in relapsed/refractory diffuse large B-cell lymphoma
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Maud D'Aveni-Piney, Catherine Thieblemont, Caroline Bodet-Milin, Loic Ysebaert, Pierre Feugier, Eugenio Galli, Marie-Thérèse Rubio, Roberta Di Blasi, Pierre Bories, Benoit Tessoulin, Pierre Olivier, Ingrid Lafon, Alina Berriolo-Riedinger, Sylvie Chevret, Sophie Bernard, Laetitia Vercellino, Céline Bossard, Salim Kanoun, Lucie Oberic, Pascal Merlet, Michel Meignan, Olivier Casasnovas, Steven Le Gouill, Véronique Meignin, Cédric Rossi, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse], Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service d'Hématologie [IUCT Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Nucléaire [Nantes], Hôpital Laennec, Service de Médecine Nucléaire [Nancy], Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Centre hospitalier universitaire de Nantes (CHU Nantes), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Henri Mondor, Service de biostatistiques et information médicale [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), NF-kappaB, Différenciation et Cancer (OncokappaB (URP_7324)), and Université de Paris (UP)
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0301 basic medicine ,medicine.medical_specialty ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Immunotherapy, Adoptive ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,International Prognostic Index ,Refractory ,Internal medicine ,medicine ,Humans ,Progression-free survival ,Stage (cooking) ,Retrospective Studies ,Univariate analysis ,business.industry ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,Hematology ,medicine.disease ,Progression-Free Survival ,Confidence interval ,Tumor Burden ,3. Good health ,Lymphoma ,030104 developmental biology ,030220 oncology & carcinogenesis ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma - Abstract
Chimeric antigen receptor (CAR) T-cell therapy has emerged as an option for relapsed/refractory aggressive B-cell lymphomas that have failed 2 lines of therapy. Failures usually occur early after infusion. The purpose of our study was to identify factors that may predict failure, particularly early progression (EP), within the first month after infusion. Characteristics of 116 patients were analyzed at the time of decision (TD) to use commercial CAR (axicabtagene ciloleucel, n = 49; tisagenlecleucel n = 67) and at the time of treatment (TT), together with total metabolic tumor volume (TMTV) at TT. With a median follow-up of 8.2 months, 55 patients failed treatment; 27 (49%) were early progressors. The estimated 12-month progression-free survival (PFS) and overall survival (OS) were 47.2% (95% confidence interval [CI], 38.0-58.6) and 67.0% (95% CI, 57-79), respectively. Univariate analyses for PFS and OS identified Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥2, stage III/IV disease, extranodal (EN) sites ≥2, elevated lactate dehydrogenase (LDH), increased C-reactive protein (CRP), high International Prognostic Index at TD and at TT, as well as increased CRP, bulky mass, and high TMTV at TT, as risk factors. Multivariate analyses for PFS, EP, and OS identified elevated LDH and EN sites ≥2 at TD and the same predictors at TT (ie, increased CRP, EN sites ≥2, and TMTV >80 mL). In summary, risk factors identified for early progression at TD and at TT were EN involvement (≥2 sites) and lymphoma burden (LDH, TMTV).
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- 2020
13. Outcomes after first-line immunochemotherapy for primary mediastinal B-cell lymphoma: a LYSA study
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Cédric Rossi, Kamel Laribi, Alexandra Traverse-Glehen, Fabrice Jardin, Roch Houot, Alexandre Willaume, Martin Gauthier, Sophie Bernard, David Tonnelet, Katell Le Du, Gandhi Damaj, Pierre Sesques, Magalie Pascale Tardy, Julien Lazarovici, Hélène Monjanel, Hervé Tilly, Laure Lebras, Corinne Haioun, Adrien Chauchet, Chloe Antier, Alina Berriolo-Riedinger, Caroline Besson, Herve Gerard Maisonneuve, Vincent Camus, Christophe Bonnet, Justine Lequesne, Eric Durot, Sylvain Choquet, Stéphanie Becker, Sarah Bailly, Marie-Pierre Moles-Moreau, Pierre Decazes, UCL - SSS/DDUV/SIGN - Cell signalling, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Service d'hématologie
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Oncology ,Vincristine ,medicine.medical_specialty ,Aggressive lymphoma ,CHOP ,Transplantation, Autologous ,Antibodies, Monoclonal, Murine-Derived ,Autologous stem-cell transplantation ,Prednisone ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Retrospective Studies ,Lymphoid Neoplasia ,business.industry ,Hematopoietic Stem Cell Transplantation ,Hematology ,medicine.disease ,Treatment Outcome ,Vindesine ,Rituximab ,Female ,Primary mediastinal B-cell lymphoma ,Lymphoma, Large B-Cell, Diffuse ,business ,medicine.drug - Abstract
Primary mediastinal B-cell lymphoma (PMBL) is a rare type of aggressive lymphoma typically affecting young female patients. The first-line standard of care remains debated. We performed a large multicenter retrospective study in 25 centers in France and Belgium to describe PMBL patient outcomes after first-line treatment in real-life settings. A total of 313 patients were enrolled and received rituximab (R) plus ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone) (n = 180) or CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) delivered every 14 days (R-CHOP14, n = 76) or 21 days (R-CHOP21, n = 57) and consolidation strategies in modalities that varied according to time and institution, mainly guided by positron emission tomography. Consolidation autologous stem cell transplantation was performed for 46 (25.6%), 24 (31.6%), and 1 (1.8%) patient in the R-ACVBP, R-CHOP14, and R-CHOP21 groups, respectively (P < .001); only 17 (5.4%) patients received mediastinal radiotherapy. The end-of-treatment complete metabolic response rates were 86.3%, 86.8%, and 76.6% (P = .23) in the R-ACVBP, R-CHOP14, and R-CHOP21 groups. The median follow-up was 44 months, and the R-ACVBP, R-CHOP14, and R-CHOP21 three-year progression-free survival probabilities were 89.4% (95% confidence interval [CI], 84.8-94.2), 89.4% (95% CI, 82.7-96.6), and 74.7% (95% CI, 64-87.1) (P = .018). A baseline total metabolic tumor volume (TMTV) ≥360 cm3 was associated with a lower progression-free survival (hazard ratio, 2.18; 95% CI, 1.05-4.53). Excess febrile neutropenia (24.4% vs 5.3% vs 5.3%; P < .001) and mucositis (22.8% vs 3.9% vs 1.8%; P < .001) were observed with R-ACVBP compared with the R-CHOP regimens. Patients with PMBL treated with dose-dense immunochemotherapy without radiotherapy have excellent outcomes. R-ACVBP acute toxicity was higher than that of R-CHOP14. Our data confirmed the prognostic importance of baseline TMTV.
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- 2021
14. [Effect of obesity, age and gender on glomerular filtration rate measured in normal adults]
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Alexandre Cochet, Alina Berriolo-Riedinger, Clément Drouet, Jean-Marc Riedinger, Alexandra Nicolas, and Matthieu Gallet
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Adult ,Male ,medicine.medical_specialty ,Urology ,Renal function ,Normal values ,urologic and male genital diseases ,Kidney ,Age and gender ,medicine ,Humans ,Obesity ,Edetic Acid ,Retrospective Studies ,Body surface area ,urogenital system ,business.industry ,Retrospective cohort study ,General Medicine ,Nomogram ,medicine.disease ,female genital diseases and pregnancy complications ,medicine.anatomical_structure ,Female ,business ,Glomerular Filtration Rate - Abstract
The aims of this study were to assess the dependence of glomerular filtration rate (GFR) on age and gender and to produce reference data for the interpretation of 51Cr-EDTA GFR measurements in adults. METHODS This was a retrospective study of 120 live kidney donors (75 females, 45 males). GFR was evaluated from 51Cr-EDTA plasma clearance using blood samples taken at 3, 4 and 5 hours. The slope-intercept GFR was corrected for body surface area using the Dubois & Dubois and for the fast exponential using the Brochner-Mortensen equation. Scatter plot of DFG against age in live kidney donors was plotted and the 98% range limits have been defined. RESULTS The median GFR obtained for kidney donors was 88 mL/min/1.73 m2 [68-130]. No significant difference with gender was found. 51Cr-EDTA clearance was strongly correlated with patient age (r = - 0.62, P
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- 2021
15. Fully automatic segmentation of diffuse large B cell lymphoma lesions on 3D FDG-PET/CT for total metabolic tumour volume prediction using a convolutional neural network
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Alina Berriolo-Riedinger, Emmanuel Itti, Salim Kanoun, Thomas Carlier, Michel Meignan, Caroline Bodet-Milin, Steven Le Gouill, Paul Blanc-Durand, Simon Jégou, Françoise Kraeber-Bodéré, Rene-Olivier Casasnovas, Bernardo, Elizabeth, Service de médecine nucléaire [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), The Lymphoma Academic Research Organisation [Lyon] (LYSARC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), E-Patient : Images, données & mOdèles pour la médeciNe numériquE (EPIONE), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Owkin France, Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Nuclear Oncology (CRCINA-ÉQUIPE 13), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine Nucléaire [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Service d'Hématologie [Nantes], and Service de Médecine Nucléaire [CHRU Nancy]
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Positron emission tomography ,Jaccard index ,Lymphoma ,Convolutional neural network ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Cross-validation ,U-net ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Total metabolic tumour volume ,0302 clinical medicine ,Segmentation ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Deep learning ,General Medicine ,medicine.disease ,Thresholding ,Tumor Burden ,030220 oncology & carcinogenesis ,Cohort ,Lymphoma, Large B-Cell, Diffuse ,Neural Networks, Computer ,Nuclear medicine ,business ,Diffuse large B-cell lymphoma - Abstract
International audience; Purpose Lymphoma lesion detection and segmentation on whole-body FDG-PET/CT are a challenging task because of the diversity of involved nodes, organs or physiological uptakes. We sought to investigate the performances of a three-dimensional (3D) convolutional neural network (CNN) to automatically segment total metabolic tumour volume (TMTV) in large datasets of patients with diffuse large B cell lymphoma (DLBCL). Methods The dataset contained pre-therapy FDG-PET/CT from 733 DLBCL patients of 2 prospective LYmphoma Study Association (LYSA) trials. The first cohort (n = 639) was used for training using a 5-fold cross validation scheme. The second cohort (n = 94) was used for external validation of TMTV predictions. Ground truth masks were manually obtained after a 41% SUVmax adaptive thresholding of lymphoma lesions. A 3D U-net architecture with 2 input channels for PET and CT was trained on patches randomly sampled within PET/CTs with a summed cross entropy and Dice similarity coefficient (DSC) loss. Segmentation performance was assessed by the DSC and Jaccard coefficients. Finally, TMTV predictions were validated on the second independent cohort. Results Mean DSC and Jaccard coefficients (± standard deviation) in the validations set were 0.73 ± 0.20 and 0.68 ± 0.21, respectively. An underestimation of mean TMTV by − 12 mL (2.8%) ± 263 was found in the validation sets of the first cohort (P = 0.27). In the second cohort, an underestimation of mean TMTV by − 116 mL (20.8%) ± 425 was statistically significant (P = 0.01). Conclusion Our CNN is a promising tool for automatic detection and segmentation of lymphoma lesions, despite slight underestimation of TMTV. The fully automatic and open-source features of this CNN will allow to increase both dissemination in routine practice and reproducibility of TMTV assessment in lymphoma patients.
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- 2021
16. Long-term outcomes in patients with PET-predicted poor-responsive HER2-positive breast cancer treated with neoadjuvant bevacizumab added to trastuzumab and docetaxel: 5-year follow-up of the randomised Avataxher study
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Jean-Yves Pierga, Alina Berriolo-Riedinger, Thierry Petit, Laurent Arnould, David Coeffic, Abdennour Ferhat, Gilles Paintaud, Jean-Briac Prevost, Pierre-Francois Dupre, Fanny Le Du, Thomas Bachelot, Marie-Pierre Chauvet, Jean-Marc Ferrero, Gilles Thibault, Kaldoun Kerrou, Philippe Gabelle, Catherine Barbe, Julien Dupin, Bruno Coudert, Marie-Ange Mouret-Reynier, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Institut Curie [Paris], Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Paul Strauss, CRLCC Paul Strauss, Centre Eugène Marquis (CRLCC), Hôpital Morvan - CHRU de Brest (CHU - BREST ), Centre Léon Bérard [Lyon], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Roche France, Département d'information médicale [Centre Georges-François Leclerc] (DIM), UNICANCER-UNICANCER, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Lille-UNICANCER
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Oncology ,medicine.medical_specialty ,Positron emission tomography ,Early pet assessment ,Bevacizumab ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,01 natural sciences ,Group B ,03 medical and health sciences ,Her-2 positive breast cancer ,0302 clinical medicine ,Breast cancer ,Trastuzumab ,Internal medicine ,medicine ,Adjuvant therapy ,030212 general & internal medicine ,0101 mathematics ,Adverse effect ,Long-term follow-up ,Neoadjuvant therapy ,lcsh:R5-920 ,business.industry ,010102 general mathematics ,General Medicine ,medicine.disease ,3. Good health ,Docetaxel ,pathological complete response ,Δsuvmax ,Neoadjuvant ,lcsh:Medicine (General) ,business ,Research Paper ,medicine.drug - Abstract
Background: The open-label, randomised Phase 2 AVATAXHER study (NCT01142778) demonstrated that early PET assessment identified HER2-positive breast cancer patients who responded poorly to neoadjuvant docetaxel plus trastuzumab. Adding neoadjuvant bevacizumab for PET-predicted poor-responders improved pathological complete response (pCR) rates (43.8% vs 24.0%). We investigated long-term study outcomes. Methods: Patients were treated in three groups. All patients initially received two cycles of standard neoadjuvant therapy with [¹⁸F]-FDG PET conducted before each cycle. Those with ≥70% change in the maximum standardised uptake value (∆SUVmax) received four further cycles of standard neoadjuvant therapy (PET responders). PET-predicted poor-responders (∆SUVmax
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- 2020
17. Prognostic value of FDG-PET in patients with mantle cell lymphoma: results from the LyMa-PET Project
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Anne Moreau, Olivier Casasnovas, Clément Bailly, Thomas Carlier, Steven Le Gouill, Thierry Lamy, Caroline Bodet-Milin, Françoise Kraeber-Bodéré, Olivier Hermine, Emmanuel Gyan, Michel Meignan, Anne Devillers, Barbara Burroni, Loïc Djaileb, Remy Gressin, Alina Berriolo-Riedinger, Catherine Thieblemont, Bernardo, Elizabeth, Radiopharmaceutiques Innovants en Oncologie et Neurologie - - IRON2011 - ANR-11-LABX-0018 - LABX - VALID, Nucléaire pour la Santé - - ARRONAXPLUS2011 - ANR-11-EQPX-0004 - EQPX - VALID, Gestes Médico-Chirurgicaux Assistés par Ordinateur - - CAMI2011 - ANR-11-LABX-0004 - LABX - VALID, Nuclear Oncology (CRCINA-ÉQUIPE 13), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Département de Médecine Nucléaire [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'hématologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, LYSA Imaging (Créteil) (LYSA-IM), CHU Henri Mondor, Département de Pathologie [CHU Nantes], Service de Pathologie [AP-HP Hôpital Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de médecine Nucléaire [CHU Grenoble-Alpes], Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'hématologie et d'Oncologie [CHU Grenoble], Département de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), CHU Pontchaillou [Rennes], Microenvironment, Cell Differentiation, Immunology and Cancer (MICMAC), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'onco-hématologie [AP-HP Hôpital Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hématologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma (CRCINA-ÉQUIPE 10), Département d'Hématologie [CHU Nantes], This work has been supported in part by grants from the French National Agency for Research, called 'Investissements d’Avenir' IRON Labex nY ANR-11-LABX-0018-01, SIRIC ILIAD and Arronax Plus Equipex nY ANR-11-EQPX-0004, and by grants from DHU Oncogreffe (Nantes -France)., ANR-11-LABX-0018,IRON,Radiopharmaceutiques Innovants en Oncologie et Neurologie(2011), ANR-11-EQPX-0004,ARRONAXPLUS,Nucléaire pour la Santé(2011), ANR-11-LABX-0004,CAMI,Gestes Médico-Chirurgicaux Assistés par Ordinateur(2011), CHU Henri Mondor [Créteil], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Laboratoire d'Hematologie [CHU Pontchaillou, Rennes] (Pôle de Biologie), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
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medicine.medical_specialty ,business.industry ,Mantle Cell Lymphoma ,LyMa Trial ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Hematology ,medicine.disease ,3. Good health ,SUV ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,030220 oncology & carcinogenesis ,medicine ,Mantle cell lymphoma ,In patient ,Radiology ,business ,FDG-PET ,Online Only Articles ,Value (mathematics) ,ComputingMilieux_MISCELLANEOUS ,030215 immunology - Abstract
International audience
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- 2020
18. Nivolumab First-Line Therapy for Elderly, Frail Hodgkin Lymphoma Patients: Niviniho, a Lysa Phase II Study
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Thomas Gastinne, Julien Lazarovici, Veronique Edeline, Alexandra Traverse-Glehen, Anne Corby, Lysiane Molina, Nawel Belmecheri, Krimo Bouabdallah, Sandy Amorim, Diane Damotte, David Sibon, Rene-Olivier Casasnovas, Vincent Ribrag, Emmanuelle Nicolas-Virelizier, Franck Morschhauser, Alina Berriolo-Riedinger, Thierry Vander Borght, Anne-Claire Gac, Bohrane Slama, Eric Durot, Stéphanie Guidez, Vincent Launay, Pierre Feugier, Kamel Laribi, and Marc André
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Oncology ,medicine.medical_specialty ,business.industry ,Immunology ,Phases of clinical research ,Cell Biology ,Hematology ,Biochemistry ,First line therapy ,Internal medicine ,medicine ,Hodgkin lymphoma ,Frail elderly ,Nivolumab ,business - Abstract
Background In contrast to the high cure rates in young patients (pts) treated with anthracycline-based chemotherapy, classical Hodgkin lymphoma (cHL) prognosis is poor in elderly pts, and very few data exist for pts considered too frail to receive standard-dose chemotherapy. In those patients, limited therapeutic options are available. Among the new immune-oncology drugs, Nivolumab, an anti-PD1 antibody, has demonstrated high response rate and very good tolerance, and is now approved in relapse and refractory (R/R) cHL. However, data on its use in the frontline setting are scarce. Material and methods We designed a prospective, open-label, multi-centric phase II study, to assess the efficacy and safety of nivolumab alone, or in combination with vinblastine in naive pts aged 61 years and older, with cHL and coexisting medical conditions. Pts were eligible if they had a Cumulative Illness Rating Scale-Geriatric (CIRS-G) score of 6 or more. Treatment consisted in an induction phase of 6 nivolumab injections, delivered at a flat dose of 240 mg every 14 days. Early assessment was done at 12 weeks by PET-CT and CT-scan. Pts who achieved complete metabolic response (CMR) at early assessment completed treatment with nivolumab monotherapy for 18 additional cycles (consolidation phase). Pts who obtained partial metabolic response (PMR) or non metabolic response (NMR, stable disease) received a combination of 18 cycles of nivolumab plus vinblastine, administered intravenously. The primary objective of the study was to assess the CMR rate based on central review at the end of treatment (EOT). Results From August 30th, 2018 to April 28 th, 2020, 64 pts were included in 31 centers, which composed the full analysis set (FAS), used for safety evaluation. Among these 64 pts, 56 pts were fully evaluable and constituted the efficacy set (ES) used for the efficacy analysis (8 pts progressed early or were not assessed by PET-CT). The median age at inclusion in the ES was 75 years [range: 62-91]. Patients had a median CIRS-G score of 10 [range: 6-18] at baseline, and a median G8 score of 12.5 [range: 6-17]. Seventy-three percent of pts had a stage III-IV disease and 42.9% of pts had B symptoms. At EOT, 16 pts (28.6%) achieved CMR according to central PET-CT review. Ten pts (17.9%) achieved PMR, 10 pts were in NMR (17.9%) and progressive metabolic disease was observed in 17 pts (30.4%). Three pts were not evaluated. The overall response rate at end of induction was 51.9%, (9 CMR and 18 PMR). 23 pts received a consolidation with nivolumab and vinblastine. With a median follow-up of 20.1 months, median PFS was 9.8 months [95% CI: 4.2;12]. 15/64 pts of the FAS died during treatment (23.4%): 6 pts from lymphoma, 2 pts from toxicity of study treatment and 2 pts from concurrent illness. One patient died from toxicity of additional treatment after progression, and 4 pts from other causes. The 2-year overall survival was 76.7% [95% CI: 59.6;87.3]. 49/64 pts (76.6%) experienced at least one AE, among which 32 pts experienced grade 3-4 AEs. The 3 more frequent grade 3-4 AEs were neutropenia (8 pts), sepsis (7 pts) and respiratory tract infection (5 pts). Adverse events were related to nivolumab in 36 pts and led to treatment discontinuation in 19 pts (29.7%). Adverse events of special interest i.e., immune-related AEs, were recorded in 22 pts, including 3 pneumonitis, 1 myocarditis, 1 encephalitis and 1 colitis. Among the 64 pts of the FAS, 34% of pts completed the treatment. The median number of cycles administered was 7 [range: 1-24] for nivolumab and 17 [range: 1-18] for vinblastine. Conclusion The NIVINIHO study is the first study to assess the efficacy and safety of an immune checkpoint inhibitor for first line therapy in elderly, frail patients with cHL. The results suggest that in this setting, a nivolumab-based therapy is active in a subset of pts. Further studies and biological analysis are planned to determine which patients may benefit from this approach. Figure 1 Figure 1. Disclosures Lazarovici: Mundipharma: Other: Travel grant. Bouabdallah: Takeda: Consultancy, Honoraria, Other: Travel/Accommodations/Expenses; Sandoz: Consultancy, Honoraria; Abbvie: Honoraria; Kite/Gilead: Consultancy, Honoraria, Other: Travel/Accommodations/Expenses; Roche: Consultancy, Honoraria, Other: Travel/Accommodations/Expenses. Morschhauser: Roche: Consultancy, Speakers Bureau; Chugai: Honoraria; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees; AstraZenenca: Membership on an entity's Board of Directors or advisory committees; Genentech, Inc.: Consultancy; Genmab: Membership on an entity's Board of Directors or advisory committees; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria; Epizyme: Consultancy, Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy; Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees. Laribi: Takeda: Other: Personal Fees, Research Funding; Novartis: Other: Personal Fees, Research Funding; AbbVie: Other: Personal Fees, Research Funding; BeiGene: Other: Personal Fees; Le Mans Hospital: Research Funding; IQONE: Other: Personal Fees; Astellas Phama, Inc.: Other: Personal Fees; AstraZeneca: Other: Personal Fees; Jansen: Research Funding. Feugier: Abbvie: Consultancy, Honoraria; Amgen: Honoraria; Janssen: Consultancy, Honoraria; Gilead: Consultancy, Honoraria; Astrazeneca: Consultancy, Honoraria. Sibon: iQone: Consultancy; Takeda: Consultancy; Abbvie: Consultancy; Roche: Consultancy; Janssen: Consultancy. Ribrag: Gilead: Membership on an entity's Board of Directors or advisory committees; PharmaMar: Honoraria, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy, Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees; Nanostring: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Argen-X: Research Funding; MSD Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Epizyme: Honoraria, Research Funding; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Astex Pharmaceuticals: Research Funding; GSK: Research Funding; Infinity Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. OffLabel Disclosure: Nivolumab. Presently labelled for relapse and refractory classical Hodgkin lymphoma and other malignancies
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- 2021
19. Final Analysis of a Prospective Multicenter Phase II Trial of the Lymphoma Study Association (LYSA) Using Prednisone, Vinblastine, Doxorubicin and Bendamustine (PVAB) Regimen in First Line Therapy for Patients over 60 Years with Advanced-Stage Classical Hodgkin Lymphoma
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Agathe Waultier, Kamel Laribi, Marc André, Christophe Bonnet, Alexandra Traverse-Glehen, Marguerite Fournier, Hervé Ghesquières, Diane Damotte, Vincent Delwail, Frédérique Orsini-Piocelle, Arnaud Jaccard, Alina Berriolo-Riedinger, Franck Morschhauser, Fabienne Morand, Philippe Quittet, Salim Kanoun, Emmanuelle Nicolas-Virelizier, Pauline Brice, Gandhi Damaj, and Rene-Olivier Casasnovas
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Oncology ,Bendamustine ,medicine.medical_specialty ,business.industry ,Immunology ,Advanced stage ,Cell Biology ,Hematology ,medicine.disease ,Biochemistry ,Vinblastine ,Lymphoma ,Regimen ,First line therapy ,Prednisone ,Internal medicine ,medicine ,Doxorubicin ,business ,medicine.drug - Abstract
Introduction: Older classical Hodgkin lymphoma (cHL) patients are characterized by a significant reduced survival as compared to younger patients. In relapsed and refractory HL, prospective and retrospective studies showed that bendamustine monotherapy provided interesting efficacy with 30% of complete response with an acceptable toxicity profile. We developed the PVAB (Prednisone, Vinblastine, Doxorubicin, Bendamustine) regimen in first line therapy to improve prognosis of older HL with advanced stage. Methods: In this prospective phase II, we recruited newly diagnosed classical HL patients age of 61 years or older with an advanced stage (Ann Arbor stage III, IV, IIB with risk factors). Inclusion criteria were: ECOG performance status 0-2; adequate cardio-pulmonary function with LVEF ≥ 50%; adequate renal function with creatinine clearance ≥ 40 mL/min; HIV negative; For patients aged 70 years old and more, a Mini Nutritional Assessment (MNA) ≥ 17. Treatment consisted of 6 cycles of prednisone (40mg/m 2 D1-5), vinblastine (6mg/m 2, D1), doxorubicin (40mg/m 2, D1) and bendamustine (120mg/m 2, D1) every 21 days. The primary endpoint was the complete metabolic response (CMR) rate according to local review after 6 cycles of study treatment or at premature treatment discontinuation according to Lugano Classification. We presented the final analysis of the study with a median follow-up of 42 months (range, 0.5-63.8), with prognostic analyses for progression free survival (PFS) measured from the date of inclusion to the date of progression, relapse or death from any cause. Prognostic factors included baseline clinical and biological characteristics, geriatric assessments and 18F-FDG PET/CT metabolic parameters especially baseline total metabolic tumor volume (TMTV). Optimal thresholds for some parameters were calculated using X-Tile approach. Results: Between July 2015 and July 2018, 89 patients were included in 34 LYSA centers. The median age was 68 years (range, 61-88) with 35 patients ≥70 years old (39%). The main histological subtype was nodular sclerosis cHL (n=56, 63%) with 26 EBV associated cases (LMP1 staining). Ann Arbor stages were as follows: II (n=3, 3%), III (n=30, 34%), IV (n=56, 63%). B symptoms were present in 57% of patients; 70 patients (80%) had IPS≥3. The median of CIRS-G score was 3 (range, 0-12). Seventy-eight patients (88%) completed the 6 cycles of PVAB. Update results for toxicity showed that 28 patients (32%) presented at least one serious adverse event (SAE) in particular infections (n=13, 15%), blood (n=11, 12%) and cardiac disorders (n=4, 4.5%). The CMR rate according to local review corresponding to the primary endpoint of the study was 77.5% (95%CI, 67-86) with 69 patients in CMR. After central review of 79 available PET/CT images, the CMR rate was 78.5%. Thirty-one patients relapsed or progressed (35%). The 4-year PFS rate was 50% (95%CI, 39-61). For the 69 patients achieving CMR, the 4-year disease free survival (DFS) rate was 62.8% (95%CI, 49-74). Twenty-four patients (27%) died: 11 cHL (46%), 4 treatment toxicity (17%), 6 second cancers (25%), 3 other causes after treatment (infection, cardiac insufficiency, pulmonary embolism, 12%). The 4-year overall survival rate was 69% (95%CI, 57-79). In univariate analysis, altered ECOG PS, Ann Arbor stage IV, bulky disease (>7cm), B-symptoms, extra-nodal involvement (>1), bone or medullar involvement, liver involvement, albumin (≤30g/l), hemoglobin level (88mg/l), TMTV (>450ml) and number of medications non-related to HL (>5) were associated with PFS. In multivariate analysis, liver involvement (HR: 3.79; 95%CI,1.71-8.43; P=0.001), lymphopenia (HR: 3.04; 95%CI,1.54-6.01; P=0.001), CRP (HR: 3.37; 95%CI, 1.69-6.69; P=0.0005) and co-medications (HR: 2.85; 95%CI,1.44-5.66; P=0.003) were independently associated with PFS. Conclusions: PVAB regimen provided high CMR (77.5%) with acceptable toxicity for advanced stage cHL patient over 60 years. The 4-year PFS and OS rates were 50% and 69% respectively, these survival endpoints were influenced by not related-lymphoma events. Prognostic analyses showed that specific involved site (liver), biological parameters (lymphocyte count and CRP) and patient's comorbidity (co-medications) influenced independently PFS. Disclosures Ghesquieres: Celgene: Consultancy, Honoraria, Other: Travel, accommodation, expenses; Roche: Consultancy, Honoraria, Other: Travel, accommodation, expenses; Gilead Sciences: Consultancy, Honoraria, Other: Travel, accommodation, expenses; Mundipharma Research Limited: Consultancy, Honoraria; Takeda: Other: Travel, accommodation, expenses. Casasnovas: Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead Kite: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; MSD: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria. Jaccard: Janssen: Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria; Abbvie: Honoraria. Laribi: Jansen: Research Funding; Novartis: Other: Personal Fees, Research Funding; Takeda: Other: Personal Fees, Research Funding; AbbVie: Other: Personal Fees, Research Funding; IQONE: Other: Personal Fees; Astellas Phama, Inc.: Other: Personal Fees; BeiGene: Other: Personal Fees; AstraZeneca: Other: Personal Fees; Le Mans Hospital: Research Funding. Morschhauser: BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy; Incyte: Membership on an entity's Board of Directors or advisory committees; Chugai: Honoraria; Epizyme: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Genentech, Inc.: Consultancy; Genmab: Membership on an entity's Board of Directors or advisory committees; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees; AstraZenenca: Membership on an entity's Board of Directors or advisory committees; Roche: Consultancy, Speakers Bureau; Janssen: Honoraria; Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees. Brice: Takeda: Consultancy, Honoraria, Research Funding; BMS: Honoraria; MSD: Honoraria. OffLabel Disclosure: Bendamustine is off-label drug use in Hodgkin lymphoma
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- 2021
20. Total Metabolic Tumor Volume and Tumor Dissemination Are Independent Prognostic Factors in Advanced Hodgkin Lymphoma
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Julien Lazarovici, Ilan Tal, Thomas Gastinne, Aspasia Stamatoullas-Bastard, Rene-Olivier Casasnovas, Salim Kanoun, Reda Bouabdallah, Hervé Ghesquières, Samuel Griolet, Veronique Edeline, Pauline Brice, Anne-Ségolène Cottereau, Cédric Rossi, Michel Meignan, Alina Berriolo-Riedinger, Jehan Dupuis, and Marc André
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Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,Immunology ,medicine ,Hodgkin lymphoma ,Cell Biology ,Hematology ,Metabolic tumor volume ,business ,Biochemistry - Abstract
Background: The AHL2011 study demonstrated that a PET-driven strategy allows to deescalate treatment to 4 x ABVD in PET negative patients after 2 cycles of escalated BEACOPP (BEACOPPesc) without loss of tumor control in patients with advanced Hodgkin lymphoma (HL) compared to a non PET-monitored treatment delivering 6 x BEACOPPesc (Casasnovas RO et al, Lancet Oncol 2019). The interim PET results after 2 (PET2) and 4 (PET4) cycles of chemotherapy were found to influence patients PFS and OS independently of IPS. To further refine the patients outcome prediction we evaluate the prognostic value of baseline Total Metabolic Tumor Volume (TMTV) and tumor dissemination (SDmax) in Ann Arbor stage III-IV patients included in the AHL2011 trial. Patients and methods: 634 patients enrolled in the AHL2011 trial with stage Ann Arbor III or IV were included in the study. According to the AHL2011 trial, patients were randomized in a standard arm (6 x BEACOPPesc) or a PET-driven arm (2 x BEACOPPesc and 4 x ABVD in negative PET2 patients or 4 x BEACOPPesc in positive PET2 patients). For each patient, a semi automatic tumor segmentation was retrospectively performed in baseline PET to calculate TMTV using the 41% of SUVmax threshold and compute the maximum distance between the delineated lesions normalized by body surface area (SDmax). Optimal thresholds for TMTV and SDmax were calculated using X-Tile and ROC curve approaches in a randomly assigned training (n=317) and validation sets (n=317). The per protocol PET2 and PET4 responses were analyzed using the modified Deauville criteria (positive if residual uptake >140% background liver). Multivariate analysis included treatment arm, TMTV, SDmax, international prognosis score (IPS), PET2, and PET4 as covariates. The median follow-up was 5.6y. Results : Median TMTV and SDmax were 215 ml and 0.221 m-1 in the whole population and similar in both randomized arms and in the training and validation sets. Optimal cutoffs were 220ml for TMTV (312 patients [49%] had High TMTV) and 0.330 m-1 for SDmax (149 patients [24%] had High SDmax) and similar in the training and validation sets. 5-year PFS for patients with TMTV>220ml was 84.1% vs 90.2% in low TMTV patients (p=0.02) in the whole population (in the training set: 83% vs 89%, p=0.088 ; in the validation set : 86% vs 92% p=0.11). 5-year PFS was significantly lower in patients with SDmax>0.333 m-1 (78.8% vs 89.7%; HR=2.15 [95%CI: 1.38-3.35], p=0.0005) in the whole population (in the training set: 77% vs 89%; p=0.0037); in the validation set: 81% vs 91; p=0.046). The combination of TMTV and SDmax allows to identify two subgroups of patients, those having both low TMTV and low SDmax (n= 281; 44%) and those having high TMTV and/or SDmax (5-year PFS: 92% vs 83.4%; HR=2.24 [95%CI: 1.39-3.62], p=0.0007) (figure 1). In multivariate analysis, high TMTV (p=0.034), high SDmax (p=0.0002), PET2 (p=0.02) and PET4 (p Conclusion: Tumor burden (TMTV) and dissemination (SDmax) assessed on baseline 18FDG PET allow to predict, independently of early reponse to treatment, the outcome of patients with advanced HL. These two parameters overcome the prognosis value of IPS and could be included into new prognostic scores to tailor personalized therapy in advanced Hodgkin Lymphoma. Figure 1 : PFS according to TMTV and SDmax in stage III-IV HL patients enrolled in the AHL2011 study Figure 1 Figure 1. Disclosures Brice: Takeda: Consultancy, Honoraria, Research Funding; BMS: Honoraria; MSD: Honoraria. Ghesquieres: Janssen: Honoraria; Mundipharma: Consultancy, Honoraria; Roche: Consultancy; Celgene: Consultancy, Honoraria; Gilead Science: Consultancy, Honoraria. Stamatoullas-Bastard: Takeda: Consultancy. André: AbbVie: Other: Travel/accomodation/expenses; Roche: Other: Travel/accomodation/expenses, Research Funding; Johnson & Johnson: Research Funding; Incyte: Consultancy; Gilead: Consultancy, Other: Travel/Accommodations/Expenses; Karyopharm: Consultancy; Bristol-Myers-Squibb: Consultancy, Other: Travel/Accommodations/Expenses; Celgene: Other: Travel/accomodation/expenses; Takeda: Consultancy, Research Funding. Rossi: ROCHE: Honoraria, Research Funding; Takeda: Honoraria; JANSSEN: Honoraria; ABBVIE: Honoraria. Casasnovas: Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead Kite: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; MSD: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria.
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- 2021
21. R-CHOP14 As a Standard of Care in Primary Mediastinal B Cell Lymphoma: A 10-YEARS Experience of Lysa Centers
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Laure Lebras, Kamel Laribi, Stéphanie Becker, Alina Berriolo-Riedinger, Marie-Pierre Moles, Hervé Tilly, Christophe Bonnet, Roch Houot, Alexandre Willaume, Hélène Monjanel, Eric Durot, Pierre Decazes, Pierre Sesques, Julien Lazarovici, Adrien Chauchet, Sophie Bernard, Damaj Gandhi Laurent, Martin Gauthier, Fabrice Jardin, Magalie Pascale Tardy, Chloe Antier, Choquet Sylvain, Caroline Besson, David Tonnelet, Corinne Haioun, Cédric Rossi, Hervé Maisonneuve, J. Lequesne, Sarah Bailly, Katell Le Du, and Vincent Camus
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medicine.medical_specialty ,Standard of care ,business.industry ,Immunology ,Medicine ,Cell Biology ,Hematology ,Primary mediastinal B-cell lymphoma ,Radiology ,business ,medicine.disease ,Biochemistry - Abstract
Introduction: Primary mediastinal B cell lymphoma (PMBL) is clinically and biologically distinct from the other subtypes of diffuse large B cell lymphoma (DLBCL), typically affecting young female patients (pts) with a bulky mediastinal mass. Standard treatment (TRT) is a combination of anti-CD20 antibody (Ab) and anthracycline-based chemotherapy. We aimed to compare patients' outcomes after CHOP delivered every 21 days (CHOP21) or 14 days (CHOP14) or ACVBP combined with anti-CD20 Ab in real life. Methods: All Pts treated in LYSA centers were eligible in this retrospective analysis. Inclusion criteria were as follow: age ≥18 years (yrs), newly diagnosed PMBL, TRT with CHOP or ACVBP plus anti-CD20 Ab between 2006 and 2017, and patient non-opposition statement. Primary endpoint was progression-free survival (PFS), secondary endpoints were: overall survival (OS), response rate (Lugano 2014) and total metabolic tumor volume (TMTV). Results: 313 pts were enrolled from 25 LYSA centers in France and Belgium. In all, median age at diagnosis was 32 (18-88) yrs. Majority of pts were female pts (60.7%) and presented at diagnosis with a good performance status (0-1: 81.8%), stage I-II (57.5%), elevated LDH (85%), Bulk>10cm (58.5%) and low/low-intermediate aaIPI 0-1 (56.7%). Pts in the CHOP21 (n=57) group were older (median 40 yrs, vs 33 vs 29.5, p Complete metabolic response rates at end of TRT were comparable between CHOP21, CHOP14 and ACVBP groups: 81.1%, 90.9%, and 85.5%, respectively (p=0.46). 37 (11.8%) pts progressed including 32 (10.2%) who displayed primary refractory disease and 6 (16.2%) pts who relapsed after consolidation ASCT. CNS relapse occurred in 9 (2.9%) pts. Median time between ASCT and relapse was 3 (2-58) months. Patients received the following salvage TRTs: high dose chemotherapy (HDC: R-ICE/R-DHAOX-like) (n=30) followed by second-line consolidation ASCT (n=11/30) and post-ASCT mediastinal RT (n=5/11); salvage RT without chemotherapy (n=1); other regimens (R-CHOP, R-GEMOX) (n=3); none (n=3). 2-yrs second PFS (PFS2) rates in pts who had previously received CHOP21, CHOP14 and ACVBP were: 20.5% vs 62.5% vs 18.8% (p=0.43). Only HDC + ASCT strategy granted disease control (2-yrs PFS2: 32.3%). Median follow up was 44 (1-153) months and the CHOP21, CHOP14, ACVBP 5-yrs PFS and 5-yrs OS were: 74.7% (95%CI: 64-97.1%), 89.4% (82.7-96.6%), 89.4% (84.8-94.2%) (p=0.018, Figure A); and 81% (70-94.4%), 100% (100-100%), 92.4% (88.4-96.7%) (p=0.0036, Figure B), respectively. In a multivariate model including TRT group, consolidation ASCT and/or RT, aaIPI, Bulk>10cm and TMTV≥360cm3, CHOP14 was not associated with better PFS as compared to ACVBP and CHOP21 (p=0.1548). Baseline higher TMTV (≥ 360 cm3) was associated with lower PFS in multivariate analysis, independently of TRT (HR=0.41 [0.2-0.85], p=0.02). All grades TRT-related adverse events were similar between the groups, except for an excess of febrile neutropenia (5.3% vs 5.3% vs 24.4%, p Conclusion These results confirm the favorable outcome of PMBL pts treated with CHOP14 and ACVBP plus anti CD20 Ab. The toxicity of ACVBP was more pronounced and CHOP14 was associated with a better OS. Baseline TMTV≥360cm3 is a highly predictive factor of unfavorable outcome in PMBL pts, independently of TRT. We recommend R-CHOP14 as standard of care in PMBL. Figure Disclosures Camus: ROCHE: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); PFIZER: Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); AMGEN: Honoraria; JANSSEN: Honoraria. Decazes:Bayer: Other: travel, accomodations, expenses. Bernard:Janssen: Other: Travel and accommodation . Gandhi Laurent:Abbevie, Pfizer, Takeda, Roche: Other: Travel; Roche, Takeda, Iqone, Accord: Consultancy; Roche, Takeda, Accord: Honoraria. Laribi:amgen: Research Funding; novartis: Honoraria, Research Funding; takeda: Research Funding; abbvie: Honoraria, Research Funding. Houot:Gilead: Honoraria; Kite: Honoraria; Roche: Honoraria; Novartis: Honoraria; Janssen: Honoraria; Celgene: Honoraria; Bristol-Myers Squibb: Honoraria; MSD: Honoraria. Tilly:BMS: Honoraria.
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- 2020
22. PET-Guided Strategy Improves the Safety of Beacopp-Based Treatment in Advanced Hodgkin Lymphoma: Prolonged Follow-up of the Lysa Ahl 2011 Phase 3 Study
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Jehan Dupuis, Veronique Edeline, Aspasia Stamatoulas Bastard, Clementine Joubert, Anne Claire Gac, Herve Ghesquieres, Julien Lazarovici, Emmanuelle Nicolas-Virelizier, Bertrand Joly, Reda Bouabdallah, Alina Berriolo-Riedinger, Pauline Brice, Julie Dechene, Krimo Bouabdallah, Marc André, Michel Meignan, Judith Racapé, P. Feugier, Franck Morschhauser, Isabelle Demeestere, Olivier Casasnovas, and Thomas Gastinne
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BEACOPP ,Poor prognosis ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Immunology ,Phases of clinical research ,Cell Biology ,Hematology ,University hospital ,Biochemistry ,Interim pet ,Sciences biomédicales ,Cancérologie ,Spontaneous pregnancy ,Gynécologie ,ABVD ,Family medicine ,medicine ,Hodgkin lymphoma ,business ,medicine.drug - Abstract
Background AHL2011 study (NCT01358747) demonstrated that PET negativity after 2 cycles of upfront BEACOPPescalated (BEA) allows to switch to 4 cycles of ABVD 84% of patients (pts) with advanced Hodgkin lymphoma (HL) leading to reduce immediate treatment toxicity without loss of tumor control (Casasnovas RO, Lancet Oncol 2019). We report an updated follow-up of the study with a focus on the late treatment-related adverse events including secondary primary malignancies (SPM) and unfertility. Methods In AHL2011 823 patients aged 18-60 with a newly diagnosed advanced HL defined by an Ann Arbor stage III, IV or IIB with M/T>0.33 or extranodal involvement were prospectively randomized between a standard arm (n=413) delivering 6 x BEA and a PET-driven arm (n=410) after 2 x BEA delivering 4 x ABVD in PET2- pts and 4 x BEA in PET2+ pts. In both arms PET performed after 4 cycles of chemotherapy had to be negative to complete the planned treatment. We aimed at excluding inferiority of the PET-driven arm of at least 10% compared to the standard arm which was achieved with the analysis on 10/2017. The data cutoff for the present analysis was 29 April 2019. A prospective fertility substudy for patients 24 IU/L twice during 5y follow-up when available, with estradiol < 50pg/ml, and low ovarian reserve (OR) by AMH < 0.16ng/ml. - In males, FSH serum levels and sperm analysis. Results With a 5.6 year median follow-up, 5y PFS and OS were similar in both randomization arms (PFS: 87.5% vs 86.7% ;HR 1.07, 95%CI 0.74-1.57; p=0.67; OS: 97.7% in both arms; HR=1.012, 95%CI 0.50-2.10; p=0.53). In the whole cohort full interim PET assessment predicted patients PFS (5y PFS = 92.3% in PET2-/PET4-, 75.4% [HR= 3.26 ;95%CI 18.3-5.77] in PET2+/PET4- and 46.5% [HR= 12.4 ;95%CI :7.31-19.51] in PET4+ pts respectively; p 5g (HR=0.36, 95%CI 0.14-0.96; p=0.04) but not to arms. In males, median baseline FSH levels were similar in both arms but 19 and 23% experienced severe oligospermia at baseline in standard (n=214) and PET-driven arms (n=210), respectively. Chemotherapy dramatically reduced sperm numeration in both arms but recovery occured more frequently in the PET-driven arm (severe oligospermia at 4-5 year: 50% vs 93%). A total of 84 patients (14.7%) reported pregnancies including 49 (17.2%) in the PET driven arm vs 35 (12.3%) in the standard arm (p=0.12) and required assisted reproductive technology treatment more frequently in the standard arm (23% vs 14%). Conclusions The prolonged follow-up confirms that the PET-driven strategy delivering 4 cycles of ABVD in PET negative patients after 2 cycles of BEA is non inferior compared to standard 6 cycles of BEA. PET4 provides additionnal prognostic information to PET2 and identifies patients with particularly poor prognosis. The PET-driven treatment allows to reduce significantly the risk of infertility in both men (recovery of oligospermia) and women (decreasing by 5 the risk of POI) and improves the chances of spontaneous pregnancy after completion of HL treatment. With the current follow-up the risk of SPM was low (2.7%) and similar in both arms. Disclosures Casasnovas: Roche: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria, Research Funding; Gilead: Consultancy, Honoraria, Research Funding; MSD: Consultancy, Honoraria; BMS: Consultancy, Honoraria; AMGEN: Consultancy, Honoraria; abbvie: Consultancy, Honoraria. Brice:Takeda: Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; BMS: Honoraria; MSD: Honoraria; Roche: Other: TRAVEL, ACCOMMODATIONS, EXPENSES. Ghesquieres:Gilead: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; CELGENE: Consultancy, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; Roche: Consultancy, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; Janssen: Honoraria. Stamatoulas Bastard:Takeda: Consultancy; Celgene: Honoraria; Pfizer: Other: TRAVEL, ACCOMMODATIONS, EXPENSES. Dupuis:Henri Mondor University Hospital Creteil France: Current Employment. Gac:Roche: Consultancy; Takeda: Consultancy. Bouabdallah:Takeda: Consultancy, Honoraria; Roche: Consultancy, Honoraria; Gilead Sciences: Consultancy, Honoraria. Morschhauser:Genentech, Inc. Consultancy; Abbvie: Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria; Gilead: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Servier: Consultancy; Celgene: Membership on an entity's Board of Directors or advisory committees; Epizyme: Membership on an entity's Board of Directors or advisory committees; F. Hoffmann-La Roche: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. André:Johnson & Johnson: Research Funding; Celgene: Other, Research Funding; Takeda: Consultancy; Bristol-Myers-Squibb: Consultancy, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); CHU UCL Namur, site Godinne, Yvoir, Belgium: Current Employment; Seattle Genetics: Consultancy; Novartis: Consultancy, Research Funding; Gilead: Consultancy, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); Karyopharm: Consultancy; Abbvie: Consultancy; Amgen: Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding; Roche: Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding. Meignan:ROCHE: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company). Demeestere:Roche: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria; THERAMEX FERRING: Other: TRAVEL, ACCOMMODATIONS, EXPENSES., info:eu-repo/semantics/published
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- 2020
23. FDG-PET–driven consolidation strategy in diffuse large B-cell lymphoma: final results of a randomized phase 2 study
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Marc André, Alain Delmer, Catherine Thieblemont, Jean-François Emile, Nicolas Mounier, Richard Delarue, Stéphane Bardet, Franck Morschhauser, Loic Ysebaert, Jean-Philippe Jais, Emmanuel Bachy, Corinne Haioun, Alina Berriolo-Riedinger, Jean Gabarre, Hervé Tilly, Christophe Fruchart, Pierre Feugier, René-Olivier Casasnovas, Michel Meignan, and Sabine Tricot
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Adult ,Male ,medicine.medical_specialty ,Vincristine ,Endpoint Determination ,Immunology ,Salvage therapy ,Phases of clinical research ,Standardized uptake value ,Biochemistry ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Autologous stem-cell transplantation ,Fluorodeoxyglucose F18 ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,business.industry ,Hematopoietic Stem Cell Transplantation ,Reproducibility of Results ,Cell Biology ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Consolidation Chemotherapy ,Treatment Outcome ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Vindesine ,Female ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma ,030215 immunology ,medicine.drug - Abstract
Dose-dense induction and up-front consolidation with autologous stem cell transplantation (ASCT) remain controversial issues when treating patients with high-risk diffuse large B-cell lymphoma. GELA designed a randomized phase 2 trial evaluating the efficacy of either rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone (R-ACVBP) or rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP14) induction and a positron emission tomography (PET)-driven ASCT or standard immunochemotherapy (SIC) consolidation in age-adjusted international prognosis index 2 (aaIPI2)-aaIPI3 patients. PET was performed at baseline, after 2 (PET2) and 4 (PET4) induction cycles, and centrally assessed using international harmonization project (IHP) criteria. PET2-/PET4- patients were assigned SIC, PET2+/PET4- patients were assigned ASCT, and PET4+ patients were treated with the investigator's choice. The primary end-point was the 2007 international working group complete response (CR) rate after induction. Change in maximum standard uptake value (ΔSUVmax) after PET assessment was explored. Two hundred eleven patients were randomly assigned to R-ACVBP (n = 109) or R-CHOP14 (n = 102). PET4-/CR rates were 53%/47% with R-ACVBP and 41%/39% with R-CHOP14 (CR 95% confidence interval [CI], 38%-67% and 28%-54%, respectively; P = .076). Consolidation in the R-ACVBP and R-CHOP14 groups was SIC in 26% and 23% of patients and ASCT in 28% and 18% of patients, respectively. PET4 positivity was higher with R-CHOP14 vs R-ACVBP (54% vs 41%; P = .08), leading to more salvage therapy (37% vs 26%; P = .07) and lower event-free survival (EFS; 4-year EFS, 31% vs 43%; P 70% was associated with better outcome (4-year PFS, 84% vs 35%; 4-year OS, 91% vs 57%; P < .0001), whatever the consolidation. Superiority of R-ACVBP over R-CHOP14 was not established, as IHP criteria did not properly reflect disease control. ΔSUVmax may help better select patients needing an alternative to SIC, including ASCT.
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- 2017
24. Clinical value of CEA for detection of distant metastases in newly diagnosed breast cancer: comparison with CA 15-3
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Alina Berriolo-Riedinger, Guillaume Maccio, Jean-Marc Riedinger, and Vincent Goussot
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Adult ,Oncology ,medicine.medical_specialty ,Population ,CA 15-3 ,Breast Neoplasms ,Newly diagnosed ,Sensitivity and Specificity ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Carcinoembryonic antigen ,Predictive Value of Tests ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Neoplasm Metastasis ,education ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,biology ,business.industry ,Mucin-1 ,010401 analytical chemistry ,Cancer ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Metastatic breast cancer ,Carcinoembryonic Antigen ,0104 chemical sciences ,ROC Curve ,Disease Progression ,030221 ophthalmology & optometry ,biology.protein ,Female ,business - Abstract
The aim of the study is to investigate the clinical value of CEA (carcinoembryonic antigen) for detection of distant metastases (DM) in newly diagnosed breast cancer. This retrospective study focuses on a population of 929 patients with locally advanced breast cancer (n=521) or metastatic breast cancer (n=408) diagnosed at the CGFL (Centre Georges Francois Leclerc) from 1998 to 2014. These patients underwent a measurement of CA 15-3, a measurement of CEA and an assessment of extension before any treatment. The initial concentrations of CEA are correlated with conventional prognostic factors. The cut-off value of CEA was determined and verified on two independents subpopulations determined in drawing lots. The ROC curve shows an AUC of 0.82 (p0.0001). At the threshold of 6.7 μg/L, CEA before treatment has a predictive value on the existence of DM independently of the CA 15-3 and other prognostic factors. The combination of CEA and CA 15-3 increases significantly the predictive value of CA 15-3 on the whole population (sensitivity increased by 9%) and on tumors expressing hormonal receptors. Concerning the only CEA the rate of false negative is of 52% and depends on the number and the type of the metastatic localization. Among the 28 patients without DM and a CEA6.7 μg/L, 15 have developed DM and 2 a new cancer. Thirteen will die of cancer. In conclusion, these facts confirm the independently predictive value of CEA before treatment on the existence of DM and its complementarity with CA 15-3 during the assessment of extension by imagery.
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- 2017
25. PET-guided, BEACOPP
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René-Olivier, Casasnovas, Reda, Bouabdallah, Pauline, Brice, Julien, Lazarovici, Hervé, Ghesquieres, Aspasia, Stamatoullas, Alina, Berriolo-Riedinger, Luc-Matthieu, Fornecker, Marc, André, and Michel, Meignan
- Subjects
Vincristine ,Positron-Emission Tomography ,Procarbazine ,Humans ,Cyclophosphamide ,Hodgkin Disease - Published
- 2019
26. Long-Term Outcomes in Patients with PET-Predicted Poor-Responsive HER2-Positive Breast Cancer Treated with Neoadjuvant Bevacizumab Added to Trastuzumab and Docetaxel: 5-Year Follow-Up of the Randomised AVATAXHER Study
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Pierre-Francois Dupre, Marie-Pierre Chauvet, Jean Marc Ferrero, David Coeffic, Jean-Briac Prevost, Thomas Bachelot, Thierry Petit, Alina Berriolo-Riedinger, Catherine Barbe, Julien Dupin, Gilles Paintaud, Kaldoun Kerrou, Philippe Gabelle, Laurent Arnould, Jean-Yves Pierga, Fanny Le Du, Marie-Ange Mouret-Reynier, Bruno Coudert, and Abdennour Ferhat
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medicine.medical_specialty ,Bevacizumab ,business.industry ,medicine.medical_treatment ,medicine.disease ,Breast cancer ,Docetaxel ,Trastuzumab ,Internal medicine ,medicine ,Hormonal therapy ,Cumulative incidence ,business ,Adverse effect ,Neoadjuvant therapy ,medicine.drug - Abstract
Background: The open-label, randomised Phase 2 AVATAXHER study demonstrated that early PET assessment identified patients with HER-2 positive breast cancer who responded poorly to standard neoadjuvant therapy (docetaxel plus trastuzumab). Adding bevacizumab to neoadjuvant therapy in PET-predicted poor-responders improved pathological complete response (pCR) rates (from 24·0% to 43·8%). We investigated whether the improved pCR rate translated into improved long-term outcomes. Methods: Patients were treated in three groups. All patients initially received two cycles of standard neoadjuvant therapy with [¹⁸F]-FDG PET conducted before each cycle. Those with a change in the maximum standardised uptake value (∆SUVmax) ≥70% received four further cycles of standard neoadjuvant therapy (PET responder group). PET-predicted poor-responders (∆SUVmax
- Published
- 2019
27. PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study
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Richard Delarue, Emmanuelle Nicolas-Virelizier, Reda Bouabdallah, Veronique Edeline, Bertrand Joly, Adrian Tempescul, Hassan Farhat, Luc-Matthieu Fornecker, Peggy Dartigues, René-Olivier Casasnovas, Laurent Martin, Franck Morschhauser, Aspasia Stamatoullas, Pauline Brice, Marc André, Alain Delmer, Michel Meignan, Nicolas Mounier, Hervé Ghesquières, Jehan Dupuis, Philippe Quittet, Krimo Bouabdallah, Julien Lazarovici, Alina Berriolo-Riedinger, Anne-Claire Gac, Alexandra Traverse-Glehen, Pierre Feugier, Thierry Lamy, Thomas Gastinne, Hervé Maisonneuve, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Université Paris-Saclay, Département d'hématologie [Gustave Roussy], Institut Gustave Roussy (IGR), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Hôpital Henri Mondor, Institut d'Hématologie de Basse-Normandie (IHBN), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Sud Francilien, CHU Bordeaux [Bordeaux], Centre Léon Bérard [Lyon], Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Recherche translationelle relations hôte-pathogènes, Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier de Versailles André Mignot (CHV), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHRU Brest - Service d'Hématologie (CHU-Brest-Hemato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital René HUGUENIN (Saint-Cloud), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Département d'Oncologie et Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Reims (CHU Reims), Département de biologie et pathologie médicales [Gustave Roussy], Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre Hospitalier Universitaire de Nice (CHU Nice), LYSA Imaging (Créteil) (LYSA-IM), CHU Henri Mondor, CHU Dijon, Département d'Hematologie, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service d'hématologie-oncologie adultes, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CRLCC Henri Becquerel, Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Hématologie, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Hématologie [Nantes], Hôpital Sud-Fancilien, CH Sud-Fancilien, Service d'hématologie, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'hématologie Hôpital Mignot, Service d'hématologie et oncologie médicale, Hôpital Lapeyronie-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CH La Roche-sur-Yon, Service d’Hématologie Clinique [CHU Pontchaillou, Rennes], Service d'hématologie et immunologie pédiatrique, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Dinant-Godinne UCL Namur, Service de cancérologie, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de médecine nucléaire [Créteil], Université Grenoble Alpes (UGA), Département Hématologie (FNCLCC), Groupe d'étude des proliférations lymphoïdes (GPL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Groupe Régional d'Etudes sur le CANcer (GRECAN), IFR146-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse )-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Département d'Hématologie Clinique [CHU Nantes], Université Mohamed Boudiaf de M'sila, Service d’Hématologie Clinique [CHRU Nancy], Hôpital Claude Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Institut d'Electronique et de Télécommunications de Rennes (IETR), Université de Nantes (UN)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Centre hospitalier La Roche-Sur-Yon, Microenvironnement et cancer (MiCa), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'hématologie [Reims], Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologie morphologique, Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Service de Pathologie [CHU de Dijon], Service de Médecine Interne Clermont Ferrand (MéDECINE INTERNE - CLERMONT-FERRAND), Hopital, Hôpital Archet 2 [Nice] (CHU), Laboratoire d'anatomie et de cytopathologie - Centre hospitalier Lyon Sud, CH Evry-Corbeil, Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, CCSD, Accord Elsevier, Service d'Hématologie Clinique (CHU de Dijon), Institut Universitaire d'Hématologie [Hôpital Saint-Louis - APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d’Hématologie [Rouen], CHU Rouen, Service hématologie Créteil, CHU, Laboratoire d'Hématologie Biologique [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Service d'hématologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Département d'hématologie biologique[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Département de médecine nucléaire (Institut Curie, Saint-Cloud), Institut Curie [Paris], Hématologie clinique [CH La Roche-sur-Yon], service hématologie Strasbourg, CHU Strasbourg, Service d’Hématologie Clinique [Rennes], Service hématologie Nice, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (MGD) Service d'hématologie, CHU Henri Mondor [Créteil], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, and Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM)
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Adult ,Male ,medicine.medical_specialty ,Vincristine ,Dacarbazine ,[SDV]Life Sciences [q-bio] ,Salvage therapy ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Procarbazine ,Gastroenterology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Humans ,ComputingMilieux_MISCELLANEOUS ,Neoplasm Staging ,business.industry ,Standard treatment ,medicine.disease ,Hodgkin Disease ,3. Good health ,Vinblastine ,Drug Therapy, Computer-Assisted ,[SDV] Life Sciences [q-bio] ,Oncology ,ABVD ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,Female ,business ,Febrile neutropenia ,030215 immunology ,medicine.drug - Abstract
International audience; Background: Increased-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPescalated) improves progression-free survival in patients with advanced Hodgkin lymphoma compared with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), but is associated with increased risks of haematological toxicity, secondary myelodysplasia or leukaemia, and infertility. We investigated whether PET monitoring during treatment could allow dose de-escalation by switching regimen (BEACOPPescalated to ABVD) in early responders without loss of disease control compared with standard treatment without PET monitoring.Methods: AHL2011 is a randomised, non-inferiority, phase 3 study done in 90 centres across Belgium and France. Eligible patients were aged 16-60 years and had newly diagnosed Hodgkin lymphoma, excluding nodular lymphocyte predominant subtype, an Eastern Cooperative Oncology Group performance status score less than 3, a life expectancy of at least 3 months, an Ann Arbor disease stage III, IV, or IIB with mediastinum-to-thorax ratio of 0·33 or greater than or extranodal localisation, and had received no previous treatment for Hodgkin lymphoma. Randomisation was unmasked and done centrally by the permuted block method. Patients were randomly assigned to standard treatment (BEACOPPescalated given every 21 days for six cycles) or PET-driven treatment. All patients received two cycles of upfront BEACOPPescalated, after which PET assessment was done (PET2). In the standard treatment group, PET2 patients completed two additional cycles of BEACOPPescalated induction therapy irrespective of PET2 findings. In the PET-driven treatment group, patients with positive PET2 scans received the further two cycles of BEACOPPescalated and those with a negative PET2 scan switched to two cycles of ABVD for the remaining induction therapy. In both treatment groups, PET at the end of induction therapy was used to decide whether to continue with consolidation therapy in those with negative scans or start salvage therapy in patients with positive scans (either two cycles of ABVD in PET2-negative patients in the PET-driven arm or two cycles of BEACOPPescalated). BEACOPPescalated consisted of bleomycin 10 mg/m2 and vincristine 1·4 mg/m2 intravenously on day 8, etoposide 200 mg/m2 intravenously on days 1-3, doxorubicin 35 mg/m2 and cyclophosphamide 1250 mg/m2 intravenously on day 1, 100 mg/m2 oral procarbazine on days 1-7, and 40 mg/m2 oral prednisone on days 1-14. ABVD was given every 28 days (doxorubicin 25 mg/m2, bleomycin 10 mg/m2, vinblastine 6 mg/m2, and dacarbazine 375 mg/m2 intravenously on days 1 and 15). The primary endpoint was investigator-assessed progression-free survival. Non-inferiority analyses were done by intention to treat and per protocol. The study had a non-inferiority margin of 10%, to show non-inferiority of PET-guided treatment versus standard care with 80% power and an alpha of 2·5% (one-sided). This study is registered with ClinicalTrials.gov, number NCT01358747.Findings: From May 19, 2011, to April 29, 2014, 823 patients were enrolled-413 in the standard care group and 410 in the PET-driven group. 346 (84%) of 410 patients in the PET-driven treatment group were assigned to receive ABVD and 51 (12%) to continue receiving BEACOPPescalated after PET2. With a median follow-up of 50·4 months (IQR 42·9-59·3), 5-year progression-free survival by intention to treat was 86·2%, 95% CI 81·6-89·8 in the standard treatment group versus 85·7%, 81·4-89·1 in the PET-driven treatment group (hazard ratio [HR] 1·084, 95% CI 0·737-1·596; p=0·65) and per protocol the values were 86·7%, 95% CI 81·9-90·3 and 85·4%, 80·7-89·0, respectively (HR 1·144, 0·758-1·726; p=0·74). The most common grade 3-4 adverse events were leucopenia (381 [92%] in the standard treatment group and 387 [95%] in the PET-driven treatment group), neutropenia (359 [87%] and 366 [90%]), anaemia (286 [69%] vs 114 [28%]), thrombocytopenia (271 [66%] and 163 [40%]), febrile neutropenia (145 [35%] and 93 [23%]), infections (88 [22%] and 47 [11%]), and gastrointestinal disorders (49 [11%] and 48 [11%]). Serious adverse events related to treatment were reported in 192 (47%) patients in the standard treatment group and 114 (28%) in the PET-driven treatment group, including infections (84 [20%] of 412 vs 50 [12%] of 407) and febrile neutropenia (21 [5%] vs 23 [6%]). Six (1%) patients in the standard care group died from treatment-related causes (two from septic shock, two from pneumopathy, one from heart failure, and one from acute myeloblastic leukaemia), as did two (
- Published
- 2019
28. [CA 125 assay in the extension assessment of newly diagnosed breast cancers: why and how?]
- Author
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Anne, Laffont, Vincent, Goussot, Alina, Berriolo-Riedinger, and Jean-Marc, Riedinger
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Adult ,Aged, 80 and over ,Mucin-1 ,Aftercare ,Breast Neoplasms ,Middle Aged ,Sensitivity and Specificity ,Carcinoembryonic Antigen ,Cystadenocarcinoma, Serous ,ROC Curve ,Predictive Value of Tests ,CA-125 Antigen ,Biomarkers, Tumor ,Humans ,Female ,Inflammatory Breast Neoplasms ,Neoplasm Metastasis ,Aged ,Retrospective Studies - Abstract
CA 125 assay is sometimes combined in practice with the one of CA 15-3 and CEA in the extension assessment of breast cancers. The purpose of this work is to evaluate the contribution of the initial CA 125 as an indicator of distant metastases (DM) or of serous inflammation (SI). This retrospective study concerns a population of 620 patients with breast cancer without metastatic extension (n=325) or metastatic breast cancer (n=295) diagnosed at the Georges-François Leclerc center from 1998 to 2014. Seventy-four patients had SI. We showed that initial CA 125 level is linked to the TNM clinic status, the HER2 status, the nature and the number of metastatic locations, the inflammation of the tumor or serous. The ROC curves and logistic regression analyses show that CA 125 is an independent predictive criterion of DM presence (threshold of 55 kU/L): this is the only positive marker in 7% of patients with DM. At the threshold of 110 kU/L, the CA 125 is the only predictive biologic factor for SI. In conclusion, these data present the independent predictive value of CA 125 on the presence of DM or SI on condition of usinga specific threshold for each of these uses.
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- 2018
29. Prognostic model for high-tumor-burden follicular lymphoma integrating baseline and end-induction PET: a LYSA/FIL study
- Author
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Corinne Haioun, Judith Trotman, Gilles Salles, Stefano Luminari, Loïc Chartier, Hervé Tilly, Michel Meignan, Rene-Olivier Casasnovas, Jehan Dupuis, Massimo Menga, Vittoria Tarantino, Annibale Versari, Massimo Federico, Alina Berriolo-Riedinger, Anne-Ségolène Cottereau, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service de médecine nucléaire [AP-HP Hôpital Cochin], CHU Cochin [AP-HP], IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Institut de Mathématiques de Toulouse UMR5219 ( IMT ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National des Sciences Appliquées - Toulouse ( INSA Toulouse ), Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -PRES Université de Toulouse-Université Paul Sabatier - Toulouse 3 ( UPS ) -Université Toulouse - Jean Jaurès ( UT2J ) -Université Toulouse 1 Capitole ( UT1 ), Epidémiologie des Maladies Emergentes, Conservatoire National des Arts et Métiers [CNAM] ( CNAM ) -Institut Pasteur [Paris]-Pasteur-Cnam risques infectieux et émergents ( PACRI ), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] : EA4628-Conservatoire National des Arts et Métiers [CNAM] : EA4628, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Service d'hématologie clinique, Groupe d'étude des proliférations lymphoïdes ( GPL ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Department of Oncology and Hematology, University of Modena and Reggio Emilia, Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ), Concord Repatriation General Hospital, Service de médecine nucléaire [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de Mathématiques de Toulouse UMR5219 (IMT), Université Toulouse 1 Capitole (UT1)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UPS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-PRES Université de Toulouse-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Groupe d'étude des proliférations lymphoïdes (GPL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Università degli Studi di Modena e Reggio Emilia (UNIMORE)
- Subjects
Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Biochemistry ,Immunology ,Hematology ,Cell Biology ,Population ,Follicular lymphoma ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Models, Biological ,Disease-Free Survival ,[ SDV.CAN ] Life Sciences [q-bio]/Cancer ,03 medical and health sciences ,0302 clinical medicine ,Median follow-up ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,education ,Prospective cohort study ,Lymphoma, Follicular ,Aged ,education.field_of_study ,business.industry ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Confidence interval ,Tumor Burden ,Lymphoma ,030104 developmental biology ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Disease Progression ,Female ,business - Abstract
International audience; Both total metabolic tumor volume (TMTV), computed on baseline positron emission tomography (PET), and end of induction (EOI) PET are imaging biomarkers showing promise for early risk stratification in patients with high-tumor-burden follicular lymphoma. A model was built incorporating these 2 factors in 159 patients from three prospective trials: 2 Lymphoma Study Association (LYSA) studies and 1 Fondazione Italiana Linfomi (FIL) trial. Median follow up was 64 months. High TMTV (>510 cm3) and positive EOI PET were independent, significant risk factors for progression. Their combination stratified the population into 3 risk groups: patients with no risk factors (n = 102; 64%) had a 5-year progression-free survival (PFS) of 67% vs 33% (hazard ratio [HR], 2.9; 95% confidence interval [CI], 1.8-4.9) for patients with 1 risk factor (n = 44; 27%) and only 23% (HR, 4.6; 95% CI, 2.3-9.2) for patients with both risk factors (n = 13; 8%). 2-year PFS was respectively 90% vs 61% (HR, 4.8; 95% CI, 2.2-10.4) and 46% (HR, 8.1; 95%CI, 3.1-21.3). This model enhances the prognostic value of PET staging and response assessment, identifying a subset of patients with a very high risk of progression and early treatment failure at 2 years.
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- 2018
30. Total metabolic tumor volume, circulating tumor cells, cell-free DNA: distinct prognostic value in follicular lymphoma
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Axel Van Der Gucht, Jehan Dupuis, E. Itti, René-Olivier Casasnovas, Philippine Robert, Alina Berriolo-Riedinger, Salma Hamdane, Jean-Philippe Jais, Asma Beldi-Ferchiou, Gaelle Laboure, Christiane Copie-Bergman, Benjamin Verret, Marie-Hélène Delfau-Larue, Ichrafe Benmaad, Isabelle Nel, Corinne Haioun, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, The lymphoma study association (LYSA), CHU Henri Mondor, Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
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Adult ,Male ,0301 basic medicine ,Oncology ,endocrine system ,medicine.medical_specialty ,Follicular lymphoma ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Polymerase Chain Reaction ,Circulating Tumor DNA ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Circulating tumor cell ,immune system diseases ,Predictive Value of Tests ,law ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Digital polymerase chain reaction ,Lymphoma, Follicular ,Polymerase chain reaction ,Survival analysis ,Aged ,Retrospective Studies ,Lymphoid Neoplasia ,business.industry ,Hematology ,Middle Aged ,Neoplastic Cells, Circulating ,Prognosis ,medicine.disease ,Survival Analysis ,Tumor Burden ,3. Good health ,Lymphoma ,030104 developmental biology ,Cell-free fetal DNA ,030220 oncology & carcinogenesis ,Predictive value of tests ,Female ,business - Abstract
International audience; Outcomes for follicular lymphoma (FL) have greatly improved, but most patients will ultimately relapse. High total metabolic tumor volume (TMTV), computed from baseline 18F-fluorodeoxyglucose-positron emission tomography (PET), is associated with shorter progression-free survival (PFS), but circulating tumor cells (CTCs) and cell-free DNA (cfDNA) may also reflect tumor burden and be of prognostic value. The aim of our study was to correlate CTCs and cfDNA with TMTV in FL at diagnosis and to determine their prognostic values. We retrospectively analyzed 133 patients (with previously untreated FL and a baseline PET) from 2 cohorts with either a baseline plasma sample (n = 61) or a bcl2-JH-informative peripheral blood (PB) sample (n = 68). Quantification of circulating bcl2-JH+ cells and cfDNA was performed by droplet digital polymerase chain reaction. A significant correlation was found between TMTV and both CTCs (P < .0001) and cfDNA (P < .0001). With a median 48-month follow-up, 4-year PFS was lower in patients with TMTV > 510 cm3 (P = .0004), CTCs >0.0018 PB cells (P = .03), or cfDNA >2550 equivalent-genome/mL (P = .04). In comparison with TMTV alone, no additional prognostic information was obtained by measuring CTCs. In contrast, Cox multivariate analysis, including cfDNA and TMTV, showed that both cfDNA and TMTV remained predictive of outcome. In conclusion, CTCs and cfDNA correlate with TMTV in FL, and all 3 influence patient outcome. PFS was shorter for patients with high cfDNA and TMTV, suggesting that these parameters provide relevant information for tumor-tailored therapy.
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- 2018
31. Role of FDG PET-CT in the treatment management of Hodgkin lymphoma
- Author
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Veronique Edeline, S. Becker, T. Vander Borght, Olivier Casasnovas, Alina Berriolo-Riedinger, Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Département de médecine nucléaire (CHU UCL Namur), CHU UCL Namur, Namur Research Institute for Life Sciences (NARILIS), Département de médecine nucléaire (Institut Curie, Saint-Cloud), and Institut Curie [Paris]
- Subjects
medicine.medical_specialty ,Interim PET ,Neoplasm, Residual ,PET-CT ,Clinical Decision-Making ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Antineoplastic Agents ,030218 nuclear medicine & medical imaging ,TEP-scanographie ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Staging ,Fluorodeoxyglucose ,Lymphome de Hogkin ,Lymphatic Irradiation ,business.industry ,Advanced stage ,Complete remission ,Hematopoietic Stem Cell Transplantation ,Gold standard (test) ,Prognosis ,Hodgkin Disease ,3. Good health ,Treatment management ,Oncology ,Imagerie ,030220 oncology & carcinogenesis ,Hodgkin lymphoma ,Fdg pet ct ,Radiology ,Tomography ,Lymph Nodes ,Radiopharmaceuticals ,business ,medicine.drug ,Radiotherapy, Image-Guided - Abstract
IF 1.128; International audience; Fluorodeoxyglucose (FDG) positons emission tomography (PET)-computed tomography (CT) is used in many ways at baseline and during the treatment of patients with Hodgkin lymphoma. Many properties of the technique are used in the different steps of patient's management. Initial staging with PET-CT is more accurate than conventional imaging and PET-CT also became the gold standard imaging at the end of treatment with a negative PET-CT mandatory for reaching a complete remission. Early assessment of response by PET-CT is one of the most powerful prognostic factors for progression-free survival of patients with localized and advanced stages and allows guiding treatment. Conversely, previous studies showed that there is no role of FDG PET-CT for the patient's follow-up.; La tomographie par émission de positrons (TEP)-tomodensitométrie au fluorodésoxyglucose est utilisée de différentes manières au moment du diagnostic et pendant le traitement des lymphomes de Hodgkin. Plusieurs particularités de la TEP sont utilisées à différentes étapes de la prise en charge des patients. Lors du bilan initial, la TEP-tomodensitométrie est plus performante que les techniques d’imageries conventionnelles, mais l’est aussi en fin de traitement, un examen normal étant indispensable pour affirmer l’obtention d’une rémission complète. L’évaluation précoce en cours de traitement est un des facteurs pronostiques les plus puissants pour la survie sans progression et pour guider le traitement dans les maladies localisées et disséminées. À l’inverse, la TEP-tomodensitométrie n’a pas de rôle dans le suivi des patients.
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- 2018
32. Phase II Study of a Radiotherapy Total Dose Increase in Hypoxic Lesions Identified by 18 F-Misonidazole PET/CT in Patients with Non–Small Cell Lung Carcinoma (RTEP5 Study)
- Author
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Romain Modzelewski, Mathieu Salaün, Fabrice Denis, Naji Salem, Pierre Bohn, Jean-Pierre Muratet, Pierre Olivier, Sophie Guillemard, Nicolas Aide, Enrique Chajon, Laurent Vervueren, Pierre Vera, Alina Berriolo Riedinger, Claire Houzard, Marie Lacombe, Françoise Mornex, Etienne Martin, Maximilien Vermandel, Nathalie Charrier, P.O. Kotzki, Frédéric Courbon, Anne Devillers, Véronique Beckendorf, S. Danhier, Carole Massabeau, Marc-André Mahé, Eric Dansin, P. Boisselier, Philippe Chaumet-Riffaud, Philippe Fernandez, Sébastien Thureau, Amaury Paumier, Marie-Pierre Farcy Jacquet, Hélène Kolesnikov-Gauthier, Amandine Pallardy, Sébastien Hapdey, Bernard Dubray, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-CRLCC Henri Becquerel, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de Biophysique et de Médecine Nucléaire, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Therapies Interventionnelles Assistees Par l'Image et la Simulation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Service de Médecine Nucléaire [Nantes], Hôpital Laennec, CRLCC René Gauducheau, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de médecine nucléaire [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Lab-STICC_UBO_CACS_MOCS, Université de Brest (UBO)-Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Centre Alexis Vautrin (CAV), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), CRLCC Eugène Marquis (CRLCC), Département de médecine nucléaire [Rennes], Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Centre Jean Bernard (ILC Le Mans), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), UNICANCER-Université Lille Nord de France (COMUE), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches en Cancérologie de Toulouse (CRCT), Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Cancérologie du GARD ICG - CHU Nîmes (Instit Cancéro - GARD), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CRLCC Paul Papin, Centre des Sciences de la Terre, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Département de radiothérapie et de physique médicale, CRLCC Henri Becquerel, Département de Radiothérapie, Centre René Gauducheau-Institut de Cancérologie de l'Ouest (ICO)-Centre de Lutte Contre le Cancer Nantes Atlantique 'René Gauducheau' (CLCC), Institut de cancérologie de l'Ouest - Nantes (ICO Nantes), CRLCC Paul Papin-CRLCC René Gauducheau, CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse (CRLC François Baclesse ), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Radiation oncologie, CGFL, Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Department of Radiation Oncology, Centre Hospitalier Universitaire Lyon Sud, Pierre Benite, France
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Misonidazole ,positron emission tomography ,medicine.medical_treatment ,Phases of clinical research ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Carcinoma ,medicine ,Radiology, Nuclear Medicine and imaging ,fluoro-deoxy-D-glucose ,Lung cancer ,Survival rate ,Radiation oncologist ,Pneumonitis ,f-misonidasole ,business.industry ,hypoxia ,medicine.disease ,3. Good health ,radiotherapy dose ,Radiation therapy ,lung cancer ,chemistry ,030220 oncology & carcinogenesis ,business ,Nuclear medicine - Abstract
International audience; See an invited perspective on this article on page 1043.This multicenter phase II study investigated a selective radiotherapy dose increase to tumor areas with significant (18)F-misonidazole ((18)F-FMISO) uptake in patients with non-small cell lung carcinoma (NSCLC). Methods: Eligible patients had locally advanced NSCLC and no contraindication to concomitant chemoradiotherapy. The (18)F-FMISO uptake on PET/CT was assessed by trained experts. If there was no uptake, 66 Gy were delivered. In (18)F-FMISO-positive patients, the contours of the hypoxic area were transferred to the radiation oncologist. It was necessary for the radiotherapy dose to be as high as possible while fulfilling dose-limiting constraints for the spinal cord and lungs. The primary endpoint was tumor response (complete response plus partial response) at 3 mo. The secondary endpoints were toxicity, disease-free survival (DFS), and overall survival at 1 y. The target sample size was set to demonstrate a response rate of 40% or more (bilateral α = 0.05, power 1-β = 0.95). Results: Seventy-nine patients were preincluded, 54 were included, and 34 were (18)F-FMISO-positive, 24 of whom received escalated doses of up to 86 Gy. The response rate at 3 mo was 31 of 54 (57%; 95% confidence interval [CI], 43%-71%) using RECIST 1.1 (17/34 responders in the (18)F-FMISO-positive group). DFS and overall survival at 1 y were 0.86 (95% CI, 0.77-0.96) and 0.63 (95% CI, 0.49-0.74), respectively. DFS was longer in the (18)F-FMISO-negative patients (P = 0.004). The radiotherapy dose was not associated with DFS when adjusting for the (18)F-FMISO status. One toxic death (66 Gy) and 1 case of grade 4 pneumonitis (>66 Gy) were reported. Conclusion: Our approach results in a response rate of 40% or more, with acceptable toxicity. (18)F-FMISO uptake in NSCLC patients is strongly associated with poor prognosis features that could not be reversed by radiotherapy doses up to 86 Gy.
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- 2017
33. Interim PET in Hodgkin Lymphoma: Is It So Useless?
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Olivier Casasnovas, Anne-Ségolène Cottereau, Salim Kanoun, Bénédicte Deau, Michel Meignan, and Alina Berriolo-Riedinger
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medicine.medical_specialty ,Clinical Trials as Topic ,business.industry ,Interim pet ,Hodgkin Disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,medicine ,Hodgkin lymphoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,030215 immunology - Published
- 2017
34. Usual and unusual pitfalls of 18F-FDG-PET/CT in lymphoma after treatment: a pictorial review
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Loïc Djaileb, Alina Berriolo-Riedinger, Juliette Bozzetto, Francesco Giammarile, Michel Meignan, Julien Leenhardt, Andrea Skanjeti, Gilles Salles, Jeremie Tordo, Julien Dubreuil, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Archéologie, Terre, Histoire, Sociétés [Dijon] ( ARTeHiS ), Ministère de la Culture et de la Communication ( MCC ) -Université de Bourgogne ( UB ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), and Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 )
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medicine.medical_specialty ,Pathology ,Standard of care ,Lymphoma ,Computed tomography ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[ SDV.CAN ] Life Sciences [q-bio]/Cancer ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,immune system diseases ,Positron Emission Tomography Computed Tomography ,hemic and lymphatic diseases ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,3. Good health ,030220 oncology & carcinogenesis ,Hodgkin lymphoma ,Fdg pet ct ,Radiology ,Treatment decision making ,business ,Diffuse large B-cell lymphoma ,After treatment - Abstract
International audience; Fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) is now a standard of care in initial staging and treatment evaluation of lymphomas. It is also used in the interim evaluation in diffuse large B cell lymphoma and Hodgkin lymphoma. However, several pitfalls may occur during or after treatment, because of the nonspecificity of F-FDG for lymphoma disease and treatment as immunotherapy, thus possibly induces misinterpretation and wrong treatment decision. The aim of this pictorial review is to provide an illustrated tutorial of the most frequent pitfalls found on F-FDG-PET/CT during or after treatment.
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- 2017
35. Phase II Study of a Radiotherapy Total Dose Increase in Hypoxic Lesions Identified by
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Pierre, Vera, Sébastien, Thureau, Philippe, Chaumet-Riffaud, Romain, Modzelewski, Pierre, Bohn, Maximilien, Vermandel, Sébastien, Hapdey, Amandine, Pallardy, Marc-André, Mahé, Marie, Lacombe, Pierre, Boisselier, Sophie, Guillemard, Pierre, Olivier, Veronique, Beckendorf, Naji, Salem, Nathalie, Charrier, Enrique, Chajon, Anne, Devillers, Nicolas, Aide, Serge, Danhier, Fabrice, Denis, Jean-Pierre, Muratet, Etienne, Martin, Alina Berriolo, Riedinger, Helène, Kolesnikov-Gauthier, Eric, Dansin, Carole, Massabeau, Fredéric, Courbon, Marie-Pierre, Farcy Jacquet, Pierre-Olivier, Kotzki, Claire, Houzard, Francoise, Mornex, Laurent, Vervueren, Amaury, Paumier, Philippe, Fernandez, Mathieu, Salaun, and Bernard, Dubray
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Male ,Observer Variation ,Lung Neoplasms ,Reproducibility of Results ,Middle Aged ,Sensitivity and Specificity ,Survival Rate ,Treatment Outcome ,Carcinoma, Non-Small-Cell Lung ,Humans ,Tumor Hypoxia ,Female ,Dose Fractionation, Radiation ,France ,Misonidazole ,Radiopharmaceuticals - Abstract
See an invited perspective on this article on page 1043.This multicenter phase II study investigated a selective radiotherapy dose increase to tumor areas with significant
- Published
- 2016
36. 18F-FDG PET-Derived Tumor Blood Flow Changes After 1 Cycle of Neoadjuvant Chemotherapy Predicts Outcome in Triple-Negative Breast Cancer
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Jean-Marc Riedinger, Olivier Humbert, Alexandre Cochet, Michel Toubeau, S. Tisserand, Alina Berriolo-Riedinger, Edouard Depardon, François Brunotte, Salim Kanoun, Jean-Marc Vrigneaud, Inna Dygai-Cochet, Maud Lassere, Pierre Fumoleau, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Médecine Nucléaire, UNICANCER-UNICANCER, Département de Biologie et pathologie des tumeurs [Centre Georges-François Leclerc], Service de radiologie et d'Imagerie médicale diagnostique et thérapeutique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -Centre National de la Recherche Scientifique ( CNRS ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon )
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Oncology ,medicine.medical_specialty ,Prognostic-Factors ,Bevacizumab ,Survival ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,medicine.medical_treatment ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,perfusion ,[ SDV.IB.MN ] Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,breast cancer ,Internal medicine ,Medicine ,blood flow ,Radiology, Nuclear Medicine and imaging ,[ SDV.IB ] Life Sciences [q-bio]/Bioengineering ,Tomography ,[ SDV.IB.IMA ] Life Sciences [q-bio]/Bioengineering/Imaging ,Neoadjuvant therapy ,Triple-negative breast cancer ,Subtypes ,Markers ,Chemotherapy ,triple-negative ,medicine.diagnostic_test ,business.industry ,Triple Negative Breast Neoplasms ,medicine.disease ,3. Good health ,PET ,Metabolism ,Positron emission tomography ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Pathological Response ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Angiogenesis ,Therapy ,business ,medicine.drug - Abstract
International audience; Previous studies have suggested that early changes in blood flow (BF) in response to neoadjuvant chemotherapy and evaluated with 150-water are a surrogate biomarker of outcome in women with breast cancer. This study investigates, in the triple-negative breast cancer subtype, the prognostic relevance of tumor BF changes (Delta BF) in response to chemotherapy, assessed using a short dynamic F-18-FDG PET acquisition. Methods: Forty-six consecutive women with triple-negative breast cancer and an indication for neoadjuvant chemotherapy were prospectively included. Women benefited from a baseline F-18-FDG PET examination with a 2-min chest-centered dynamic acquisition, started at the time of F-18-FDG injection. Breast tumor perfusion was calculated from this short dynamic image using a first-pass model. This dynamic PET acquisition was repeated after the first cycle of chemotherapy to measure early Delta BF. Delayed static PET acquisitions were also performed (90 min after F-18-FDG injection) to measure changes in tumor glucose metabolism (Delta SUVmax). The association between tumor BF, clinicopathologic characteristics, and patients' overall survival (OS) was evaluated. Results: Median baseline tumor BF was 21 mL/min/100 g (range, 6-46 mL/min/100 g) and did not significantly differ according to tumor size, Scarf-Bloom-Richardson grade, or Ki-67 expression. Median tumor Delta BF was-30%, with highly scattered values (range, -93% to +118%). A weak correlation was observed between Delta BF and Delta SUVmax (r = +0.40, P = 0.01). The median follow-up was 30 mo (range, 6-73 mo). Eight women developed recurrent disease, 7 of whom died. Low OS was associated with menopausal history (P = 0.03), persistent or increased tumor vascularization on the interim PET (6.13F cutoff =-30%; P = 0.03), non-breast-conserving surgery (P = 0.04), and the absence of a pathologic complete response (pCR) (P = 0.01). Delta BF and pCR provided incremental prognostic stratification: 3-y OS was 100% in pCR women, 87% in no-pCR women but achieving an early tumor BF response, and only 48% in no-pCR/no-BF-response women (Delta BF cutoff = -30%, P < 0.001). Conclusion: This study suggests the clinical usefulness of an early user- and patient-friendly 2-min dynamic acquisition to monitor breast tumor Delta BF to neoadjuvant chemotherapy using F-18-FDG PET/CT. Monitoring tumor perfusion and angiogenesis response to treatment seems to be a promising target for PET tracers.
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- 2016
37. PET-guided, BEACOPPescalated therapy in advanced Hodgkin lymphoma – Authors' reply
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Julien Lazarovici, Alina Berriolo-Riedinger, Reda Bouabdallah, Luc-Matthieu Fornecker, Pauline Brice, Hervé Ghesquières, René-Olivier Casasnovas, Marc André, Michel Meignan, and Aspasia Stamatoullas
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Vincristine ,medicine.medical_specialty ,Cyclophosphamide ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Procarbazine ,Text mining ,Oncology ,Positron emission tomography ,medicine ,Hodgkin lymphoma ,Radiology ,business ,medicine.drug - Published
- 2019
38. A New Simplified Prognostic Index Integrating the Type of Extra-Nodal Involvement and Age for Ann Arbor Stage IV Hodgkin Lymphoma Patients Diagnosed at TEP-Scanner Era: A Retrospective Analysis from Lymphoma Study Association (LYSA) Centers
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Florence Broussais-Guillaumot, Violaine Safar, Laure Lebras, Emmanuelle Ferrant, Jeremie Tordo, Alexandra Traverse-Glehen, Jean-Noël Bastie, Rene-Olivier Casasnovas, Laurent Martin, Lionel Karlin, Souad Assaad, Nicolas Vantard, Anne Lazareth, Alina Berriolo-Riedinger, Pierre Sesques, Dana Ghergus, Bertrand Favier, Clémentine Sarkozy, Gilles Salles, Delphine Maucort-Boulch, Hervé Ghesquières, Emmanuelle Nicolas-Virelizier, Camille Golfier, Philippe Rey, Emmanuel Bachy, and Cédric Rossi
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education.field_of_study ,medicine.medical_specialty ,business.industry ,Immunology ,Population ,Cell Biology ,Hematology ,medicine.disease ,Biochemistry ,Stage IV Hodgkin Lymphoma ,Lymphoma ,Prognostic score ,International Prognostic Index ,Nodular sclerosis ,Internal medicine ,Retrospective analysis ,Medicine ,Extra nodal ,business ,education - Abstract
Purpose International Prognostic Index (IPS) is the most widely used risk stratification index for advanced stage Hodgkin's lymphoma (HL). The use of (18F)-fluorodeoxyglucose PET/CT at diagnosis allows a better characterization of extra-nodal involvement (ENI). We investigated if the type of ENI could affect the prognosis of stage IV HL patients diagnosed with PET/CT and if a specific prognostic index could be defined for these patients (pts). Patients and methods We retrospectively analyzed 220 stage IV HL patients treated from 2005 to 2015 in three LYSA centers. We considered the local investigator interpretation based on the nuclear medicine physician PET/CT report. Regarding ENI, six subgroups were identified: involvement of lung and/or pericard and/or pleural, liver, diffuse and/or focal bone involvement, digestive system, and other involvements; we also considered bone marrow involvement based on the results of bone marrow biopsy. The main outcome was event free survival (EFS) defined by relapse, progression, death from any cause and initiation of a new therapy. For prognostication, we first evaluated the six variables of IPS-6 (corresponding to IPS without "stage IV" item) in this population. ENI was tested adjusted on the retained IPS variables. Univariate and multivariate Cox models were used to assess their prognostic ability for EFS. Cross-validation (10-fold) was used to select the more robust variables avoiding optimism. The finally selected variables constituted a score that was tested on overall survival (OS). Results Among the 220 stage IV patients, 135 (61%) were male. Median age was 33 years (range, 16-86) and 72 pts (33%) were ≥45 years. 130 pts (59%) presented constitutional symptoms. Nodular sclerosis subtype was observed in 163 pts (74%), mixed cellularity subtype in 25 pts (11%) and 47/157 pts (30%) presented EBV-positive HL. For biological parameters of IPS, 158 pts (80%) had low albumin level 15G/L in 42pts (19%) and lymphocyte count Conclusions: For stage IV HL defined by PET/CT, we developed a simple prognostic score based on age (≥45y) and liver involvement that identify a subgroup of patients with a poor outcome. These findings need to be validated in independent cohorts. Based on these results, whether HL pathogenesis differs by ENI sites should be investigated. Disclosures Bachy: Celgene: Membership on an entity's Board of Directors or advisory committees; Takeda: Research Funding; Beigene: Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria; Amgen: Honoraria. Karlin:Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel support; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel support. Sarkozy:ROCHE: Consultancy. Traverse-Glehen:Takeda: Research Funding; Astra Zeneca: Other: Travel. Salles:F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding; Servier: Honoraria, Other: Advisory Board; Novartis: Consultancy, Honoraria; BMS: Honoraria, Other: Advisory Board; Morphosys: Honoraria; Janssen: Honoraria, Other: Advisory Board; Abbvie: Honoraria; Pfizer: Honoraria; Amgen: Honoraria; Celgene: Honoraria, Other: Advisory Board, Research Funding; Epizyme: Honoraria; Gilead: Honoraria, Other: Advisory Board; Acerta: Honoraria; Merck: Honoraria; Servier: Honoraria; Takeda: Honoraria. Casasnovas:Takeda: Consultancy; Gilead: Consultancy, Research Funding; AbbVie: Consultancy; Roche: Consultancy, Research Funding; Bristol-Meyers Squibb: Consultancy; Merck: Consultancy. Ghesquieres:Celgene: Consultancy; Gilead: Consultancy; Sanofi: Consultancy.
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- 2018
39. Interobserver Agreement of Qualitative Analysis and Tumor Delineation of 18F-Fluoromisonidazole and 3′-Deoxy-3′-18F-Fluorothymidine PET Images in Lung Cancer
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Nicolas Aide, Claire Houzard, Jean Marc Caignon, Isabelle Brenot-Rossi, Romain Modzelewski, Eric Gremillet, Florent Cachin, Bernard Dubray, Alina Berriolo-Riedinger, B. Bridji, Philippe Chaumet-Riffaud, Laurent Tessonnier, Anne Devillers, Hélène Kolesnikov-Gauthier, Laurent Collombier, Philippe Fernandez, Pierre Vera, Pierre Olivier, Frédéric Courbon, Laurent Vervueren, Julie Roux, Oleg Blagosklonov, Sébastien Thureau, and Kaya Doyeux
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Adult ,Male ,Pathology ,medicine.medical_specialty ,18F-Fluoromisonidazole ,Lung Neoplasms ,medicine.medical_treatment ,Standardized uptake value ,Sensitivity and Specificity ,Qualitative analysis ,Fluorodeoxyglucose F18 ,Carcinoma, Non-Small-Cell Lung ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Misonidazole ,Lung cancer ,Aged ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Middle Aged ,Image Enhancement ,medicine.disease ,Dideoxynucleosides ,Tumor Burden ,Intensity (physics) ,Radiation therapy ,18f fluorothymidine ,Positron emission tomography ,Positron-Emission Tomography ,Female ,Radiopharmaceuticals ,business ,Nuclear medicine ,Algorithms - Abstract
As the preparation phase of a multicenter clinical trial using (18)F-fluoro-2-deoxy-d-glucose ((18)F-FDG), (18)F-fluoromisonidazole ((18)F-FMISO), and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) in non-small cell lung cancer (NSCLC) patients, we investigated whether 18 nuclear medicine centers would score tracer uptake intensity similarly and define hypoxic and proliferative volumes for 1 patient and we compared different segmentation methods.Ten (18)F-FDG, ten (18)F-FMISO, and ten (18)F-FLT PET/CT examinations were performed before and during curative-intent radiotherapy in 5 patients with NSCLC. The gold standards for uptake intensity and volume delineation were defined by experts. The between-center agreement (18 nuclear medicine departments connected with a dedicated network, SFMN-net [French Society of Nuclear Medicine]) in the scoring of uptake intensity (5-level scale, then divided into 2 levels: 0, normal; 1, abnormal) was quantified by κ-coefficients (κ). The volumes defined by different physicians were compared by overlap and κ. The uptake areas were delineated with 22 different methods of segmentation, based on fixed or adaptive thresholds of standardized uptake value (SUV).For uptake intensity, the κ values between centers were, respectively, 0.59 for (18)F-FDG, 0.43 for (18)F-FMISO, and 0.44 for (18)F-FLT using the 5-level scale; the values were 0.81 for (18)F-FDG and 0.77 for both (18)F-FMISO and (18)F-FLT using the 2-level scale. The mean overlap and mean κ between observers were 0.13 and 0.19, respectively, for (18)F-FMISO and 0.2 and 0.3, respectively, for (18)F-FLT. The segmentation methods yielded significantly different volumes for (18)F-FMISO and (18)F-FLT (P0.001). In comparison with physicians, the best method found was 1.5 × maximum SUV (SUVmax) of the aorta for (18)F-FMISO and 1.3 × SUVmax of the muscle for (18)F-FLT. The methods using the SUV of 1.4 and the method using 1.5 × the SUVmax of the aorta could be used for (18)F-FMISO and (18)F-FLT. Moreover, for (18)F-FLT, 2 other methods (adaptive threshold based on 1.5 or 1.6 × muscle SUVmax) could be used.The reproducibility of the visual analyses of (18)F-FMISO and (18)F-FLT PET/CT images was demonstrated using a 2-level scale across 18 centers, but the interobserver agreement was low for the (18)F-FMISO and (18)F-FLT volume measurements. Our data support the use of a fixed threshold (1.4) or an adaptive threshold using the aorta background to delineate the volume of increased (18)F-FMISO or (18)F-FLT uptake. With respect to the low tumor-on-background ratio of these tracers, we suggest the use of a fixed threshold (1.4).
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- 2013
40. An international confirmatory study of the prognostic value of early PET/CT in diffuse large B-cell lymphoma: comparison between Deauville criteria and ΔSUVmax
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Hervé Tilly, Rene-Olivier Casasnovas, Amanda F. Cashen, Alberto Biggi, Alina Berriolo-Riedinger, Andrea Gallamini, Barry A. Siegel, Pierre Vera, Emmanuel Itti, Michel Meignan, and Corinne Haioun
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Adult ,Male ,medicine.medical_specialty ,Interobserver reproducibility ,Newly diagnosed ,Multimodal Imaging ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Predictive Value of Tests ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Observer Variation ,PET-CT ,Reproducibility ,Kappa value ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Interim pet ,Regimen ,Data Interpretation, Statistical ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Female ,Lymphoma, Large B-Cell, Diffuse ,Radiology ,Radiopharmaceuticals ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Diffuse large B-cell lymphoma ,Follow-Up Studies - Abstract
The role of interim PET/CT in guiding therapeutic strategies in diffuse large B-cell lymphoma (DLBCL) is debated, mainly because interpretation rules vary among centres. This study aimed to explore the reproducibility and confirm the prognostic value of early PET/CT using the Deauville criteria and ΔSUVmax. This international confirmatory study retrospectively evaluated 114 patients with newly diagnosed DLBCL treated with a rituximab-containing regimen. All patients underwent 18F-FDG PET/CT at baseline (PET0) and after two cycles (PET2), with no therapy change based on the latter. Scans were interpreted by three observers using the Deauville five-point scale and ΔSUVmax between PET0 and PET2 was calculated. Interpretations were evaluated for interobserver agreement and for progression-free survival (PFS) prediction. Median follow-up was 39 months. Early PET/CT was predictive of outcome when interpreted with the Deauville criteria and ΔSUVmax. Using the five-point scale, the overall kappa value was 0.66 with the reference background set in the liver (score ≥4) and interobserver agreement was even better using a 66 % ΔSUVmax cut-off (κ = 0.83). Moreover, the prognostic value of interim PET was slightly inferior when using a Deauville score ≥4 than when using a 66 % ΔSUVmax cut-off: for the Deauville score the 3-year PFS estimate was 59 % (45–73 %) in PET2-positive patients vs. 81 % (71–91 %) in PET2-negative patients (P = 0.003); for the 66 % ΔSUVmax cut-off the 3-year PFS estimate was 44 % (23–65 %) in PET2-positive patients vs. 79 % (70–88 %) in PET2-negative patients (P = 0.0002). Although the Deauville criteria are valid for assessing the prognostic value of early PET/CT in DLBCL, computation of the ΔSUVmax leads to better performance and interobserver reproducibility, and should be preferred when a baseline scan is available.
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- 2013
41. Impact of [18F]Fluorodeoxyglucose Positron Emission Tomography Response Evaluation in Patients With High–Tumor Burden Follicular Lymphoma Treated With Immunochemotherapy: A Prospective Study From the Groupe d'Etudes des Lymphomes de l'Adulte and GOELAMS
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Hervé Tilly, Rene-Olivier Casasnovas, Luc Xerri, Jehan Dupuis, Alina Berriolo-Riedinger, Gaetano Paone, Nathalie Berenger, Pierre Soubeyran, Gilles Salles, Philippe Colombat, Pierre Feugier, Andrea Gallamini, Pauline Brice, Christelle Tychyj-Pinel, Anne Julian, Corinne Haioun, Pierre Vera, Michel Meignan, Guy Laurent, and Nicolas Mounier
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Adult ,Male ,Cancer Research ,Vincristine ,Cyclophosphamide ,Follicular lymphoma ,Aggressive lymphoma ,Antibodies, Monoclonal, Murine-Derived ,Fluorodeoxyglucose F18 ,Prednisone ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Prospective Studies ,Lymphoma, Follicular ,Aged ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Lymphoma ,Treatment Outcome ,Oncology ,Doxorubicin ,Positron emission tomography ,Positron-Emission Tomography ,Female ,Rituximab ,Nuclear medicine ,business ,medicine.drug - Abstract
Purpose [18F]Fluorodeoxyglucose positron emission tomography (PET) is widely used for the staging and restaging of patients with aggressive lymphoma, but less is known about the utility of PET in patients with follicular lymphoma (FL). In a prospective study, we evaluated the prognostic value of PET performed during treatment and at the end of treatment in 121 patients with FL treated with first-line immunochemotherapy. Patients and Methods Patients with previously untreated high–tumor burden FL were treated with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) plus two cycles of rituximab, without rituximab maintenance. PET was performed before treatment, after four cycles of R-CHOP (interim PET), and at the end of treatment (final PET). PET scans were centrally reviewed. Results The total number of patients included was 121. Median age was 57 years. After central review, interim PET (n = 111) was negative in 76% of patients, and final PET (n = 106) was negative in 78%. With a median follow-up of 23 months, 2-year progression-free survival rates were 86% for interim PET–negative versus 61% for interim PET–positive patients (P = .0046) and 87% for final PET–negative versus 51% for final PET–positive patients (P < .001), respectively. Two-year overall survival also significantly differed according to final PET results: 100% versus 88% (P = .0128). Conclusion PET performed either after four cycles of R-CHOP or at the end of therapy was strongly predictive of outcome in this prospective study. Therapeutic intervention based on PET results during or after inductive treatment should be evaluated.
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- 2012
42. Valeur pronostique de la TEP au 18F-FDG dans le bilan d’extension initial du cancer de l’œsophage traité par radiochimiothérapie exclusive
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François Brunotte, Gilles Créhange, Olivier Humbert, M. Gauthier, Alexandre Cochet, Michel Toubeau, Inna Dygai-Cochet, and Alina Berriolo-Riedinger
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Radiological and Ultrasound Technology ,Biophysics ,Radiology, Nuclear Medicine and imaging - Abstract
Resume L’objectif de cette etude retrospective a ete d’evaluer la valeur pronostique de la TEP au FDG realisee initialement pour des patients presentant un cancer de l’œsophage traite par radiochimiotherapie exclusive. Vingt-neuf patients suivis pour un cancer de l’œsophage de diagnostic recent ont ete inclus. Une TEP au FDG a ete realisee dans le cadre du bilan d’extension initial, avant radiochimiotherapie exclusive. La standardised uptake value maximale (SUVmax) de la neoplasie primitive a ete mesuree et la presence d’une ou plusieurs adenopathies hypermetaboliques a ete notee. Le volume et la hauteur de la lesion tumorale primitive ont ete mesures sur la TEP en utilisant deux seuils differents de SUV pour delimiter la tumeur : SUV = 2,5 et SUV = 40 % du SUVmax. Le suivi median a ete de 35 mois (IC 95 % = 26–41 mois). Treize patients (45 %) etaient decedes au moment du dernier suivi. L’analyse univariee (modele de Cox) a montre qu’un SUVmax superieur a 9,5 (HR = 4,57, p = 0,022) et la presence d’une ou plusieurs adenopathies hypermetaboliques (HR = 3,64, p = 0,029) sont deux facteurs pronostiques pejoratifs de la survie globale. Il n’a pas ete montre de valeur pronostique de l’âge, du sexe des patients, du type anatomopathologique, du stade clinique, du volume et de la hauteur de l’hypermetabolisme tumoral evalues par la TEP au FDG. Une analyse multivariee n’a pu etre realisee du fait du trop faible nombre d’evenements. Cette etude retrospective montre que la TEP au FDG apporte des informations pronostiques precoces pour les cancers de l’œsophage traites par radiochimiotherapie exclusive.
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- 2011
43. Randomized phase III study comparing an early PET driven treatment de-escalation to a not PET-monitored strategy in patients with advanced stages Hodgkin lymphoma: Final analysis of the AHL2011 LYSA study
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Veronique Edeline, Pierre Feugier, Nicolas Mounier, Kamal Bouabdallah, Marc André, Bertrand Joly, Alexandra Traverse-Glehen, Reda Bouabdallah, Oumedaly Reman, Gilles Salles, Franck Morschhauser, Olivier Casasnovas, Emmanuelle Nicolas-Virelizier, Alina Berriolo-Riedinger, Pauline Brice, Richard Delarue, Michel Meignan, Jehan Dupuis, Aspasia Stamatoulas, and Thomas Gastinne
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Oncology ,BEACOPP ,Cancer Research ,medicine.medical_specialty ,Secondary leukemia ,business.industry ,medicine.medical_treatment ,Advanced stage ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Hematological toxicity ,ABVD ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Hodgkin lymphoma ,In patient ,business ,De-escalation ,medicine.drug - Abstract
7503Background: Escalated BEACOPP (BEA) improves PFS but not OS in pts with advanced HL compared to ABVD and is associated to a higher risk of hematological toxicity, secondary leukemia and inferti...
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- 2018
44. Place de l’imagerie dans l’évaluation de l’efficacité des traitements dans le cancer du sein
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François Brunotte, Michel Toubeau, Inna Dygai-Cochet, Alina Berriolo-Riedinger, J.M. Riedinger, and Alexandre Cochet
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Gynecology ,Light nucleus ,medicine.medical_specialty ,Optical imaging ,Radiological and Ultrasound Technology ,Neoadjuvant treatment ,Philosophy ,Biophysics ,medicine ,Radiology, Nuclear Medicine and imaging ,Human Epidermal Growth Factor Receptor 2 - Abstract
Resume Cette revue decrit le role de differentes methodes d’imagerie pour evaluer la reponse au traitement dans le cancer du sein. Deux situations sont envisageables : celle de la chimiotherapie neoadjuvante du cancer du sein et celle des metastases. Beaucoup de donnees cliniques sont disponibles pour trois criteres : le volume de la tumeur, la captation du fluorodeoxyglucose mesuree en TEP et la perfusion de la tumeur evaluee soit par IRM dynamique, soit en TEP. La TEP au 2-18F fluoro-2-desoxy-D-glucose (FDG) permet la prediction de la reponse apres une ou deux cures de chimiotherapie. De nouvelles approches pourraient prochainement affiner le role de l’imagerie. Ainsi, la TEP a la thymidine est prometteuse dans l’evaluation de la proliferation tissulaire. Les analogues des œstrogenes pourraient etre utilises pour predire la reponse au traitement du cancer du sein hormonosensible. Beaucoup d’autres approches, quoique encore moins developpees, pourraient apporter de nouvelles perspectives, comme la spectroscopie de resonance magnetique ou l’imagerie optique de l’oxygenation de l’hemoglobine. L’imagerie offre egalement un potentiel de suivi des effets des traitements sur les recepteurs membranaires : le recepteur le plus etudie dans les modeles precliniques a ete le recepteur 2 du facteur de croissance epidermique humain (HER2). Les integrines, une famille de recepteurs d’adherence cellulaire, sont egalement une cible potentiellement importante pour l’imagerie. L’apoptose, la multiresistance et l’hypoxie peuvent aussi etre etudiees en utilisant des biomarqueurs appropries. Afin de permettre les essais multicentriques fiables de nouveaux medicaments, ces differentes approches d’imagerie ont encore besoin d’une amelioration de la normalisation de l’acquisition et du traitement des images.
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- 2010
45. Images pseudoplanaires issues des tomographies pulmonaires : étude de la reproductibilité de lecture et comparaison aux images planaires
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Alexandre Cochet, Inna Dygai-Cochet, R. Ciappuccini, Michel Toubeau, François Brunotte, C. Boichot, Claude Touzery, and Alina Berriolo-Riedinger
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Radiological and Ultrasound Technology ,Biophysics ,Radiology, Nuclear Medicine and imaging - Abstract
Resume Objectifs Il est difficile, pour des raisons de duree d’acquisition, d’obtenir a la fois des tomoscintigraphies et des images planaires des poumons au cours des examens de ventilation et perfusion. Une solution retenue est d’additionner des projections afin d’obtenir des images pseudoplanaires. Le but de ce travail est de comparer ces images aux images planaires classiques en termes de classe de probabilite et de reproductibilite de lecture. Materiels et methodes Trente-quatre patients non consecutifs adresses pour suspicion d’embolie pulmonaire ont beneficie d’une scintigraphie pulmonaire de ventilation et de perfusion a l’aide d’une camera double tete. Chaque scintigraphie a ete acquise en mode planaire et en mode tomographique. Huit images pseudoplanaires ont ete generees par addition de trois projections consecutives. Deux medecins ont relu deux fois chaque examen anonyme et ont cote la probabilite d’embolie pulmonaire, selon les criteres de PIOPED modifies mais en l’absence de radiographie de thorax. Resultats La reproductibilite de lecture intraobservateur des images pseudoplanaires est bonne pour les deux lecteurs (κw = 0,69 et 0,78) et similaire a la reproductibilite de lecture des images planaires. La reproductibilite interobservateur (κw = 0,63) est egalement bonne. Il existe une bonne concordance des resultats obtenus a partir des deux modalites. Conclusions Les images pseudoplanaires presentent une bonne reproductibilite de lecture intra- et interobservateur et permettent d’obtenir, dans notre population, des resultats comparables aux images planaires conventionnelles en termes de probabilite d’embolie pulmonaire.
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- 2009
46. Identification of Biomarkers Including 18FDG-PET/CT for Early Prediction of Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer
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Alexandre Cochet, Alina Berriolo-Riedinger, François Brunotte, Isabelle Desmoulins, Salim Kanoun, Olivier Humbert, Jean-Marc Riedinger, Pierre Fumoleau, Céline Charon-Barra, Véronique Lorgis, and Charles Coutant
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Oncology ,Adult ,Cancer Research ,medicine.medical_specialty ,Pathology ,Proliferation index ,medicine.medical_treatment ,Biopsy ,Triple Negative Breast Neoplasms ,Breast cancer ,Fluorodeoxyglucose F18 ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Biomarkers, Tumor ,Humans ,Epidermal growth factor receptor ,Triple-negative breast cancer ,Neoadjuvant therapy ,Aged ,Neoplasm Staging ,Chemotherapy ,medicine.diagnostic_test ,biology ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Neoadjuvant Therapy ,Tumor Burden ,Glucose ,Treatment Outcome ,ROC Curve ,Lymphatic Metastasis ,Positron-Emission Tomography ,biology.protein ,Female ,Neoplasm Grading ,business ,Tomography, X-Ray Computed ,Biomarkers - Abstract
Purpose: To investigate the value of the metabolic tumor response assessed with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinicobiologic markers to predict pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in women with triple-negative breast cancer (TNBC). Experimental Design: Fifty consecutive women with TNBC and an indication for NAC were prospectively included. Different pretreatment clinical, biologic, and pathologic biomarkers, including SBR grade, the Ki-67 proliferation index, androgen receptor expression, EGF receptor (EGFR), and cytokeratin 5/6 staining, were assessed. Tumor glucose metabolism at baseline and its change after the first cycle of NAC (ΔSUVmax) were assessed using FDG-PET. Results: The pCR rate was 42%. High Ki-67 proliferation index (P = 0.016), negative EGFR status (P = 0.042), and high ΔSUVmax (P = 0.002) were significantly associated with pCR. In multivariate logistic regression, both negative EGFR status (OR, 6.4; P = 0.043) and high ΔSUVmax (OR, 7.1; P = 0.014) were independent predictors of pCR. Using a threshold at −50%, tumor ΔSUVmax predicted pCR with a negative, a positive predictive value, and an accuracy of 79%, 70%, and 75%, respectively. Combining a low ΔSUVmax and positive EGFR status could predict non-pCR with an accuracy of 92%. Conclusions: It is important to define the chemosensitivity of TNBC to NAC early. Combining EGFR status and the metabolic response assessed with FDG-PET can help the physician to early predict the probability of achieving pCR or not. Given these results, the interest of response-guided tailoring of the chemotherapy might be tested in multicenter trials. Clin Cancer Res; 21(24); 5460–8. ©2015 AACR.
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- 2015
47. Role of Positron Emission Tomography for the Monitoring of Response to Therapy in Breast Cancer
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Salim Kanoun, Alexandre Cochet, Olivier Humbert, Bruno Coudert, Pierre Fumoleau, François Brunotte, Alina Berriolo-Riedinger, Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Service de Médecine Nucléaire, Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, UNICANCER, and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
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Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,Response to therapy ,Receptor, ErbB-2 ,medicine.medical_treatment ,Breast Neoplasms ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,Health outcomes ,Tumor response ,030218 nuclear medicine & medical imaging ,[ SDV.IB.MN ] Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Fluorodeoxyglucose F18 ,Internal medicine ,Breast Cancer ,Humans ,Medicine ,skin and connective tissue diseases ,ComputingMilieux_MISCELLANEOUS ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Tumor biology ,Cancer ,Prognosis ,medicine.disease ,3. Good health ,Radiography ,Positron emission tomography ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Female ,business - Abstract
This review considers the potential utility of positron emission tomography (PET) tracers in the setting of response monitoring in breast cancer, with a special emphasis on glucose metabolic changes assessed with 18F-fluorodeoxyglucose (FDG). In the neoadjuvant setting of breast cancer, the metabolic response can predict the final complete pathologic response after the first cycles of chemotherapy. Because tumor metabolic behavior highly depends on cancer subtype, studies are ongoing to define the optimal metabolic criteria of tumor response in each subtype. The recent multicentric randomized AVATAXHER trial has suggested, in the human epidermal growth factor 2-positive subtype, a clinical benefit of early tailoring the neoadjuvant treatment in women with poor metabolic response after the first course of treatment. In the bone-dominant metastatic setting, there is increasing clinical evidence that FDG-PET/computed tomography (CT) is the most accurate imaging modality for assessment of the tumor response to treatment when both metabolic information and morphologic information are considered. Nevertheless, there is a need to define standardized metabolic criteria of response, including the heterogeneity of response among metastases, and to evaluate the costs and health outcome of FDG-PET/CT compared with conventional imaging. New non-FDG radiotracers highlighting specific molecular hallmarks of breast cancer cells have recently emerged in preclinical and clinical studies. These biomarkers can take into account the heterogeneity of tumor biology in metastatic lesions. They may provide valuable clinical information for physicians to select and monitor the effectiveness of novel therapeutics targeting the same molecular pathways of breast tumor.
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- 2015
48. Use of [(18)F]-FDG PET to predict response to neoadjuvant trastuzumab and docetaxel in patients with HER2-positive breast cancer, and addition of bevacizumab to neoadjuvant trastuzumab and docetaxel in [(18)F]-FDG PET-predicted non-responders (AVATAXHER): an open-label, randomised phase 2 trial
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Alina Berriolo-Riedinger, Thomas Bachelot, David Coeffic, Jean-Briac Prevost, Juana Hernandez, Philippe Gabelle, Jean-Yves Pierga, Pierre-Francois Dupre, Laurent Arnould, Gilles Thibault, Kaldoun Kerrou, Philippe Bougnoux, Thierry Petit, Jean-Marc Ferrero, Gilles Paintaud, Bruno Coudert, Sylvia Giard, Marie-Ange Mouret-Reynier, Pierre Kerbrat, and Mathieu Coudert
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Oncology ,Adult ,medicine.medical_specialty ,Bevacizumab ,Receptor, ErbB-2 ,medicine.medical_treatment ,Population ,Breast Neoplasms ,Docetaxel ,Antibodies, Monoclonal, Humanized ,Breast cancer ,Fluorodeoxyglucose F18 ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Clinical endpoint ,Humans ,education ,Survival rate ,Neoadjuvant therapy ,Neoplasm Staging ,education.field_of_study ,business.industry ,Carcinoma, Ductal, Breast ,Middle Aged ,Trastuzumab ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Neoadjuvant Therapy ,Surgery ,Survival Rate ,Chemotherapy, Adjuvant ,Lymphatic Metastasis ,Positron-Emission Tomography ,Female ,Taxoids ,Neoplasm Grading ,Radiopharmaceuticals ,business ,Febrile neutropenia ,medicine.drug ,Follow-Up Studies - Abstract
Summary Background An effective and well tolerated treatment is needed for patients with early HER2-positive breast cancer who do not achieve a pathological complete response after neoadjuvant therapy. The AVATAXHER trial aimed to predict pathological complete response early with the use of PET and to investigate whether the addition of bevacizumab could improve the proportion of patients achieving a pathological complete response in patients unlikely to respond to treatment. Methods AVATAXHER was a randomised, open-label, non-comparative, multicentre phase 2 study that enrolled women (≥18 years of age) with early-stage HER2-positive breast cancer from 26 oncology centres in France. Patients initially received two cycles of neoadjuvant docetaxel (100 mg/m 2 intravenously every 3 weeks) plus trastuzumab (8 mg/kg intravenously every 3 weeks then 6 mg/kg intravenously every 3 weeks for the second course). Before the first and second cycles, [ 18 F]-fluorodeoxyglucose (FDG) PET was done and the change in standardised uptake value was used to predict pathological complete response in each patient. Patients who were predicted to be responders on PET continued to receive standard therapy. Predicted non-responders were randomly assigned (2:1) to receive four cycles of docetaxel (100 mg/m 2 intravenously every 3 weeks) and trastuzumab (6 mg/kg intravenously every 3 weeks) plus bevacizumab (15 mg/kg intravenously every 3 weeks; group A) or continue on docetaxel plus trastuzumab alone (group B). Randomisation was open label and was done by an adaptive minimisation method. Although investigators and patients were aware of group assignment, the anatomo-pathologist in charge of centralised review of surgical samples and lymph nodes was masked to treatment assignment. The primary endpoint was centrally assessed pathological complete response according to the Chevallier classification. Efficacy analyses were done in the intention-to-treat population. Safety analyses in this Article were done on all patients who received at least one dose of treatment starting from cycle 3. Survival outcomes are not yet mature. This study is registered with ClinicalTrials.gov (NCT01142778) and EUDRACT (2009-013410-26). Findings Between May 19, 2010, and Oct 1, 2012, 152 patients were recruited for the study. Ten patients were subsequently excluded, leaving 142 patients in the intention-to-treat population. Of these 142 patients, 69 were predicted by [ 18 F]-FDG PET to be treatment responders after two cycles of treatment. The 73 predicted non-responders were randomly assigned to group A (n=48) and group B (n=25). Pathological complete responses were noted in 37 (53·6%, 95% CI 41·2–65·7) of the PET responders, 21 (43·8%, 29·5–58·8) of those in group A, and six (24·0%, 9·4–45·1) of those in group B. Incidences of grade 3–4 adverse events were similar in all three groups. The most common grade 3–4 adverse events were neutropenia (four in PET responders, five in group A, and three in group B), febrile neutropenia (one, three, and one, respectively), and myalgia (four, none, and one, respectively). Overall, 24 serious adverse events were reported in 15 patients (PET responders: nine events in four [6%] of 67 patients; group A: 14 events in ten [21%] of 47 patients; group B: one event in one [4%] of 25 patients). No deaths occurred during the study. Interpretation In patients with HER2-positive breast cancer, early PET assessment can help to identify non-responders to neoadjuvant docetaxel plus trastuzumab therapy. In these patients, the addition of bevacizumab can increase the proportion of patients achieving a pathological complete response. This potential new role for PET and the activity of bevacizumab in this setting need to be confirmed in larger phase 3 trials. Funding Roche France.
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- 2014
49. Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma
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Amanda F. Cashen, Hervé Tilly, Michel Meignan, Myriam Sasanelli, Rene-Olivier Casasnovas, Annibale Versari, Alberto Biggi, Emmanuel Itti, Barry A. Siegel, Corinne Haioun, Pierre Vera, Alina Berriolo-Riedinger, Andrea Gallamini, Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Médecine Nucléaire, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Groupe d'étude des proliférations lymphoïdes (GPL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [Créteil], Breton, Céline, Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Disease-Free Survival ,Young Adult ,immune system diseases ,Fluorodeoxyglucose F18 ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Survival analysis ,Aged ,Fluorodeoxyglucose ,Aged, 80 and over ,PET-CT ,Chemotherapy ,Reproducibility of Results ,General Medicine ,Immunotherapy ,Middle Aged ,medicine.disease ,3. Good health ,Lymphoma ,Tumor Burden ,[SDV] Life Sciences [q-bio] ,Positron-Emission Tomography ,Multivariate Analysis ,Tumour volume ,Female ,Lymphoma, Large B-Cell, Diffuse ,Tomography, X-Ray Computed ,Diffuse large B-cell lymphoma ,medicine.drug - Abstract
International audience; We investigated the prognostic value of total metabolic tumour volume (TMTV) in diffuse large B-cell lymphoma (DLBCL). TMTV was measured in 114 patients with newly diagnosed DLBCL who underwent (18)F-FDG PET/CT at baseline before immunochemotherapy. TMTV was computed by summing the volumes of all lymphomatous lesions after applying the local SUVmax threshold of 41% using semiautomatic software. Prognostic value was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS). Median follow-up was 39 months. Average pretherapy TMTV was 509 ± 568 cm(3). The 3-year estimates of PFS were 77 % in the low metabolic burden group (TMTV ≤550 cm(3)) and 60% in the high metabolic burden group (TMTV >550 cm(3), p = 0.04), and prediction of OS was even better (87% vs. 60%, p = 0.0003). Cox regression showed independence of TMTV for OS prediction (p = 0.002) compared with other pretherapy indices of tumour burden, such as tumour bulk and the International Prognostic Index. Pretherapy TMTV is an independent predictor of outcome in patients with DLBCL.
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- 2014
50. HER2-positive breast cancer: 18F-FDG PET for early prediction of response to trastuzumab plus taxane-based neoadjuvant chemotherapy
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Michel Toubeau, François Brunotte, Jean-Marc Riedinger, Charles Coutant, Alina Berriolo-Riedinger, Inna Dygai-Cochet, Laurent Arnould, Séverine Guiu, Alexandre Cochet, Bruno Coudert, Pierre Fumoleau, Olivier Humbert, Isabelle Desmoulins, Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Biologie Médicale [Centre Georges-François leclerc], Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Service de Médecine Nucléaire, Département de Biologie et pathologie des tumeurs [Centre Georges-François Leclerc], Recherches en Économie Gestion AgroRessources Durabilité Santé- EA ( REGARDS ), Université de Reims Champagne-Ardenne ( URCA ) -SFR Condorcet, Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, UNICANCER, Recherches en Économie Gestion AgroRessources Durabilité Santé- EA 6292 (REGARDS), Université de Reims Champagne-Ardenne (URCA)-Maison des Sciences Humaines de Champagne-Ardenne (MSH-URCA), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Estrogen receptor ,Standardized uptake value ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,030218 nuclear medicine & medical imaging ,[ SDV.IB.MN ] Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Trastuzumab ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Neoadjuvant therapy ,ComputingMilieux_MISCELLANEOUS ,Taxane ,business.industry ,General Medicine ,medicine.disease ,Primary tumor ,3. Good health ,030220 oncology & carcinogenesis ,Predictive value of tests ,business ,medicine.drug - Abstract
To investigate the value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) to predict a pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Fifty-seven consecutive women with HER2-positive breast cancer, treated with trastuzumab plus taxane-based NAC, were prospectively included. Maximum Standardized Uptake Value of the primary tumor and axillary nodes were measured at baseline (PET1.SUVmax) and after the first course of NAC (PET2.SUVmax). Tumor metabolic volumes were assessed to determine Total Lesion Glycolysis (TLG). The tumor metabolic response (ΔSUVmax and ΔTLG) was calculated. In univariate analysis, negative hormonal receptor status (p = 0.04), high tumor grade (p = 0.03), and low tumor PET 2 .SUVmax (p = 0.001) were predictive of pCR. Tumor ΔSUVmax correlated with pCR (p = 0.03), provided that tumors with low metabolic activity at baseline were excluded. ΔTLG did not correlate with pCR. In multivariate analysis, tumor PET2.SUVmax
- Published
- 2014
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