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1. Decision of Adjuvant Systemic Treatment in HR+ HER2- Early Invasive Breast Cancer: Which Biomarkers Could Help?

Author

Alexandre M, Maran-Gonzalez A, Viala M, Firmin N, D'Hondt V, Gutowski M, Bourgier C, Jacot W, and Guiu S

Subjects
breast cancer, adjuvant chemotherapy, biomarkers, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Marie Alexandre,1 Aurélie Maran-Gonzalez,2 Marie Viala,1 Nelly Firmin,1 Véronique D’Hondt,1,3,4 Marian Gutowski,5 Céline Bourgier,3,6 William Jacot,1,3,4 Séverine Guiu1,3,4 1Department of Medical Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 2Department of Pathology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 3INSERM U1194 – Institut de Recherche en Cancérologie de Montpellier (IRCM), Montpellier, France; 4University of Montpellier, Montpellier,France; 5Department of Surgery, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 6Department of Radiation Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, FranceCorrespondence: Marie AlexandreMedical Oncology Department, Institut Régional du Cancer Montpellier, 208, Rue des Apothicaires, Montpellier Cedex 5 34298, FranceTel +33-4 67 61 23 93Fax +33-4 67 61 37 64Email marie.alexandre@icm.unicancer.frAbstract: The decision to administer adjuvant chemotherapy in treatment of early invasive breast cancer (EBC) is often complex, particularly for hormone receptor-positive (HR+) diseases, and current guidelines often classify these patients in an intermediate-risk group. Several biomarkers are currently available in this indication, in order to obtain additional and more accurate prognostic information compared to classic clinicopathological characteristics and guide the indication of adjuvant chemotherapy, optimizing the efficacy/toxicity ratio. We conducted a systematic review to evaluate the clinical validity and clinical utility of five biomarkers (uPA/PAI-1, OncotypeDX®, MammaPrint®, PAM50, and EndoPredict®) in HR+/HER2- EBC, whatever the nodal status. A total of 89 studies met the inclusion criteria. Even though data currently available confirm the clinical validity of these biomarkers, there is a lack of data regarding clinical utility for most of them. Prospective studies in well-defined populations are needed to integrate these biomarkers in a decision strategy.Keywords: breast cancer, adjuvant chemotherapy, biomarkers

Published
2019

6. The 2022 Assisi Think Tank Meeting: White paper on optimising radiation therapy for breast cancer

Author

Aristei, C., Kaidar-Person, O., Boersma, L., Leonardi, M.C., Offersen, B., Franco, P., Arenas, M., Bourgier, C., Pfeffer, R., Kouloulias, V., Bölükbaşı, Y., Meattini, I., Coles, C., Luis, A. Montero, Masiello, V., Palumbo, I., Morganti, A.G., Perrucci, E., Tombolini, V., Krengli, M., Marazzi, F., Trigo, L., Borghesi, S., Ciabattoni, A., Ratoša, I., Valentini, V., and Poortmans, P.

Published
2023
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7. Radiotherapy of breast cancer

Author

Hennequin, C., Belkacémi, Y., Bourgier, C., Cowen, D., Cutuli, B., Fourquet, A., Hannoun-Lévi, J.-M., Pasquier, D., Racadot, S., and Rivera, S.

Published
2022
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19. Early Results of the French Multicenter, Randomized SHARE Trial Comparing Whole Breast Irradiation vs. Accelerated Partial Breast Irradiation in Postmenopausal Women with Early-Stage Breast Cancer

Author

Belkacemi, Y., primary, Gabelle-Flandin, I., additional, Deley, M. C. Le, additional, Petit, A., additional, Guilbert, P., additional, Geffrelot, J., additional, Carrie, C., additional, Rivin del Campo, E., additional, Hanzen, C., additional, Brunaud, C. Charra, additional, Lecouillard, I., additional, Magne, N., additional, Tallet, A. Richard, additional, Leduc, N., additional, Belgadi, B., additional, Auzac, G., additional, Lacornerie, T., additional, Lemonnier, J., additional, Bourgier, C., additional, and Lartigau, E., additional

Published
2023
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20. CANTO: Skin Toxicities Evaluation of a Multicenter Large Prospective Cohort of Irradiated Patients for Early-Stage Breast Cancer

Author

Allali, S., primary, Carton, M., additional, Sarrade, T., additional, Everhard, S., additional, Rivera, S., additional, Ghannam, Y., additional, Peignaux, K., additional, Guilbert, P., additional, Chara-Brunaud, C., additional, Blanchecotte, J., additional, Pasquier, D., additional, Racadot, S., additional, Bourgier, C., additional, Cottu, P., additional, and Kirova, Y., additional

Published
2023
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27. Genome-wide association study of treatment-related toxicity two years following radiotherapy for breast cancer

Author

Jandu, H, Veal, C, Fachal, L, Luccarini, C, Aguado-Barrera, M, Altabas, M, Azria, D, Baten, A, Bourgier, C, Bultijnck, R, Colciago, R, Farcy-Jacquet, M, Chang-Claude, J, Choudhury, A, Dunning, A, Elliott, R, Green, S, Gutiérrez-Enríquez, S, Herskind, C, Lambrecht, M, Monten, C, Rancati, T, Reyes, V, Rosenstein, B, De Ruysscher, D, Carmen De Santis, M, Seibold, P, Sperk, E, Veldwijk, M, Paul Symonds, R, Stobart, H, Taboada-Valladares, B, Vega, A, Veldeman, L, Webb, A, Weltens, C, West, C, Rattay, T, Talbot, C, Jandu, Harkeran K., Veal, Colin D., Fachal, Laura, Luccarini, Craig, Aguado-Barrera, Miguel E., Altabas, Manuel, Azria, David, Baten, Adinda, Bourgier, Celine, Bultijnck, Renée, Colciago, Riccardo R., Farcy-Jacquet, Marie-Pierre, Chang-Claude, Jenny, Choudhury, Ananya, Dunning, Alison, Elliott, Rebecca M., Green, Sheryl, Gutiérrez-Enríquez, Sara, Herskind, Carsten, Lambrecht, Maarten, Monten, Christel, Rancati, Tiziana, Reyes, Victoria, Rosenstein, Barry S., De Ruysscher, Dirk, Carmen De Santis, Maria, Seibold, Petra, Sperk, Elena, Veldwijk, Marlon, Paul Symonds, R., Stobart, Hilary, Taboada-Valladares, Begoña, Vega, Ana, Veldeman, Liv, Webb, Adam J., Weltens, Caroline, West, Catharine M., Rattay, Tim, Talbot, Christopher J., Jandu, H, Veal, C, Fachal, L, Luccarini, C, Aguado-Barrera, M, Altabas, M, Azria, D, Baten, A, Bourgier, C, Bultijnck, R, Colciago, R, Farcy-Jacquet, M, Chang-Claude, J, Choudhury, A, Dunning, A, Elliott, R, Green, S, Gutiérrez-Enríquez, S, Herskind, C, Lambrecht, M, Monten, C, Rancati, T, Reyes, V, Rosenstein, B, De Ruysscher, D, Carmen De Santis, M, Seibold, P, Sperk, E, Veldwijk, M, Paul Symonds, R, Stobart, H, Taboada-Valladares, B, Vega, A, Veldeman, L, Webb, A, Weltens, C, West, C, Rattay, T, Talbot, C, Jandu, Harkeran K., Veal, Colin D., Fachal, Laura, Luccarini, Craig, Aguado-Barrera, Miguel E., Altabas, Manuel, Azria, David, Baten, Adinda, Bourgier, Celine, Bultijnck, Renée, Colciago, Riccardo R., Farcy-Jacquet, Marie-Pierre, Chang-Claude, Jenny, Choudhury, Ananya, Dunning, Alison, Elliott, Rebecca M., Green, Sheryl, Gutiérrez-Enríquez, Sara, Herskind, Carsten, Lambrecht, Maarten, Monten, Christel, Rancati, Tiziana, Reyes, Victoria, Rosenstein, Barry S., De Ruysscher, Dirk, Carmen De Santis, Maria, Seibold, Petra, Sperk, Elena, Veldwijk, Marlon, Paul Symonds, R., Stobart, Hilary, Taboada-Valladares, Begoña, Vega, Ana, Veldeman, Liv, Webb, Adam J., Weltens, Caroline, West, Catharine M., Rattay, Tim, and Talbot, Christopher J.

Abstract

Background and purpose: Up to a quarter of breast cancer patients treated by surgery and radiotherapy experience clinically significant toxicity. If patients at high risk of adverse effects could be identified at diagnosis, their treatment could be tailored accordingly. This study was designed to identify common single nucleotide polymorphisms (SNPs) associated with toxicity two years following whole breast radiotherapy. Materials and methods: A genome-wide association study (GWAS) was performed in 1,640 breast cancer patients with complete SNP, clinical, treatment and toxicity data, recruited across 18 European and US centres into the prospective REQUITE cohort study. Toxicity data (CTCAE v4.0) were collected at baseline, end of radiotherapy, and annual follow-up. A total of 7,097,340 SNPs were tested for association with the residuals of toxicity endpoints, adjusted for clinical, treatment co-variates and population substructure. Results: Quantile-quantile plots showed more associations with toxicity above the p < 5 × 10-5 level than expected by chance. Eight SNPs reached genome-wide significance. Nipple retraction grade ≥ 2 was associated with the rs188287402 variant (p = 2.80 × 10-8), breast oedema grade ≥ 2 with rs12657177 (p = 1.12 × 10-10), rs75912034 (p = 1.12 × 10-10), rs145328458 (p = 1.06 × 10-9) and rs61966612 (p = 1.23 × 10-9), induration grade ≥ 2 with rs77311050 (p = 2.54 × 10-8) and rs34063419 (p = 1.21 × 10-8), and arm lymphoedema grade ≥ 1 with rs643644 (p = 3.54 × 10-8). Heritability estimates across significant endpoints ranged from 25% to 39%. Our study did not replicate previously reported SNPs associated with breast radiation toxicity at the pre-specified significance level. Conclusions: This GWAS for long-term breast radiat

Published
2023

28. The 2022 Assisi Think Tank Meeting: White paper on optimising radiation therapy for breast cancer

Author

Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Aristei C; Kaidar-Person O; Boersma L; Leonardi MC; Offersen B; Franco P; Arenas M; Bourgier C; Pfeffer R; Kouloulias V; Bölükbaşı Y; Meattini I; Coles C; Luis AM; Masiello V; Palumbo I; Morganti AG; Perrucci E; Tombolini V; Krengli M; Marazzi F; Trigo L; Borghesi S; Ciabattoni A; Ratoša I; Valentini V; Poortmans P, Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Aristei C; Kaidar-Person O; Boersma L; Leonardi MC; Offersen B; Franco P; Arenas M; Bourgier C; Pfeffer R; Kouloulias V; Bölükbaşı Y; Meattini I; Coles C; Luis AM; Masiello V; Palumbo I; Morganti AG; Perrucci E; Tombolini V; Krengli M; Marazzi F; Trigo L; Borghesi S; Ciabattoni A; Ratoša I; Valentini V; Poortmans P

Abstract

The present white paper, referring to the 4th Assisi Think Tank Meeting on breast cancer, reviews state-of-the-art data, on-going studies and research proposals. < 70% agreement in an online questionnaire identified the following clinical challenges: 1: Nodal RT in patients who have a) 1-2 positive sentinel nodes without ALND (axillary lymph node dissection); b) cN1 disease transformed into ypN0 by primary systemic therapy and c) 1-3 positive nodes after mastectomy and ALND. 2. The optimal combination of RT and immunotherapy (IT), patient selection, IT-RT timing, and RT optimal dose, fractionation and target volume. Most experts agreed that RT- IT combination does not enhance toxicity. 3: Re-irradiation for local relapse converged on the use of partial breast irradiation after second breast conserving surgery. Hyperthermia aroused support but is not widely available. Further studies are required to finetune best practice, especially given the increasing use of re-irradiation.Copyright © 2023. Published by Elsevier B.V.

Published
2023

38. Improving Patients' Life Quality after Radiotherapy Treatment by Predicting Late Toxicities

Author

Lapierre, A., Bourillon, L., Larroque, M., Gouveia, T., Bourgier, C., Ozsahin, M., Pèlegrin, A., Azria, D., and Brengues, M.

Subjects
biomarkers, late toxicities prediction, personalized treatment, radiotherapy
Abstract

Personalized treatment and precision medicine have become the new standard of care in oncology and radiotherapy. Because treatment outcomes have considerably improved over the last few years, permanent side-effects are becoming an increasingly significant issue for cancer survivors. Five to ten percent of patients will develop severe late toxicity after radiotherapy. Identifying these patients before treatment start would allow for treatment adaptation to minimize definitive side effects that could impair their long-term quality of life. Over the last decades, several tests and biomarkers have been developed to identify these patients. However, out of these, only the Radiation-Induced Lymphocyte Apoptosis (RILA) assay has been prospectively validated in multi-center cohorts. This test, based on a simple blood draught, has been shown to be correlated with late radiation-induced toxicity in breast, prostate, cervical and head and neck cancer. It could therefore greatly improve decision making in precision radiation oncology. This literature review summarizes the development and bases of this assay, as well as its clinical results and compares its results to the other available assays.

Published
2022

39. Ways to improve breast cancer patients' management and clinical outcome: The 2020 Assisi Think Tank Meeting

Author

Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P, Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, and Aristei C; Bölükbaşı Y; Kaidar-Person O; Pfeffer R; Arenas M; Boersma LJ; Ciabattoni A; Coles CE; Franco P; Krengli M; Leonardi MC; Marazzi F; Masiello V; Meattini I; Montero A; Offersen B; Trigo ML; Bourgier C; Genovesi D; Kouloulias V; Morganti AG; Meduri B; Pasinetti N; Pedretti S; Perrucci E; Rivera S; Tombolini V; Vidali C; Valentini V; Poortmans P

Abstract

We report on the third Assisi Think Tank Meeting (ATTM) on breast cancer, a brainstorming project which involved European radiation and clinical oncologists who were dedicated to breast cancer research and treatment. Held on February 2020, the ATTM aimed at identifying key clinical questions in current clinical practice and "grey" areas requiring research to improve management and outcomes. Before the meeting, three key topics were selected: 1) managing patients with frailty due to either age and/or multi-morbidity; 2) stereotactic radiation therapy and systemic therapy in the management of oligometastatic disease; 3) contralateral breast tumour prevention in BCRA-mutated patients. Clinical practice in these areas was investigated by means of an online questionnaire. In the lapse period between the survey and the meeting, the working groups reviewed data, on-going studies and the clinical challenges which were then discussed in-depth and subjected to intense brainstorming during the meeting; research protocols were also proposed. Methodology, outcome of discussions, conclusions and study proposals are summarized in the present paper. In conclusion, this report presents an in-depth analysis of the state of the art, grey areas and controversies in breast cancer radiation therapy and discusses how to confront them in the absence of evidence-based data to guide clinical decision-making.Copyright © 2022 Elsevier B.V. All rights reserved.

Published
2022

46. MO-0800 CANTO-RT: Skin toxicities evaluation of prospective cohort of irradiated patients for breast cancer

Author

allali, S., primary, Carton, M., additional, Sarrade, T., additional, Everhard, S., additional, Querel, O., additional, Rivera, S., additional, Peignaux, K., additional, Guilbert, P., additional, Chara-Brunaud, C., additional, Blanchecotte, J., additional, Labib, A., additional, Pasquier, D., additional, Racadot, S., additional, Bourgier, C., additional, Julien, G., additional, Cottu, P., additional, Vaz-Luis, I., additional, and Kirova, Y., additional

Published
2022
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