Author: "Jacques, Cadranel" / Topic: pulmonary and respiratory medicine - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Jacques, Cadranel"' showing total 369 results

Start Over Author "Jacques, Cadranel" Topic pulmonary and respiratory medicine

369 results on '"Jacques, Cadranel"'

1. Pralsetinib and Sequential MET Inhibitors to Overcome MET Amplification Resistance in a Patient With a RET Fusion Driven Lung Cancer – Case Report

Author: Pascal Wang, Lise Matton, Fatima Kebir, Khaldoun Kerrou, Antonin Dubois, Roger Lacave, Jacques Cadranel, and Vincent Fallet
Subjects: Pulmonary and Respiratory Medicine, Cancer Research, Oncology
Published: 2022
Full Text: View/download PDF

2. Severe sotorasib-related hepatotoxicity and non-liver adverse events associated with sequential anti-PD(L)1 and sotorasib therapy in KRASG12C-mutant lung cancer

Author: Ali Chour, Julie Denis, Céline Mascaux, Maeva Zysman, Laurence Bigay-Game, Aurélie Swalduz, Valérie Gounant, Alexis Cortot, Marie Darrason, Vincent Fallet, Edouard Auclin, Clémence Basse, Claire Tissot, Chantal Decroisette, Pierre Bombaron, Etienne Giroux-Leprieur, Luc Odier, Solenn Brosseau, Quentin Creusot, Marina Gueçamburu, Corentin Meersseman, Adrien Rochand, Adrien Costantini, Claire Marine Gaillard, Eric Wasielewski, Nicolas Girard, Jacques Cadranel, Claire Lafitte, Fanny Lebossé, and Michael Duruisseaux
Subjects: Pulmonary and Respiratory Medicine, Oncology
Published: 2023
Full Text: View/download PDF

3. Tailoring maintenance chemotherapy upon response to induction chemotherapy as compared with pemetrexed continuation maintenance in advanced non-squamous NSCLC patients: Results of the IFCT-GFPC-1101 multicenter randomized phase III trial

Author: Alexis B. Cortot, Didier Debieuvre, L. Moreau, Radj Gervais, Jacques Margery, Julien Mazieres, Olivier Molinier, Michel Poudenx, Alexandra Langlais, Nicolas Girard, Patrick Dumont, Gérard Zalcman, Franck Morin, Virginie Westeel, Pierre-Jean Souquet, Eric Pichon, Fabrice Barlesi, Maurice Pérol, Jérôme Dauba, Jacques Cadranel, Clarisse Audigier-Valette, and Denis Moro-Sibilot
Subjects: Adult, Pulmonary and Respiratory Medicine, Oncology, Cancer Research, medicine.medical_specialty, Lung Neoplasms, Adolescent, Pemetrexed, Maintenance Chemotherapy, Young Adult, Carcinoma, Non-Small-Cell Lung, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Aged, Maintenance chemotherapy, business.industry, Induction chemotherapy, Induction Chemotherapy, Middle Aged, Treatment Outcome, Non squamous, Cisplatin, business, medicine.drug
Abstract: Benefit from maintenance in advanced non-squamous non-small cell lung cancer (NS-NSCLC) might favor switch maintenance after disease stabilization (SD) and continuation after objective response (OR). This trial assessed a maintenance strategy conditioned by response to cisplatin-gemcitabine (CG) with G continuation for patients with OR or switch to pemetrexed (P) for patients with SD as compared with a control arm based on the Paramount regimen.Eligibility criteria: age 18-70 years, ECOG PS 0-1, untreated stage IV NS-NSCLC without EGFR or ALK alteration, ineligibility to bevacizumab. Patients were randomized 1:1 to receive either CG (4 cycles) followed by G maintenance in case of OR followed by P at progression, or switch to P for patients with SD, or 4 cycles of CP followed by P (control arm). Primary endpoint: overall Survival.Between 2012 and 2016, 932 patients were randomized (CG: 467, CP: 465) with well-balanced characteristics. 257 patients (56.7%) in the CG arm received maintenance (G: 142, P: 113) versus 277 patients (59.7%) in the CP arm. Median number of maintenance cycles was 5 for G and P (CG induction) and 4 for P (CP induction). OS adjusted HR was 0.97 (95% CI 0.84, 1.13; p = 0.71) with a median of 10.9 months (CG) versus 10.4 (CP). HR for PFS was 0.95 (95% CI 0.83, 1.09; p = 0.45) with a median of 4.8 months for CG versus 4.5 for CP. Safety profile was as expected.Adapting maintenance strategy according to response to induction chemotherapy does not improve patient outcome.NCT01631136.
Published: 2022
Full Text: View/download PDF

4. Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis (EXAFIP): a randomised, double-blind, placebo-controlled, phase 3 trial

Author: Abdellatif Tazi, Aurélie Le Borgne-Krams, Marine Cachanado, Tabassome Simon, Sylvain Marchand-Adam, Morgane Didier, Lidwine Wemeau-Stervinou, Sandrine Hirschi, Frédéric Rivière, Arnaud Bourdin, François Lebargy, Stéphane Dominique, Aude Gibelin, Alexandre Chabrol, Tristan Dégot, Jacques Cadranel, Martine Reynaud-Gaubert, Marie-Pierre Debray, Sylvie Leroy, Frédéric Gagnadoux, Emmanuel Bergot, François-Xavier Blanc, Alexandra Rousseau, Raphael Borie, Pierre Yves Brillet, Guillaume Beltramo, Mallorie Kerjouan, Hilario Nunes, Olivia Freynet, Julie Traclet, Bruno Crestani, Anne-Sophie Gamez, Grégoire Prévot, Jean Pastré, Dominique Israel-Biet, Marie-Christine Dombret, Laurent Plantier, Cécile Chenivesse, Laurence Berard, Ana Nieves, Emmanuel Gomez, Dominique Valeyre, Stéphane Jouneau, Anne Gondouin, Elodie Blanchard, C. Launois, Nathalie Bautin, Jean-Marc Naccache, Vincent Cottin, Antoine Parrot, Philippe Bonniaud, Centre de référence maladies rares des maladies pulmonaires rares de l’adulte (CHU Dijon) (CRMR des maladies pulmonaires rares de l’adulte), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Sorbonne Université (SU), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Foch [Suresnes], CHU Pontchaillou [Rennes], École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Hôpital Avicenne [AP-HP], Laboratoire d'Excellence INFLAMEX [Paris], Université Sorbonne Paris Cité (USPC), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Saint-Antoine [AP-HP], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre régional de pharmacovigilance de Marseille Provence Corse [CHU de Marseille] (CRPV-Marseille), Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, CHU Dijon, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Les Hôpitaux Universitaires de Strasbourg (HUS), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Lille, Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hospices Civils de Lyon (HCL), Université de Lyon, CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Université d'Angers (UA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital JeanMinjoz, CHU Bordeaux [Bordeaux], Hôpital Haut-Lévêque [CHU Bordeaux], unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Rouen, Normandie Université (NU), CHU Tenon [AP-HP], Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut de Recherche Saint-Louis - Hématologie Immunologie Oncologie (Département de recherche de l’UFR de médecine, ex- Institut Universitaire Hématologie-IUH) (IRSL), Université Paris Cité (UPCité), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), CHU Montpellier, Université de Lille, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Roche, Ministere de la Sante et des Solidarites, 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)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Marseille-Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Université de Paris (UP), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, education.field_of_study, Exacerbation, Cyclophosphamide, business.industry, [SDV]Life Sciences [q-bio], Population, medicine.disease, Placebo, 3. Good health, 03 medical and health sciences, Idiopathic pulmonary fibrosis, 0302 clinical medicine, 030228 respiratory system, Methylprednisolone, Internal medicine, Clinical endpoint, Medicine, 030212 general & internal medicine, business, education, Adverse effect, ComputingMilieux_MISCELLANEOUS, medicine.drug
Abstract: Summary Background The use of cyclophosphamide in patients with acute exacerbation of idiopathic pulmonary fibrosis (IPF) is unknown. Our study was designed to evaluate the efficacy and safety of four cyclophosphamide pulses in addition to high-dose methylprednisolone in this population. Methods In this double-blind, placebo-controlled trial done in 35 departments across 31 hospitals in France, adult patients (≥18 years) with acute exacerbation of IPF and those with suspected acute exacerbation of IPF were randomly assigned in a 1:1 ratio using a web-based system to receive either intravenous pulses of cyclophosphamide (600 mg/m2) plus uromitexan as haemorrhagic cystitis prophylaxis (200 mg/m2) at the time of cyclophosphamide administration and then again, 4 h later, or placebo at days 0, 15, 30, and 60. Random assignment was stratified according to the severity of IPF and was block-balanced with variable block sizes of four or six patients. Patients receiving mechanical ventilation, with active infection, with active cancer, or who were registered on the lung transplant waiting list were excluded. All patients received standardised high-dose glucocorticoids. The investigators, patients, and the sponsor were masked to the treatment assignments. The primary endpoint was 3-month all-cause mortality, analysed by a χ2 test adhering to an intention-to-treat principle. The trial is now complete and registered with ClinicalTrials.gov , NCT02460588 . Findings Between Jan 22, 2016, and July 19, 2018, 183 patients were assessed for eligibility, of whom 120 patients were randomly assigned and 119 patients (62 [52%] with severe IPF) received at least one dose of cyclophosphamide (n=60) or placebo (n=59), all of whom were included in the intention-to-treat analysis. The 3-month all-cause mortality was 45% (27/60) in patients given cyclophosphamide compared with 31% (18/59) in the placebo group (difference 14·5% [95% CI −3·1 to 31·6]; p=0·10). Similar results were found after adjustment by IPF severity (odds ratio [OR] 1·89 [95% CI 0·89–4·04]). The risk of death at 3 months, independent of the treatment received, was higher with severe than non-severe IPF (OR 2·62 [1·12–6·12]) and was lower with the use of antifibrotic therapy (OR 0·33 [0·13–0·82]). Adverse events were similar between groups by 6 months (25 [42%] in the cyclophosphamide group vs 30 [51%] in the placebo group) and their proportion, including infections, did not differ. Overall infection was the main adverse event and occurred in 20 (33%) of 60 patients in the cyclophosphamide group versus 21 (36%) of 59 patients in the placebo group. Interpretation In patients with acute exacerbation of IPF, adding intravenous cyclophosphamide pulses to glucocorticoids increased 3-month mortality. These findings provide evidence against the use of intravenous cyclophosphamide in such patients. Funding Programme Hospitalier de Recherche Clinique of the French Ministry of Health (PHRC 2014–502), Roche Pharmaceuticals.
Published: 2022
Full Text: View/download PDF

5. Respiratory recovery trajectories after severe-to-critical COVID-19: a 1-year prospective multicentre study

Author: Frédéric Schlemmer, Simon Valentin, Laurent Boyer, Anne Guillaumot, François Chabot, Clairelyne Dupin, Pierre Le Guen, Gwenael Lorillon, Anne Bergeron, Damien Basille, Julia Delomez, Claire Andrejak, Valentine Bonnefoy, Hélène Goussault, Jean-Baptiste Assié, Pascaline Choinier, Anne-Marie Ruppert, Jacques Cadranel, Maria Chiara Mennitti, Mehdi Roumila, Charlotte Colin, Sven Günther, Olivier Sanchez, Thomas Gille, Lucile Sésé, Yurdagul Uzunhan, Morgane Faure, Maxime Patout, Capucine Morelot-Panzini, Pierantonio Laveneziana, Maeva Zysman, Elodie Blanchard, Chantal Raherison-Semjen, Violaine Giraud, Etienne Giroux-Leprieur, Stéfanie Habib, Nicolas Roche, Anh Tuan Dinh-Xuan, Islem Sifaoui, Pierre-Yves Brillet, Camille Jung, Emmanuelle Boutin, Richard Layese, Florence Canoui-Poitrine, Bernard Maitre, 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), 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpitaux Universitaires de Genève (HUG), CHU Amiens-Picardie, Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université de Picardie Jules Verne (UPJV), Service de Pneumologie [CHI Créteil], CHI Créteil, Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier de Versailles André Mignot (CHV), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Avicenne [AP-HP], Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, CHU Pitié-Salpêtrière [AP-HP], Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de Basse-Terre [Guadeloupe], Hôpital Ambroise Paré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Service de physiologie et explorations fonctionelles [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Service de radiologie [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Sorbonne Paris Nord, Centre Hospitalier Intercommunal de Créteil (CHIC), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-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)
Subjects: Pulmonary and Respiratory Medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: BackgroundSurvivors of severe-to-critical coronavirus disease 2019 (COVID-19) may have functional impairment, radiological sequelae and persistent symptoms requiring prolonged follow-up. This pragmatic study aimed to describe their clinical follow-up and determine their respiratory recovery trajectories, and the factors that could influence them and their health-related quality of life.MethodsAdults hospitalised for severe-to-critical COVID-19 were evaluated at 3 months and up to 12 months post-hospital discharge in this prospective, multicentre, cohort study.ResultsAmong 485 enrolled participants, 293 (60%) were reassessed at 6 months and 163 (35%) at 12 months; 89 (51%) and 47 (27%) of the 173 participants initially managed with standard oxygen were reassessed at 6 and 12 months, respectively. At 3 months, 34%, 70% and 56% of the participants had a restrictive lung defect, impaired diffusing capacity of the lung for carbon monoxide (DLCO) and significant radiological sequelae, respectively. During extended follow-up, bothDLCOand forced vital capacity percentage predicted increased by means of +4 points at 6 months and +6 points at 12 months. Sex, body mass index, chronic respiratory disease, immunosuppression, pneumonia extent or corticosteroid use during acute COVID-19 and prolonged invasive mechanical ventilation (IMV) were associated withDLCOat 3 months, but not its trajectory thereafter. Among 475 (98%) patients with at least one chest computed tomography scan during follow-up, 196 (41%) had significant sequelae on their last images.ConclusionsAlthough pulmonary function and radiological abnormalities improved up to 1 year post-acute COVID-19, high percentages of severe-to-critical disease survivors, including a notable proportion of those managed with standard oxygen, had significant lung sequelae and residual symptoms justifying prolonged follow-up.
Published: 2023
Full Text: View/download PDF

6. Parcours de diagnostic rapide du cancer du poumon : évaluation à un an

Author: D. Moal, S. Guegan, A. Canellas, Armelle Lavolé, F. Millet, A.-M. Ruppert, L. Rosencher, Marie Wislez, M. Baud, Jacques Cadranel, C. Epaud, Vincent Fallet, Jalal Assouad, and Martine Antoine
Subjects: Pulmonary and Respiratory Medicine, Gynecology, medicine.medical_specialty, business.industry, medicine, Lung cancer, medicine.disease, business
Abstract: Resume Introduction Le parcours de soins des patients atteints de cancers du poumon (CP) est complexe. L’objectif du Plan cancer 2014–2019 est la maitrise des delais de prise en charge. En 2016, un parcours diagnostic rapide ambulatoire du CP a ete mis en place dans le service de pneumologie. L’objectif de cette etude est d’evaluer sa faisabilite et son impact sur les delais de prise en charge. Methode Il s’agit d’une etude epidemiologique retrospective realisee au CHU de Tenon entre mai 2016 et mai 2017. Resultats Un diagnostic de CP a ete fait dans 60 % des cas (n = 118). Le delai median d’acces a la prise en charge (D1) (demande-consultation) etait de 4 jours (2–7). Le delai median d’acces a la proposition de traitement (D4) (histologie-RCP) etait de 4 jours (0–8). Le delai d’acces au premier traitement (D5) (RCP-traitement) etait de 10 jours (4–15) pour la chimiotherapie et de 27 jours (16–34) jours pour la chirurgie. Le delai global de pris en charge (D6) (imagerie-traitement) etait de 49 jours (34–70). Conclusion Les delais de prise en charge du CP etaient conformes aux recommandations internationales. L’infirmiere de coordination a occupe un role central organisationnel et dans l’accompagnement du patient.
Published: 2021
Full Text: View/download PDF

7. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis – 2021 update. Full-length version

Author: Vincent Cottin, Philippe Bonniaud, Jacques Cadranel, Bruno Crestani, Stéphane Jouneau, Sylvain Marchand-Adam, Hilario Nunes, Lidwine Wémeau-Stervinou, Emmanuel Bergot, Elodie Blanchard, Raphaël Borie, Arnaud Bourdin, Cécile Chenivesse, Annick Clément, Emmanuel Gomez, Anne Gondouin, Sandrine Hirschi, François Lebargy, Charles-Hugo Marquette, David Montani, Grégoire Prévot, Sébastien Quetant, Martine Reynaud-Gaubert, Mathieu Salaun, Olivier Sanchez, Bruno Trumbic, Karim Berkani, Pierre-Yves Brillet, Marion Campana, Lara Chalabreysse, Gérard Chatté, Didier Debieuvre, Gilbert Ferretti, Jean-Michel Fourrier, Nicolas Just, Marianne Kambouchner, Bertrand Legrand, Frédéric Le Guillou, Jean-Pierre Lhuillier, Anas Mehdaoui, Jean-Marc Naccache, Catherine Paganon, Martine Rémy-Jardin, Salim Si-Mohamed, Philippe Terrioux, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Avicenne [AP-HP], Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Pessac, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Pasteur [Nice] (CHU), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Marseille, 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), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Centre Hospitalier Régional d'Orléans (CHRO), Hospices Civils de Lyon (HCL), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Eure-Seine - Hôpital d'Evreux - Vernon (Evreux), Groupe Hospitalier Paris Saint-Joseph (hpsj), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Pulmonary and Respiratory Medicine, Biopsy, Biopsie, [SDV]Life Sciences [q-bio], Fibrose pulmonaire, Pneumopathie interstitielle commune, Interstitial lung disease, Common interstitial lung disease, Pneumopathie interstitielle diffuse, Pulmonary fibrosis
Abstract: National audience; BACKGROUND: Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS: Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients’ association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS: After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION: These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
Published: 2022
Full Text: View/download PDF

8. A Severe COVID-19 Pneumonia Revealing a Lepidic Adenocarcinoma: A Diagnostic Challenge during the Pandemic Period

Author: Guillaume Voiriot, Alexandre Elabbadi, Muriel Fartoukh, Aude Gibelin, Martine Antoine, Anne Fajac, Jacques Cadranel, Service d'Anesthésie réanimation [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Anatomie et cytologie pathologiques [CHU Tenon], Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d’Anatomie et cytologie pathologiques [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'anatomie pathologique [CHU Tenon], and Unité pneumologie et oncologie thoracique [CHU Tenon]
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Lung Neoplasms, Coronavirus disease 2019 (COVID-19), Period (gene), Adenocarcinoma, Acute respiratory failure, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pandemic, medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Coronavirus disease 2019, business.industry, COVID-19, Middle Aged, medicine.disease, 3. Good health, Pneumonia, 030228 respiratory system, Female, Lepidic adenocarcinoma, business
Abstract: International audience
Published: 2022
Full Text: View/download PDF

9. Reply to: Nebulised liposomal amphotericin-B: a promising strategy for preventing ABPA relapse

Author: Cendrine Godet, Jacques Cadranel, Jean-Pierre Frat, Stéphanie Ragot, and Francis Couturaud
Subjects: Pulmonary and Respiratory Medicine, Antifungal Agents, Recurrence, Amphotericin B, Aspergillosis, Allergic Bronchopulmonary, Humans
Published: 2022

10. Strong ALK and PD-L1 positive IHC expression related ALK amplification in an advanced lung sarcomatoid carcinoma: A therapeutic trap?

Author: Sébastien Gendarme, Khaldoun Kerrou, Anne-Marie Ruppert, Jacques Cadranel, Lise Matton, Vincent Fallet, Martine Antoine, C. Epaud, Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Oncologie médicale [CHU Tenon], Sorbonne Université (SU), Service d’Anatomie et cytologie pathologiques [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de médecine nucléaire [CHU Tenon], Theranoscan [CHU Tenon] (GRC 4), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Service des maladies respiratoires [CHU Tenon]
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Cancer Research, Lung Neoplasms, Amplification, [SDV.CAN]Life Sciences [q-bio]/Cancer, Adenocarcinoma, B7-H1 Antigen, PD-L1 Positive, 03 medical and health sciences, 0302 clinical medicine, hemic and lymphatic diseases, medicine, Carcinoma, Humans, Lung cancer, Lung, In Situ Hybridization, Fluorescence, Gene Rearrangement, medicine.diagnostic_test, business.industry, Lung Sarcomatoid Carcinoma, Receptor Protein-Tyrosine Kinases, medicine.disease, Immunohistochemistry, Sarcomatoid, 3. Good health, 030104 developmental biology, ALK, Oncology, 030220 oncology & carcinogenesis, Cancer research, Immunotherapy, business, Tyrosine kinase, Fluorescence in situ hybridization
Abstract: Objectives Immunohistochemistry (IHC) is considered as a screening method for ALK rearrangement thanks to its excellent sensitivity. Strong marking on immunohistochemistry give the go-ahead to start ALK tyrosine kinase inhibitors (ALK TKI). Lack of therapeutic response may then lead to the suspicion of molecular alterations other than ALK rearrangements. Methods We present a patient with strong ALK and PD-L1 positive IHC expression lung sarcomatoid carcinoma with initial life-threatening disease progression after beginning ALK TKI. We also review the literature to summarize ALK amplification clinical features and therapeutic management in lung cancers. Results Fluorescence in situ Hybridization (FISH) revealed ALK amplification on the initial anatomopathological samples. Lack of ALK rearrangement and strong PD-L1 positive IHC expression led to the initiation of immune checkpoint inhibitor (ICI) as a second line of treatment, with an excellent response. Conclusion We demonstrated that IHC positive test, in these cases, must be interpreted with caution. FISH analysis has to be recommended to confirm IHC results in case of unusual phenotype, such as smoker or lung cancer other than adenocarcinoma. Although lung carcinoma with ALK rearrangement seems to be not sensitive to ICI, further investigations should be conducted on other types of ALK molecular alterations. ALK amplifications, as observed in the present case, should not be an impediment to taking into account the PD-L1 marking for the initiation of treatment by immunotherapy.
Published: 2021
Full Text: View/download PDF

11. Comment réduire la mortalité par cancer du poumon chez les personnes vivant avec le VIH ? Du sevrage tabagique au dépistage radiologique

Author: A.-M. Ruppert, B. Le Maître, Jacques Cadranel, Armelle Lavolé, and Alain Makinson
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, media_common.quotation_subject, medicine.medical_treatment, Population, Placebo, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Medicine, 030212 general & internal medicine, education, Lung cancer, Varenicline, media_common, education.field_of_study, business.industry, Cancer, Abstinence, medicine.disease, 3. Good health, 030228 respiratory system, chemistry, Smoking cessation, business, Lung cancer screening
Abstract: Lung cancer is the leading cause of cancer related death among people living with HIV (PLHIV). Tobacco exposure is higher among PLHIV (38.5%) and mainly explains the increased risk of lung cancer. To reduce lung cancer mortality, two approaches need to be implemented: lung cancer screening with low-dose thoracic CT scan and smoking cessation. Low dose CT scan is feasible in PLHIV. The false positive rate is not higher than in the general population, except for cases with CD4
Published: 2020
Full Text: View/download PDF

12. Somatic profile in lung cancers is associated to reproductive factors in never-smokers women: Results from the IFCT-1002 BioCAST study

Author: Bruno Coudert, Bénédicte Mastroianni, P. Foucher, Séverine Fraboulet, Adrien Dixmier, Julien Mazieres, Michel Vincent, Eric Dansin, Eric Pichon, M. Locatelli-Sanchez, Jacques Cadranel, Sébastien Couraud, N. Baize, Isabelle Monnet, Franck Morin, Catherine Dubos-Arvis, P. Missy, C. Fontaine-Delaruelle, Patrick Dumont, Denis Moro-Sibilot, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Service de pneumologie, Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Férération d'oncologie thoracique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université d'Angers (UA), INSAVALOR, Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA), Intergroupe Francophone de Cancérologie Thoracique [Paris] (IFCT), Intergroupe Francophone de Cancérologie thoracique, Unité pneumologie et oncologie thoracique [CHU Tenon], CHU Tenon [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Multivariate analysis, [SDV]Life Sciences [q-bio], DNA Mutational Analysis, Cohort Studies, Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, 0302 clinical medicine, Gene Frequency, Risk Factors, Internal medicine, Humans, Medicine, Anaplastic Lymphoma Kinase, Lung cancer, Reproductive History, Aged, 030304 developmental biology, Aged, 80 and over, 0303 health sciences, Smokers, Lung, business.industry, Oncogenes, Middle Aged, medicine.disease, 3. Good health, ErbB Receptors, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Cohort, Menarche, Biomarker (medicine), Female, Observational study, France, business, Hormone
Abstract: Background Lung cancer in women is on the rise, with a higher proportion occurring in lifelong never-smokers. Lung cancer in never-smokers (LCINS) exhibits a high frequency of driver oncogene alterations. In this study, we aimed to investigate whether exposure to reproductive factors in women with LCINS may modulate the molecular pattern. Methods All newly diagnosed LCINSs were included in a prospective, observational study (IFCT-1002 BioCAST). Each patient responded to a questionnaire including reproductive factors. Biomarker test results were also collected. Results Two hundred and sixty women were included in this analysis, and 166 alterations were characterized. EGFR mutation frequency proved greater among patients with late menarche (74% in age > 14 vs. 40% and 41% for 12–14 and ≤ 12 years, respectively; P = 0.020) and tended to decrease with increasingly late age at menopause. In multivariate analysis, EGFR mutation frequency increased by 23% per increment of 1 year of age at menarche (P = 0.048), and by 9% for each year at age at first birth (P = 0.035). ALK alteration frequency was greater in women with high parity (50% in ≥ 5 vs. 12% and 7% for 1–4 and nulliparity, respectively; P = 0.021). Conclusion In a cohort of women LCINSs, female hormonal factors appear to impact molecular pattern.
Published: 2020
Full Text: View/download PDF

13. Characterization of lung cancers in patients with BRCA germline variants: A multicenter series

Author: Mateo Sanchis-Borja, Vincent Fallet, Elisabeth Fabre, Marie Wislez, Stéphane Culine, Gérard Zalcman, Jean-Philippe Spano, Nathalie Chabbert Buffet, Florence Coulet, Patrick R. Benusiglio, and Jacques Cadranel
Subjects: Pulmonary and Respiratory Medicine, Cancer Research, Germ Cells, Lung Neoplasms, Oncology, BRCA1 Protein, Genes, BRCA2, Humans, Female, Adenocarcinoma, Germ-Line Mutation, Retrospective Studies
Abstract: BRCA1 and BRCA2 (BReast CAncer susceptibility genes) are two tumor-suppressor genes associated with the hereditary breast and ovarian cancer susceptibility syndrome. Recent studies also suggest an increased lung adenocarcinoma risk in carriers.We conducted a multi-center retrospective study in 18 different French pulmonology and/or oncology departments on medico-administrative and clinical data prospectively collected in the Clinical Data Warehouse (CDW) of Greater Paris University Hospitals (Assistance Publique-Hôpitaux de Paris, AP-HP). Clinical characteristics and outcomes of patients with LC and a previously known BRCA1/2gl variant were retrospectively evaluated.17 patients with LC and known BRCA1/2gl variant were included. Patients were most women, former smokers with localized disease and BRCA2 variants. All LC were adenocarcinoma. For patients with medical history of cancer, median time from the first cancer in the BRCA spectrum and the LC occurrence was 20 years. Median disease-free survival (DFS) and overall survival (OS) in localized tumor (Stage I and II) was not reached and 78.6 months, respectively. In advanced cancer (Stade III and IV) median progression free survival was 9.7 months and median OS was 17.8 months. Univariate OS and DFS/PFS analyses by BRCA status did not find significant differences.Results seem to show particular LC features in carriers of BRCA2 variants: adenocarcinoma subtype, woman, former or non-smoker.
Published: 2022

14. Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial

Author: Julie Mankikian, Agnès Caille, Martine Reynaud-Gaubert, Marie-Sara Agier, Julien Bermudez, Philippe Bonniaud, Raphael Borie, Pierre-Yves Brillet, Jacques Cadranel, Isabelle Court-Fortune, Bruno Crestani, Marie-Pierre Debray, Emmanuel Gomez, Anne Gondouin, Sandrine Hirschi-Santelmo, Dominique Israel-Biet, Stéphane Jouneau, Karine Juvin, Julie Leger, Mallorie Kerjouan, Charles-Hugo Marquette, Jean-Marc Naccache, Hilario Nunes, Laurent Plantier, Grégoire Prevot, Sébastien Quetant, Julie Traclet, Victor Valentin, Yurdagul Uzunhan, Lidwine Wémeau-Stervinou, Theodora Bejan-Angoulvant, Vincent Cottin, Sylvain Marchand-Adam, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Univ - UFR Pharmacie), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), 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)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Laboratoire d'Excellence INFLAMEX [Paris], Université Sorbonne Paris Cité (USPC), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13), Hôpital Avicenne [AP-HP], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Biologie Intégrative du Tissu Osseux (LBTO), Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Les Hôpitaux Universitaires de Strasbourg (HUS), Nouvel Hôpital Civil de Strasbourg, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Pontchaillou, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre hospitalier Saint-Joseph [Paris], Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, CHU Lille, EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), PHRC national, and This study was supported by a grant from the French Ministry of Health (Programme Hospitalier de Recherche Clinique) 2015
Subjects: Pulmonary and Respiratory Medicine, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract: BackgroundStandard of care for interstitial lung disease (ILD) with a nonspecific interstitial pneumonia (NSIP) pattern proposes mycophenolate mofetil (MMF) as one of the first step therapies while rituximab is used as rescue therapy.MethodsIn a randomised, double blind, two-parallel group, placebo-controlled trial (NCT02990286), patients with connective tissue disease-associated ILD or idiopathic interstitial pneumonia (with or without autoimmune feature) and a NSIP pattern (defined on NSIP pathological pattern or on integration of clinico-biological data and a NSIP-like HRCT pattern) were randomly assigned in a 1:1 ratio to receive rituximab (1000 mg) or placebo on day 1 and day 15 in addition to MMF (2 g daily) for six months. The primary endpoint was the change in percent of predicted forced vital capacity (FVC) from baseline to 6 months analysed by a linear mixed model for repeated measures analysis. Secondary endpoints included progression-free survival (PFS) up to 6 months and safety.FindingsBetween January 2017 and January 2019, 122 randomised patients received at least one dose of rituximab (n=63) or placebo (n=59). The least-squares mean change from baseline to 6 months in FVC (% predicted) was +1.60 (se1.13) in the rituximab+MMF group and −2.01 (se1.17) in the placebo+MMF group (between-group difference, 3.60 [95% CI 0.41 to 6.80]; p=0.0273). PFS was better in the rituximab+MMF group (crude HR 0.47 [95%CI 0.23 to 0.96]; p=0.03). Serious adverse events occurred in 26 patients of the rituximab+MMF group (41%) and in 23 of the placebo+MMF group (39%). Nine infections were reported in the rituximab+MMF group (five bacterial infections, 3 viral infections, 1 other) and four bacterial infections in the placebo+MMF group.InterpretationCombination of rituximab and MMF was superior to MMF alone in patients with ILD and a NSIP pattern. The use of this combination must consider the risk of viral infection.
Published: 2023
Full Text: View/download PDF

15. PDL1-status predicts primary resistance of metastatic, EGFR-mutated Non Small Cell Lung cancers to EGFR tyrosine-kinase inhibitors

Author: Julie Lasvergnas, Vincent Fallet, Boris Duchemann, Stephane Jouveshomme, Jacques Cadranel, and Christos Chouaïd
Subjects: Pulmonary and Respiratory Medicine
Published: 2023
Full Text: View/download PDF

16. Diagnosis and prognosis of acute respiratory distress syndrome related to diffuse pneumonic-type adenocarcinoma: a single-center case series study

Author: Maxens Decavèle, Antoine Parrot, Michaël Duruisseaux, Martine Antoine, Anne Fajac, Audrey Milon, Marie-France Carette, Anthony Canellas, Aude Gibelin, Alexandre Elabbadi, Marie Wislez, Jacques Cadranel, and Muriel Fartoukh
Subjects: Pulmonary and Respiratory Medicine
Abstract: The absence of diagnosis of acute respiratory distress syndrome (ARDS) concerns 20% of cancer patients and is associated with poorer outcomes. Diffuse pneumonic-type adenocarcinoma (P-ADC) is part of these difficult-to-diagnose ARDS, but only limited data are available regarding critically ill patients with diffuse P-ADC. We sought to describe the diagnosis process and the prognosis of P-ADC related ARDS patients admitted to the intensive care unit (ICU).Single-center observational case series study. All consecutive patients admitted to the ICU over a two-decade period presenting with (I) histologically or cytologically proven adenocarcinoma of the lung and (II) ARDS according to Berlin definition were included. Clinical, biological, radiological and cytological features of P-ADC were collected to identify diagnostic clues. Multivariate logistic regression analyses were performed to assess factors associated with ICU and hospital mortality.Among the 24 patients included [70 (61-75) years old, 17 (71%) males], the cancer diagnosis was performed during the ICU stay in 19 (79%), and 17 (71%) required mechanical ventilation. The time between the first symptoms and the diagnosis of P-ADC was 210 days (92-246 days). A non-resolving pneumonia after 2 (2 to 3) antibiotics lines observed in 23 (96%) patients with a 34 mg/L (19 to 75 mg/L) plasma C-reactive protein level at ICU admission. Progressive dyspnea, bronchorrhea, salty expectoration, fissural bulging and compressed bronchi and vessels were present in 100%, 83%, 69%, 57% and 43% of cases. Cytological examination of sputum or broncho-alveolar lavage provided a 75% diagnostic yield. The ICU and hospital mortality rates were 25% and 63%, respectively. The time (in days) between first symptoms and diagnosis [odds ratio (OR) 1.02, 95% confidence interval (95% CI): 1.00-1.03, P=0.046] and the Simplified Acute Physiology Score II (OR 1.16, 95% CI: 1.01-1.33, P=0.040) were independently associated with ICU mortality.Non-resolving pneumonia after several antibiotics lines without inflammatory syndrome, associated with progressive dyspnea, salty bronchorrhea, and lobar swelling (i.e., fissural bulging, compressed bronchi and vessels) were suggestive of P-ADC. Delayed diagnosis of diffuse P-ADC seemed an independent prognostic predictor and disease timely recognition may contribute to prognosis improvement.
Published: 2022

17. Impact of Gender on the Characteristics of Patients with Idiopathic Pulmonary Fibrosis Included in the RaDiCo-ILD Cohort

Author: Sandrine Hirschi, Sonia Gueguen, M. Chevereau, Serge Amselem, Anne-Sophie Gamez, Martine Reynaud-Gaubert, Philippe Bonniaud, Dominique Israel-Biet, Annick Clement, I. Dufaure-Garé, Sylvain Marchand-Adam, Lidwine Wemeau-Stervinou, David Montani, Vincent Cottin, Jacques Cadranel, Hilario Nunes, Sébastien Quétant, Bruno Crestani, Stéphane Jouneau, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), CHU Pontchaillou [Rennes], Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Thorax et Vaisseaux [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Strasbourg, Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Lapeyronie [Montpellier] (CHU), CHU Trousseau [APHP], French National Research Agency under the 'cohorts' programme of the Investissements d'Avenir (Investments for the Future) French National Research Agency (ANR) [ANR-10-COHO-0003], ANR-10-COHO-0003,RADICO,Cohorte nationale maladies rares(2010), École pratique des hautes études (EPHE), Physiopathologie des maladies génétiques d'expression pédiatrique (UMRS_933), Sorbonne Université (SU)-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 )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), 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 Constitutif de Référence des Maladies Pulmonaires Rares [AP-HP Tenon], Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM)-Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), 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), Maladies génétiques d'expression pédiatrique [CHU Trousseau] (Inserm U933), Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM)-Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Tenon [AP-HP], UF de Génétique moléculaire [CHU Trousseau], Centre de référence national pour les maladies respiratoires rares de l’enfant RespiRare [CHU Trousseau], Service de Pneumologie pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Chard-Hutchinson, Xavier, and Cohortes - Cohorte nationale maladies rares - - RADICO2010 - ANR-10-COHO-0003 - COHO - VALID
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Vital capacity, Registry, [SDV]Life Sciences [q-bio], Idiopathic pulmonary fibrosis, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary function testing, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Rare Diseases, Internal medicine, medicine, Humans, 030212 general & internal medicine, Honeycombing, Idiopathic interstitial pneumonia, 10. No inequality, Emphysema, Patient characteristics, business.industry, Interstitial lung disease, Gender, respiratory system, medicine.disease, Confidence interval, 3. Good health, respiratory tract diseases, [SDV] Life Sciences [q-bio], 030228 respiratory system, Cohort, Quality of Life, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Female, France, business, Lung Diseases, Interstitial
Abstract: Background: There is growing evidence of gender-specific phenotypic differences among patients with idiopathic pulmonary fibrosis (IPF), which may affect patient outcomes. Objectives: We present the characteristics of patients with IPF at inclusion in the French Rare Disease Cohort – Interstitial Lung Disease (RaDiCo-ILD) with the aim of characterizing gender-specific phenotypic differences. Methods: Patients with IPF who were enrolled in the national, multicentre RaDiCo-ILD cohort were included. Demographic characteristics, comorbidities, health-related quality of life (HRQoL) scores, pulmonary function, chest imaging, and IPF treatment were collected at inclusion and described by gender. Results: The cohort included 724 patients with IPF (54% of RaDiCo-ILD cohort), of whom 82.9% were male. The proportion of male and female patients with a prior history of smoking was 75.0% and 26.8%, respectively. Emphysema was present in 17.0% (95% confidence interval [CI]: 10.0, 24.0) of men and 5.4% (95% CI: 1.2, 9.6) of women. At inclusion, females had poorer HRQoL than males based on St. George’s Respiratory Questionnaire scores (48.5 [95% CI: 43.9, 53.0] and 41.5 [39.4, 43.6], respectively). The mean forced vital capacity per cent predicted was 77.7% (95% CI: 76.2, 79.3) and 87.4% (83.4, 91.4) for males and females, respectively. Honeycombing on high-resolution computed tomography (HRCT) was present in 70.8% (95% CI: 61.0, 80.6) of males and 45.8% (95% CI: 35.1, 56.5) of females. Conclusions: This analysis of patients with IPF at inclusion in the RaDiCo-ILD cohort provides evidence that comorbid emphysema, lung volume reduction, and honeycombing on HRCT are more common characteristics of males than females.
Published: 2022
Full Text: View/download PDF

18. Detection of acquired TERT amplification in addition to predisposing p53 and Rb pathways alterations in EGFR-mutant lung adenocarcinomas transformed into small-cell lung cancers

Author: Anne Mc Leer, Matthieu Foll, Marie Brevet, Martine Antoine, Silvia Novello, Julie Mondet, Jacques Cadranel, Nicolas Girard, Matteo Giaj Levra, Pierre Demontrond, Clarisse Audigier-Valette, Eric Letouzé, Sylvie Lantuéjoul, Lynnette Fernandez-Cuesta, and Denis Moro-Sibilot
Subjects: Pulmonary and Respiratory Medicine, CCND1, EGFR, Histological transformation, Lung adenocarcinoma, RB1, Small-cell lung carcinoma, TERT, TP53, Cancer Research, Lung Neoplasms, Adenocarcinoma of Lung, Retinoblastoma Protein, Small Cell Lung Carcinoma, ErbB Receptors, Oncology, Drug Resistance, Neoplasm, Mutation, Humans, Carcinoma, Small Cell, Tumor Suppressor Protein p53, Protein Kinase Inhibitors, Telomerase
Abstract: Among the different mechanisms of acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) reported in EGFR-mutated lung adenocarcinoma (EGFR-LUAD) patients, histological transformation into small cell carcinoma (SCLC) occurs in 3-14% of resistant cases, regardless of the generation of EGFR-TKI. In recent studies, bi-allelic inactivation of TP53 and RB1 has been identified in a vast majority of transformed SCLCs. However, the molecular mechanisms driving this histologic transformation remain largely unknown, mainly due to the rarity of samples.Out of an initial cohort of 64 patients, tumor tissues of adequate quality and quantity for whole exome sequencing (WES) analysis were available for nine tumors for six patients: paired pre- and post-SCLC transformation samples for three Patients and post-SCLC transformation samples for three other patients.Mutational analyses showed concurrent TP53 mutations and Rb pathway alterations in five of the six patients analyzed, confirming their suggested role as predisposing genetic alterations to SCLC transformation. In addition, TERT amplification was detected in four of the six patients and found to be an event acquired during SCLC transformation. Clonal history evolution analyses from the paired LUAD/SCLC samples showed different evolution patterns. In two patients, a large proportion of mutations were present in the most recent common ancestor cell of the initial LUAD and the transformed SCLC clones, whereas in the third patient, few clonal mutations were common between the LUAD and SCLC samples and the ancestor clone that lead to SCLC was present at low frequency in the initial LUAD.Despite varied clinical presentations and clonal history evolution patterns, in addition to p53 and Rb pathways alterations, TERT amplification emerged as another common genetic mechanism of EGFR-LUAD to SCLC transformation in our cohort, and could represent a candidate therapeutic target in this subset of SCLC tumors.
Published: 2022

19. Lung cancer in patients with fibrosing interstitial lung diseases: an overview of current knowledge and challenges

Author: Namrata Kewalramani, Carlos Machahua, Venerino Poletti, Jacques Cadranel, Athol U. Wells, and Manuela Funke-Chambour
Subjects: Pulmonary and Respiratory Medicine, 610 Medicine & health, respiratory system, respiratory tract diseases
Abstract: Patients with progressive fibrosing interstitial lung diseases (fILD) have increased morbidity and mortality. Lung fibrosis can be associated with lung cancer. The pathogenesis of both diseases shows similarities, although not all mechanisms are understood. The combination of the diseases is challenging, due to the amplified risk of mortality, and also because lung cancer treatment carries additional risks in patients with underlying lung fibrosis. Acute exacerbations in fILD patients are linked to increased mortality, and the risk of acute exacerbations is increased after lung cancer treatment with surgery, chemotherapy or radiotherapy. Careful selection of treatment modalities is crucial to improve survival while maintaining acceptable quality of life in patients with combined lung cancer and fILD. This overview of epidemiology, pathogenesis, treatment and a possible role for antifibrotic drugs in patients with lung cancer and fILD is the summary of a session presented during the virtual European Respiratory Society Congress in 2021. The review summarises current knowledge and identifies areas of uncertainty. Most current data relate to patients with combined idiopathic pulmonary fibrosis and lung cancer. There is a pressing need for additional prospective studies, required for the formulation of a consensus statement or guideline on the optimal care of patients with lung cancer and fILD.
Published: 2022
Full Text: View/download PDF

20. Treatment outcome definitions in chronic pulmonary aspergillosis: a CPAnet consensus statement

Author: Eva Van Braeckel, Iain Page, Jesper Rømhild Davidsen, Christian B. Laursen, Ritesh Agarwal, Ana Alastruey-Izquierdo, Aleksandra Barac, Jacques Cadranel, Arunaloke Chakrabarti, Oliver A. Cornely, David W. Denning, Holger Flick, Jean-Pierre Gangneux, Cendrine Godet, Yuta Hayashi, Christophe Hennequin, Martin Hoenigl, Muhammed Irfan, Koichi Izumikawa, Won-Jun Koh, Chris Kosmidis, Christoph Lange, Bernd Lamprecht, Francois Laurent, Oxana Munteanu, Rita Oladele, Thomas F. Patterson, Akira Watanabe, Helmut J.F. Salzer, Universiteit Gent = Ghent University (UGENT), University of Southern Denmark (SDU), Instituto de Salud Carlos III [Madrid] (ISC), University of Belgrade [Belgrade], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Post Graduate Institute of Medical Education & Research [Chandigarh, India], German Center for Infectious Research - partner site Tübingen [Tübingen, Allemagne] (DZIF), University of Cologne, University of Manchester [Manchester], Medical University of Graz, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), University of California [San Diego] (UC San Diego), University of California (UC), The Aga Khan University, Nagasaki University, Sungkyunkwan University [Suwon] (SKKU), Manchester University NHS Foundation Trust (MFT), Karolinska Institute, Universität zu Lübeck = University of Lübeck [Lübeck], University Nicolae Testemitanu [Kishinev, Moldova] (UNT), University of Lagos, University of North Texas Health Science Center [Fort Worth], Chiba University, and Kepler University Hospital
Subjects: Pulmonary and Respiratory Medicine, Consensus, Treatment Outcome, [SDV]Life Sciences [q-bio], Medicine and Health Sciences, MANAGEMENT, Humans, Persistent Infection, Pulmonary Aspergillosis, GUIDELINES, DIAGNOSIS, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2021
Full Text: View/download PDF

21. Resistance mechanisms to osimertinib in EGFR-mutated advanced non-small-cell lung cancer: A multicentric retrospective French study

Author: Camille Mehlman, Etienne Giroux Leprieur, Valérie Gounant, Pierre Olivier Schischmanoff, Gaelle Rousseau-Bussac, Thierry Chinet, B. Duchemann, Jean Trédaniel, Cécile Dujon, Nicolas Girard, Jacques Cadranel, Céline Callens, Roger Lacave, Anaïs Pujals, Nathalie Théou-Anton, Hélène Blons, Sylvie Friard, CCSD, Accord Elsevier, Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie (BECCOH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay, Hôpital Ambroise Paré [AP-HP], Centre Constitutif de Référence des Maladies Pulmonaires Rares [AP-HP Tenon], Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM)-Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Intercommunal de Créteil (CHIC), Unité Génomique des tumeurs solides [CHU Tenon], Service d'Histologie - Embryologie - Cytogénétique biologie tumorale et génétique moléculaire [CHU Tenon], 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), Institut Curie [Paris], Université Paris sciences et lettres (PSL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Foch [Suresnes], Centre hospitalier Saint-Joseph [Paris], Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier de Versailles André Mignot (CHV), Hôpital Avicenne [AP-HP], Analyse moléculaire, modélisation et imagerie de la maladie cancéreuse (AMMICa), Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Institut Gustave Roussy (IGR), Adaptateurs de signalisation en hématologie (ASIH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Nord, Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM)-Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, 0301 basic medicine, Oncology, Cancer Research, Lung Neoplasms, [SDV]Life Sciences [q-bio], Resistance, 0302 clinical medicine, Non-small cell lung cancer, Carcinoma, Non-Small-Cell Lung, Osimertinib, Aged, 80 and over, Aniline Compounds, Middle Aged, Prognosis, 3. Good health, ErbB Receptors, Survival Rate, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Cohort, Carcinoma, Squamous Cell, MET, Female, Non small cell, Adult, C797S, Pulmonary and Respiratory Medicine, medicine.medical_specialty, EGFR, Met amplification, Adenocarcinoma of Lung, 03 medical and health sciences, Internal medicine, Biomarkers, Tumor, medicine, Humans, In patient, Progression-free survival, Lung cancer, Protein Kinase Inhibitors, Aged, Retrospective Studies, Acrylamides, business.industry, medicine.disease, 030104 developmental biology, Drug Resistance, Neoplasm, Tumor progression, Mutation, business, Follow-Up Studies
Abstract: International audience; Objectives: The understanding of histo-molecular mechanisms associated with resistance to osimertinib is a critical step to define the optimal treatment strategy in advanced EGFR-mutated Non-Small-Cell-Lung-Cancer (NSCLC).Materials and methods: We performed a multicentric retrospective analysis on a cohort of consecutive patients treated with osimertinib for an advanced EGFR-mutated NSCLC and collected histo-molecular data from plasma and tumor samples at the time of progression. Next-generation sequencing (NGS) was performed for all samples. Best Overall Response Rate (ORR), Progression Free Survival (PFS), Overall Survival (OS) and data on treatment post-progression efficacy were also collected.Results: Two-hundred and twenty-six patients were included from 9 Academic French Hospitals between April 2015-October 2018. Osimertinib was given in second-line or more in 219 patients (97%). Best ORR was 52% and best central nervous system ORR was 56%. Median PFS and OS were 9.5 months (IQR 4.0-17.2) and 24 months (IQR 12.4-NR) respectively. At the time of analysis, 150 patients (66%) had tumor progression. Among them, 73 contributive samples (56 tumor biopsies) were available. The most frequent molecular alterations were C797S mutation (n = 9 (13%)) and MET amplification (n = 8 (11%)). Histologic transformation occurred in 5 patients (9% of tumor biopsies). In T790M + NSCLC, loss of T790 M occurred in 68% of cases. Median PFS and OS with treatment beyond progression were 6.0 months (IQR 2.0-10.4) and 15.1 months (IQR 6.7-NR) respectively and longer in case of osimertinib continuation beyond progression.Conclusion: We confirmed the efficacy of osimertinib in patients with advanced EGFR mutation positive NSCLC. At progression, the most frequent molecular alterations were MET amplification and C797S mutation.
Published: 2019
Full Text: View/download PDF

22. Traitement des cancers bronchiques non à petites cellules de stades avancés mutés EGFR: quelle(s) séquence(s) ?

Author: Vincent Fallet, Simon Baldacci, Alexis B. Cortot, and Jacques Cadranel
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis
Abstract: Resume Les mutations de l’EGFR restent aujourd’hui le mecanisme de dependance le plus frequemment observe au cours des cancers bronchiques non a petites cellules (CBNPC) etendus, representant 12 % des adenocarcinomes et 44 % des CBNPC des non-fumeurs, en France. Les mutations « communes » de l’EGFR – deletions de l’exon 19 et mutation L858R de l’exon 21, sont observees dans 89 % des cas. L’utilisation des nouvelles techniques de biologie moleculaire nous confronte a l’identification de mutations « rares » de l’EGFR, mais aussi a la constatation d’une heterogeneite moleculaire au diagnostic et durant le suivi. Cette heterogeneite d’une part, explique en partie les variations d’efficacite observees des inhibiteurs de tyrosine kinase de l’EGFR (ITK-EGFR) et d’autre part, conduit a l’emergence de clones resistants qui orientent le traitement (T790M) lors de la progression tumorale. Jusqu’a recemment, les strategies therapeutiques de 1re et de 2e ligne etaient bien etablies, mais ont ete bouleversees par l’arrivee de l’osimertinib en 2e, puis en 1re ligne. En l’absence de donnees sur l’impact sur la survie globale de l’osimertinib et sur les mecanismes de resistances secondaires, il est important de mettre a jour nos connaissances concernant les nouvelles molecules, mais aussi les strategies de traitements deja disponibles. © 2019 SPLF. Publie par Elsevier Masson SAS. Tous droits reserves.
Published: 2019
Full Text: View/download PDF

23. Transplantation pulmonaire des adénocarcinomes pulmonaires invasifs « lépidiques » : d’une question clinique à une réflexion éthique

Author: P. Créquit, Hervé Mal, Jacques Cadranel, Thierry Berghmans, and Bogdan Grigoriu
Subjects: Pulmonary and Respiratory Medicine, Gynecology, medicine.medical_specialty, Neoplasm Recurrence, Clinical decision making, business.industry, medicine, MEDLINE, Adenocarcinoma, medicine.disease, business
Published: 2019
Full Text: View/download PDF

24. Toxicités pulmonaires des immunothérapies : évaluer et traiter

Author: A. Canellas, Vincent Fallet, Jacques Cadranel, and Lise Matton
Subjects: Pulmonary and Respiratory Medicine
Abstract: Resume Les pneumopathies induites par les inhibiteurs des points de controle immunitaires (P-ICI) sont rarement observees ( © 2019 SPLF. Publie par Elsevier Masson SAS. Tous droits reserves.
Published: 2019
Full Text: View/download PDF

25. Cryobiopsies trans-bronchiques au cours des pneumopathies interstielles diffuses – expériences préliminaires

Author: M. Febvre, O. Ouennoure, J. Camuset, Jalal Assouad, Jean-Marc Naccache, F. Wallyn, Marie-Christine Copin, Martine Antoine, C. Fournier, Jacques Cadranel, Xavier Dhalluin, and CHU Lille
Subjects: Pulmonary and Respiratory Medicine, Gynecology, Rigid bronchoscopy, medicine.medical_specialty, Lung, business.industry, [SDV]Life Sciences [q-bio], 3. Good health, Interventional pulmonology, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030228 respiratory system, Medicine, 030212 general & internal medicine, business
Abstract: Resume Introduction Dans l’approche diagnostique des pneumopathies interstitielles diffuses (PID), les cryobiopsies trans-bronchiques (cryo-BTB) apparaissent etre une alternative a la biopsie pulmonaire chirurgicale (BPC). Nous rapportons la rentabilite des cryo-BTB et leur securite pour le diagnostic de PID avec l’experience preliminaire de 2 centres universitaires francais. Methodes Vingt-quatre patients ont beneficie de cryo-BTB pour le diagnostic de PID au bloc operatoire entre 2014 et 2017. Tous les diagnostics histologiques obtenus etaient ensuite valides lors de discussions multidisciplinaires (DMD). Resultats Les patients ont eu en moyenne 3 cryo-BTB. Les cryo-BTB etaient analysables chez 22/24 (91,7 %) patients, permettant un diagnostic histologique chez 14/22 (63,6 %) patients et un diagnostic de certitude dans 13/22 (59 %) cas apres DMD. La rentabilite diagnostique globale des cryo-BTB etait de 13/24 (54,2 %). En tenant compte de la courbe d’apprentissage pour les 15 patients ayant eu leurs cryo-BTB apres 2015, on note un diagnostic apres DMD pour 12 d’entre eux soit 80 %. Neuf (37,5 %) patients ont eu un pneumothorax. Cinq (20,8 %) patients ont eu un saignement. Il n’y a eu aucun deces. Conclusion Une etude prospective randomisee permettrait d’evaluer la technique en France afin de preciser son rendement diagnostique et son profil de securite en comparaison a la BPC.
Published: 2019
Full Text: View/download PDF

26. Use of tyrosine kinase inhibitors during pregnancy for oncogenic-driven advanced non-small cell lung carcinoma

Author: Anne-Sophie Boudy, Cyril Touboul, Joseph Gligorov, Lise Selleret, Emile Daraï, Jacques Cadranel, Isabelle Thomassin-Naggara, and Noémie Grausz
Subjects: Pulmonary and Respiratory Medicine, Oncology, Cancer Research, medicine.medical_specialty, Lung Neoplasms, medicine.drug_class, Population, Tyrosine-kinase inhibitor, Trastuzumab, Pregnancy, Internal medicine, Carcinoma, Non-Small-Cell Lung, medicine, Carcinoma, Humans, Osimertinib, Molecular Targeted Therapy, education, Lung cancer, Protein Kinase Inhibitors, education.field_of_study, business.industry, Infant, Newborn, Cancer, medicine.disease, respiratory tract diseases, ErbB Receptors, Mutation, Female, business, medicine.drug
Abstract: Introduction Lung cancer associated with pregnancy is rare but on the increase. The use of tyrosine kinase inhibitor (TKI) therapy for advanced oncogenic-driven non-small cell lung carcinoma (NSCLC) has improved overall survival. Oncological and obstetric outcomes of patients diagnosed with NSCLC and treated by TKIs during pregnancy have been poorly evaluated. Methods Three cases of NSCLC treated by TKIs during pregnancy were collected from the prospective database of the Cancer Associe a La Grossesse (CALG) network (France) in addition to eight cases identified by a systematic review performed between 2000 and 2021. Results Among the eleven reported patients, six received an EGFR- and five an ALK-TKI. All patients were young nonsmokers and four had brain metastases at diagnosis. TKI treatment was initiated during the first trimester for three patients. Premature delivery was induced in 10/11 patients. Anamnios occurred in one patient treated by osimertinib and trastuzumab. Five newborns were hypotrophic. No newborn malformations were observed. Diffusion of the TKIs, confirmed by blood cord sampling, represented about 1/3 (EGFR-TKI) and 1/8 (ALK-TKI) of the maternal concentration. No developmental abnormalities were observed in the children (follow-up 30 months). The anti-tumor efficacy and tolerance of TKIs, when reported, appears similar to that described in the general population. Conclusions Our results support the rationale for using TKIs during pregnancy, both in terms of maternal NSCLC disease control and the relatively mild effects on the fetus. Our data will serve to better inform patients about the risks associated with TKIs used during pregnancy, contributing to shared decision making.
Published: 2021

27. Circulating tumor DNA in advanced non-small-cell lung cancer patients with HIV is associated with shorter overall survival: Results from a Phase II trial (IFCT-1001 CHIVA)

Author: Pierre Laurent-Puig, H. Janicot, Charles Ricordel, Hélène Blons, Alexandra Langlais, Laurent Greillier, Philippe Fraisse, Marie Wislez, Isabelle Monnet, Nathalie Rabbe, Alain Makinson, Clarisse Audigier-Valette, Jean Philippe Spano, Elodie Amour, Julien Mazieres, Charlotte Domblides, Jacques Cadranel, Xavier Quantin, Armelle Lavolé, Lize Kiakouama-Maleka, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO), 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)-Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Pneumologie [CHI Créteil], CHI Créteil, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Institut du Cancer de Montpellier (ICM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Nouvel Hôpital Civil de Strasbourg, Service de Pneumologie [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, Intergroupe Francophone de Cancérologie Thoracique [Paris] (IFCT), Intergroupe Francophone de Cancérologie thoracique, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Groupe de recherche clinique Biomarqueurs Théranostiques des Cancers Bronchiques Non à Petites Cellules (GRC 4 - Theranoscan), Sorbonne Université (SU), and This work was supported by Prix Alain Depierre IFCT.
Subjects: Male, 0301 basic medicine, Pulmonary and Respiratory Medicine, Oncology, Cancer Research, medicine.medical_specialty, Lung Neoplasms, Population, HIV Infections, [SDV.CAN]Life Sciences [q-bio]/Cancer, Pemetrexed, medicine.disease_cause, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Carboplatin, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Maintenance therapy, Carcinoma, Non-Small-Cell Lung, Internal medicine, Biomarkers, Tumor, medicine, Humans, Stage (cooking), Lung cancer, education, education.field_of_study, Circulating tumor DNA, Performance status, business.industry, Middle Aged, medicine.disease, HIV positivity, 030104 developmental biology, chemistry, 030220 oncology & carcinogenesis, Mutation, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, KRAS, business, Non-small-cell lung cancer, medicine.drug
Abstract: International audience; IntroductionHIV is an exclusion criterion for most lung cancer (LC) trials, however LC is the most common non-AIDS-defined malignancy in people living with HIV (PLHIV), poorer prognosis than the general population. Circulating tumor DNA (ctDNA) was a prognostic marker in LC patients from the general population. This study assessed ctDNA’s prognostic value in PLHIV from a dedicated phase II trial.MethodsOverall, 61 PLHIV with advanced non-squamous non-small-cell lung cancer (NSCLC) participated in the IFCT Phase II trial evaluating first-line four-cycle carboplatin (Ca) AUC5 pemetrexed (P) 500 mg/m2 induction therapy every 3 weeks, followed by P maintenance therapy. Blood samples collected before treatment were analyzed to detect ctDNA using ultra-deep targeted next-generation-sequencing (NGS).ResultsAppropriate samples were available from 55 PLVIH and analyzed for ctDNA detection. Including 42 males (76.4 %), 52.9 years median age, 51 smokers (92.7 %), five with non-squamous NSCLC Stage III (9%), 50 Stage IV (91 %), and performance status (PS) 0−2. ctDNA was detected in 35 patients (64 %), 22 with high and 13 with low ctDNA levels. Overall, 77 % were positive for TP53, 29 % for KRAS, and 11 % for STK11 mutations, more than one alteration was detected in 43 % of samples. Multivariate analysis showed that positive ctDNA was significantly associated with shorter PFS (HR, 4.31, 95 %CI: 2.06−8.99, p
Published: 2021
Full Text: View/download PDF

28. Daily multidisciplinary COVID-19 meeting: experiences from a French university hospital

Author: Audrey Milon, Floriane Millet, Michel Denis, Pascaline Choinier, Jean Simon Rech, Nicolas Belaube, Corinne Amiel, Deborah Sroussi, Jacques Cadranel, Martine Nadal, Muriel Fartoukh, Camille Rolland-Debord, Isabelle Debrix, Camille Petit-Hoang, Sophie Georgin-Lavialle, Antoine Parrot, S. Mattioni, Pierre Rigaud, A. Canellas, Ludovic Lassel, Emmanuelle Blin, Martin Siguier, Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon]
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Standard of care, Coronavirus disease 2019 (COVID-19), Clinical Decision-Making, prospective cohorts, 030204 cardiovascular system & hematology, World health, Article, Hospitals, University, Multidisciplinary meetings, 03 medical and health sciences, 0302 clinical medicine, Multidisciplinary approach, medicine, Medical Staff, Hospital, therapeutic trials, Humans, 030212 general & internal medicine, Medical prescription, Aged, Aged, 80 and over, business.industry, COVID-19, Middle Aged, University hospital, Therapeutic trial, 3. Good health, Group Processes, standard of care, Family medicine, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, France, business
Abstract: International audience; ObjectivesIn March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. In absence of official recommendations, implementing daily multidisciplinary team (MDT) COVID-19 meetings was urgently needed. Our aim was to describe our initial institutional standard operating procedures for implementing these meetings, and their impact on daily practice.MethodsAll consecutive patients who were hospitalized in our institution due to COVID 19, from March 31 to April 15, 2020, were included. Criteria to be presented at MDT meetings were defined as a proven COVID-19 by PCR or strongly suspected on CT scan, requiring hospitalization and treatment not included in the standard of care. Three investigators identified the patients who met the predefined criteria and compared the treatment and outcomes of patients with predefined criteria that were presented during MDT meeting with those not presented during MDT meeting. COVID-19 MDT meeting implementation and adhesion were also assessed by a hospital medical staff survey.ResultsIn all, 318 patients with confirmed or suspected COVID-19 were examined in our hospital. Of these, 230 (87%) were hospitalized in a COVID-19 unit, 91 (40%) of whom met predefined MDT meeting criteria. Fifty (55%) patients were presented at a MDT meeting versus 41 (45%) were not. Complementary exploration and inclusion in the CorImmuno cohort were higher in MDT meeting group (respectively 35 vs. 15%, P = 0.03 and 80 versus 49%, P = 0.0007). Prescription of hydrocortisone hemisuccinate was higher in group of patients not presented during MDT meeting (24 vs. 51%, P = 0.007). Almost half of the patients fulfilling the inclusion criteria were not presented at MDT meeting, which can be partly explained by technical software issues.ConclusionsMultidisciplinary COVID-19 meetings helped implementing a single standard of care, avoided using treatments that were untested or currently being tested, and facilitated the inclusion of patients in prospective cohorts and therapeutic trials.
Published: 2021
Full Text: View/download PDF

29. Assessment of nivolumab in HIV-Infected patients with advanced non-small cell lung cancer after prior chemotherapy. The IFCT-1602 CHIVA2 phase 2 clinical trial

Author: Armelle Lavolé, L. Kiakouama, Jean-Philippe Spano, Laurent Greillier, Sophie Schneider, Marine Baron, Alain Makinson, Solenn Brosseau, Franck Morin, Alexandra Langlais, Amélie Guihot, Baptiste Abbar, Julien Mazieres, Jacques Cadranel, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Centre Hospitalier de la Côte Basque (CHCB), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO), 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)-Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Intergroupe Francophone de Cancérologie Thoracique [Paris] (IFCT), and Intergroupe Francophone de Cancérologie thoracique
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Oncology, Male, Cancer Research, medicine.medical_specialty, Lung Neoplasms, Phases of clinical research, [SDV.CAN]Life Sciences [q-bio]/Cancer, HIV Infections, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Carcinoma, Non-Small-Cell Lung, Clinical endpoint, Medicine, Humans, Prospective Studies, Lung cancer, Adverse effect, MESH: Humans, MESH: Middle Aged, business.industry, HIV, Common Terminology Criteria for Adverse Events, MESH: HIV Infections, Middle Aged, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Lung Neoplasms, 030104 developmental biology, Nivolumab, Tolerability, Response Evaluation Criteria in Solid Tumors, 030220 oncology & carcinogenesis, MESH: Nivolumab, [SDV.IMM]Life Sciences [q-bio]/Immunology, Non small cell lung cancer, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Immunotherapy, business, MESH: Carcinoma, Non-Small-Cell Lung
Abstract: Importance Therapies targeting immune checkpoints, such as the programmed cell death 1 (PD-1) receptor, have become the standard-of-care for patients with non-small cell lung cancer (NSCLC), but people living with HIV (PLWH) were excluded from these studies. Objective To evaluate the efficacy and tolerability of nivolumab in PLWH with advanced NSCLC. Design The CHIVA2 study was a nonrandomized, open-label, phase 2 clinical trial in PLWH with previously treated advanced NSCLC. Setting National multicenter prospective study. Participants patients had viral load of Intervention Nivolumab was administered in second or third line, as monotherapy intravenously at 3 mg/kg every 2 weeks, until disease progression or limiting toxicity. Main Outcomes and Measures The primary endpoint was disease control rate, evaluated using the Response Evaluation Criteria in Solid Tumors, version 1.1. Adverse events were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results Sixteen patients with advanced NSCLC were enrolled: 14 (88 %) were men, median age was 58 years (range: 44−71), and all were smokers. The median duration of nivolumab treatment was 3.5 months (range: 0.5–26.5). The median follow-up was 23.6 months. Disease control rate was 62.5 % for 15 evaluable patients at 8 weeks (2 with partial response, 8 with stable disease, and 5 with disease progression). Twelve (75 %) patients had treatment-related adverse events, which were mild or moderate, except for one patient experiencing severe pruritus, onycholysis, and pemphigoid. There were no opportunistic infections or unexpected immune-related events. HIV viral load was stable during treatment. An increase in proliferating CD8+ and CD4+ T-cells was observed after 3 nivolumab cycles in a subgroup of 9 patients. Conclusions and Relevance Second/third-line nivolumab treatment was well-tolerated and beneficial in PLWH with NSCLC. Future trials should investigate immune checkpoint inhibitors in first-line settings. Trial Registration EudraCT.ema.europa.eu registration number: 2016−003796-22
Published: 2021
Full Text: View/download PDF

30. Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial

Author: Mathieu Vautier, Florence Tubach, Marion Licois, Estelle Henry, Marie-Alexandra Alyanakian, Julien Poissy, Solaya Chalal, Anne Gysembergh-Houal, Stéphanie Alary, Sophie Diemunsch, Jonathan London, Camille Petit-Hoang, Ruben Benainous, Catherine Metzger, Olivier Benveniste, Hala Semri, Charléne Jouve, Robin Dhote, johann Cailhol, Elise Morawiec, Kristina Beziriganyan, Mathieu Oberlin, Paul Legendre, Hélène François, Claire Davoine, F Louni, Myriam Virlouvet, Stéphane Renaud, Christiane Verny, Bertrand Guidet, Bob Heger, Lara Zafrani, Pierre-Louis Tharaux, Mandy Nizard, Adrien Contejean, Segolene Toquet, Ulrich Clarac, Sylviane Ravato, Gaëtan Deslée, Frédéric De Blay, Christian Richard, Raphaël Porcher, Malikhone Chansombat, Marie Lachatre, Ines Ben-Mabrouk, Matthieu Uzzan, Lauren Demerville, Amélie Servettaz, Annabelle Pourbaix, Philippe Manivet, Fanny Charbonnier, Pierre-Grégoire Guinot, Alexandre Demoule, Nicolas Champtiaux, Nicolas Belaube, Jean-Pierre Riveline, Kamil Chitour, Joseph Emmerich, Arthur Neuschwander, Mickael Henriques, Anne Hutt, Arthur Pavot, Anne Rachline, Elena Fois, Audrey Phibel, Xavier Monnet, Jean-Charles Duclos-Vallée, Félix Ackermann, Maria Pereira, Anne Sophie Korganow, Elodie Drouet, Tabassome Simon, Morgane Faure, Anne Pattyn, Aida Zahrate-Ghoul, Karine Martin, Jean-Jacques Tudesq, Gladys Aratus, Kévin Cardet, Julien Pottecher, Eric Demonsant, Arsène Mekinian, Rémy Gauzit, Julie Smati, Robin Deleris, Jean-Simon Rech, Boris Bienvenu, Nicolas Lefebvre, Elodie Baudry, Nicolas Bonnet, Alexis Régent, François Weill, Lalia Djaghout, Anne Tréhan, Isabelle Lehir, Elena Kiouris, Sophie Renet, Yasmina Mekid, Vanessa Rathouin, David Montani, Annick Tibi, Anne Blanchard, Fanette Denies, Nathalie Menage, Guillaume Becker, Valérie Camara-Clayette, Loic Kassegne, Nathalie Chavarot, Aurélie Clan Hew Wai, Jeremy Arzoine, Louise Bondeelle, Mohamad Zaidan, S Lariven, Laurent Cylly, Edouard Flamarion, Chaouki Bouras, Florence Bellenfant, Melissa Clément, Lola-Jade Palmieri, Marie hélène Pari, Lionel Galicier, Valérie Dejean, Delphine Feyeux, Naima Sguiouar, Anne Bergeron, Laurence Annonay, Anouk Walter-Petrich, Camille Knosp, Laurence Drouard, Thiziri Sadaoui, Julie Delemazure, Antoine Parrot, Carole Burger, Laurence Berard, Nicolas Gambier, Eric Marquis, Isabelle Madeleine, Gwenaël Lorillon, Matthieu Resche-Rigon, Yves Hansmann, Claire Rouzaud, Hélène Gros, Sophie Caillat-Zucman, Bernard Cholley, Celine Wilpotte, Chistophe Willekens, Lydia Suarez, Syllia Belazouz, Valérie Pourchet-Martinez, Dhiaa Meriem Hai, Olivier Collange, Paul Jaubert, Marie-Thérèse Tremorin, Nathalie Marin, Diane Le Pluart, Madona Sakkal, Juliette Djadi-Prat, Alexandre Morel, Agathe Bounhiol, Xavier Jaïs, Nicolas Meyer, Vixra Keo, Michaël Darmont, Benedicte Giroux-Leprieur, Anatole Harrois, Anne Adda, Yaël Amara, Fanny Pommeret, Antony Canellas, Matheus Vieira, Clotilde Le Tiec Le Tiec, Corinne Pernot, Bernard Goichot, Céline Louapre, Roza Rahli, Anne Jacolot, Anne Daguenel-Nguyen, Marie Dubert, Anaïs Razurel, Aurelie Sautereau, Mitja Jevnikar, Pierre Faye, Jeanne CHAUFFiER, Mathieu Jozwiak, Laurent Savale, Florence Patin, Kahina Cheref, Mélanie Dehais, Paul Michel Mertes, Caroline Morbieu, Valérie Paquet, Dominique Roulot, Giovanna Melica, Pauline Jouany, Frédéric Schlemmer, Blandine Lehmann, Pascal Martel, Tomas Urbina, Yazdan Yazdanpanah, Veronique Joly, Damien Bergerot, Claire Courtin, Benjamin Fournier, Guillaume Grailles, Asmaa Mamoune, Caroline Gaudefroy, Charlotte Kaeuffer, Bruno Crestani, Thinhinane Bariz, C Rioux, Karine Celli Lebras, Sophie Granville, Marion Bouhris, Hugues Cordel, Jean-Marie Michot, Mohamed Belloul, Nadège Lemarié, Philippe Dieudé, Sylvie Le Gac, Matthieu Mahévas, Pascal Richette, Anaïs Codorniu, Camille Rolland-Debord, Edouard Lefèvre, Sophie-Rym Hamada, Tristan Martin, Vincent Castelain, Aude Rigolet, Valentin Greigert, Gaelle Leroux, Simon Valayer, Eliane Bertrand, Eric Vicaut, Stéphane Brin, Jacques-Eric Gottenberg, Olivier Clovet, Marc Bardou, Muriel Fartoukh, Valentina Isernia, Ada Clarke, Bao Phung, Grégoire Martin de Frémont, Jeanne Meunier, Gonçalo Boleto, David Lebeaux, Hassan Tarhini, Asmaa Mabrouki, Pascaline Choinier, Etienne Canouï, Eric D'Ortenzio, Constance Guillaud, Corine Nyanou, Alexandre Moores, Linda Gimeno, Victoire De Lastours, F-Xavier Lescure, Claire Montlahuc, Sophie Georgin-Lavialle, A Soria, Xavier Mariette, Sophie Ismael, Prissile Bakouboula, Olivier Lambotte, Jérémie Zerbit, Aude Jacob, Z Julia, Nathalie Dournon, Marthe Rigal, Mireille Adda, Nathan Ebstein, Frédéric Duée, Helene Chambrin-Lauvray, Ramdane Meftali, Hélène Lafoeste, Coralie Bloch Queyrat, Sabrina Brahmi, Catherine Le Bourlout, Nicolas Noel, Emmanuelle Guillot, Hakim Tayebi, Sandrine Briois, Anne-Lise Pouliquen, Lakhdar Mameri, Sophie-Caroline Sacleux, Nathalie Rozensztajn, Lelia Escaut, Clément Jourdaine, Cédric Pierron, Marc Garnier, Yves Cohen, Abdellatif Tazi, Maxence Decavele, Paul Henri Grisot, Patrice Cacoub, Laure Allanic, Amira Benattia, Martin Siguier, Luca Semerano, Jean-Sébastien Hulot, Jean-Jacques Mourad, Sara Sambin, Miguel Alejandro Vasquez-Ibarra, Nabil Raked, Christine Lemagner, Martin Dres, Clara Campos-Vega, Tali-Anne Szwebel, Benjamin Chaigne, Emmanuel Andrès, Gabriel Steg, Frédéric Blanc, Isabelle Peigney, Catherine Fauvaux, Côme Bureau, Samira Saleh-Mghir, Julie Jambon, Pierre Dupland, Anne Lise Jegu, Mamadou Salif Cisse, Damien Roux, Moez Jallouli, Philippe Blanche, Sébastien Cavelot, Sophie Ohlmann-Caillard, Louise-Laure Mariani, Adrien Michon, Alain Wynckel, Saskia Flamand, Safaa Nemlaghi, Benjamin G. Chousterman, Geoffroy Volle, Cécile Kedzia, Fanny Domont, Lee S. Nguyen, Férial Berbour, Pierre Diemunsch, Celine Dupré, Etienne Lengliné, Claire Tantet, Gaël Leprun, Sara Virolle, Perrine Guillaume-Jugnot, Soumeya Hammal, B. Duchemann, Mathilde Le Marchand, Vincent Poindron, Victor Lancon, Ruxandra Burlacu, Guillaume Lefèvre, Kamyl Baghli, Emilia Stan, Yann Nguyen, Olivier Sanchez, Olivier Sitbon, Loren Soyez-Herkert, Fanny Defrancq, Véronique Vigna, Aurélien Guffroy, Martine Meunier, Pierre Mora, Léa Resmini, Liem Binh Luong Nguyen, Jean-Luc Diehl, Johanna Oziel, Emmanuelle Bugnet, Lamiae Grimaldi, Olivia Daconceicao, Marie Matignon, Mourad Djadel, Yasmine Messaoudi, Hassan Joumaa, Isabelle Dusanter, Sarah Benghanem, Julien Mayaux, Marc Michel, Claire Pernin, Antoine Gros, Nassim Mahtal, Philippe Benoit, Cloé Comarmond, Laurence Lecomte, Patricia Senet, Sebastien Abad, Jérôme Pacanowski, Céline Leplay, Claire Aguilar, Cédric Sublon, Jesuthasan Denis, Régis Peffault de Latour, Gabrielle Archer, Alain Fourreau, Emmanuelle Blin, Lise Bernard, Alexandra Beurton, Alexandre Buffet, Pierre Le Guen, Clairelyne Dupin, Olivier Fain, A Gervais, Marc Humbert, Yves Allenbach, Alexandre Bourgoin, Agnes Maurer, Eric Noll, Virginie Elisee, Adrien Mirouse, Cecile Larcheveque, Carine Karachi, Samy Figueiredo, Hakim Meddah, Greggory Ducrocq, Jeanne Goupil de Bouille, Awa Ndiaye, Jessica Krause le Garrec, Maxime Dougados, Yasmina Ferfar, Damien Vimpere, Olivier Olivier, Annabelle Stoclin, Jean-Louis Teboul, Ridha Belilita, Serge Bureau, Naura Gamany, Emeline Colomba, Baptiste Duceau, Philippe Ravaud, Corinne Guerin, Florence Morin, Pélagie Thibaut, Younes Keroumi, Julie Chas, Elisabeth Coupez, Laetitia Languille, Mathias Cornic, Jean-Michel Molina, Caroline Pradon, Alison Klasen, Zakaria Ait Hamou, Armand Mekontso-Dessaps, Yurdagul Uzunhan, Samir Hamiria, Anne Godier, Elsa Feredj, Nessima Yelles, Jean-Benoit Arlet, Christine Broissand, Belkacem Asselate, Jaouad Benhida, Julien Le Marec, Nawal Derridj, Laurène Deconinck, A. Dossier, Eric Oksenhendler, Eva Chatron, Lucie Aunay, Candice Estellat, Julie Fillon, Marie Antignac, Jade Ghosn, Ilias Koumis, David Schmitz, Domitille Molinari, Soraya Fellahi, Bruno Mégarbane, Aline Frazier, Ramon Junquera, Vincent Provitolo, Marie Lecronier, Dimitri Fremont, Pierrick Le Borgne, Emmanuel Weiss, Faouzi Saliba, Stéphan Pavy, Geoffrey Rossi, Chloe McAvoy, Eric Mariotte, Dorothee Vallois, Sabrine Ouamri, Pierre Tissieres, Luc Mouthon, Blandine Denis, Celine Comparon, Emmanuelle Sacco, Frédéric Pène, Marjolaine Morgand, Vasco Honsel, Laure Choupeaux, Bruno Mourvillier, Ewa Kozaliewicz, Marie-Hélène Legros, Isabelle Debrix, Gabriel Nisand, Julien Chabert, Juliette Camuset, Stéphane Jauréguiberry, Lynda Chalal, Marine Livrozet, Lucie Biard, Elodie Perrodeau, Brigitte Sabatier, Raphael Borie, Rosa Da Silva, Nathalie Costedoat-Chalumeau, Emmanuel Chatelus, Jean-Christophe Corvol, Nathalie De Castro, David Boutboul, Benjamin Planquette, Anne Claire Desbois, François Danion, Brigitte Ranque, Amélie Cransac, Marine Nadal, Coralie Gernez, Yacine Boudali, Claire Madelaine, Georgina Maalouf, Jonathan Marey, Sophie Bayer, Antoine Fayol, Souad Benarab, Luc Haudebourg, Sophie Bulifon, Claire Pacheco, Philippe Durand, Olivier Hermine, Fanny Alby-Laurent, Geoffroy Liégeon, Axelle Fuentes, Jean-Daniel Lelievre, Gilles Garcia, Céline Verstuyft Verstuyft, Marie-Aude Penet, Constance Delaugerre, Nicolas Carlier, Aurélie Durel Maurisse, Gilles Pialoux, Zeina Louis, Marion Parisey, Pascal Lim, Gaelle Clavere, Martin De Sarcus, Marie Vayssettes, Thomas Papo, Adrien Joseph, Hilario Nunes, Hanane Fodil, Solen Kernéis, Antoine Bachelard, Jacques Duranteau, Karine Lacombe, Olivia Lenoir, Mathilde Vallet, Isabelle Brindele, Robin Charreteur, Elie Azoulay, Dorothée Chopin, Aïcha Bah, Moustafa Benafla, Marie Gilbert, Matthieu Lemoine, Abolfazl Mohebbi, Mathilde Noaillon, Amina Kebir, Virginie Zarrouk, Cécile Yelnik, Benjamin Terrier, Solène Fabre, Paul Crespin, Sarah Dalibey, Thierno Dieye, Renaud Felten, Oriane Puéchal, Pernelle Vauboin, Caroline Hauw-Berlemont, Gabriel Baron, Paul Vermes, Yvon Ruch, Dominique Dautel, Tassadit Hadjam, Anne-Marie Roques, Jean-Philippe Bastard, Younes El Amine, Damien Sène, Alaki Thiemele, Catherine Boussard, Vincent Fallet, Timothee Bironne, Damien Vanhoye, Guillaume Geri, Amine Ghembaza, Bertrand Dunogue, Nadia Anguel, Laure Berton, Caroline Semaille, Thomas Volpe, Jacques Cadranel, Thomas Gorget, Julien Saussereau, Elodie Issorat, Sami Kolta, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Porcher, Raphaël
Subjects: Male, medicine.medical_treatment, [SDV]Life Sciences [q-bio], [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, law.invention, 0302 clinical medicine, Randomized controlled trial, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, law, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, education.field_of_study, Hazard ratio, Articles, Middle Aged, Intensive care unit, Hospitals, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Hospitalization, [SDV.TOX] Life Sciences [q-bio]/Toxicology, Treatment Outcome, [SDV.TOX]Life Sciences [q-bio]/Toxicology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, medicine.drug, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Care, Population, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, education, Critical Care Outcomes, Aged, Mechanical ventilation, Anakinra, SARS-CoV-2, business.industry, Comment, COVID-19, Bayes Theorem, Pneumonia, medicine.disease, Respiration, Artificial, COVID-19 Drug Treatment, Clinical trial, Interleukin 1 Receptor Antagonist Protein, 030228 respiratory system, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, business, Interleukin-1
Abstract: International audience; Background: Patients with COVID-19 pneumonia have an excess of inflammation and increased concentrations of cytokines including interleukin-1 (IL-1). We aimed to determine whether anakinra, a recombinant human IL-1 receptor antagonist, could improve outcomes in patients in hospital with mild-to-moderate COVID-19 pneumonia.Methods: In this multicentre, open-label, Bayesian randomised clinical trial (CORIMUNO-ANA-1), nested within the CORIMUNO-19 cohort, we recruited patients from 16 University hospitals in France with mild-to-moderate COVID-19 pneumonia, severe acute respiratory syndrome coronavirus 2 infection confirmed by real-time RT-PCR, requiring at least 3 L/min of oxygen by mask or nasal cannula but without ventilation assistance, a score of 5 on the WHO Clinical Progression Scale (WHO-CPS), and a C-reactive protein serum concentration of more than 25 mg/L not requiring admission to the intensive care unit at admission to hospital. Eligible patients were randomly assigned (1:1) using a web-based secure centralised system, stratified by centre and blocked with varying block sizes (randomly of size two or four), to either usual care plus anakinra (200 mg twice a day on days 1-3, 100 mg twice on day 4, 100 mg once on day 5) or usual care alone. Usual care was provided at the discretion of the site clinicians. The two coprimary outcomes were the proportion of patients who had died or needed non-invasive or mechanical ventilation by day 4 (ie, a score of >5 on the WHO-CPS) and survival without need for mechanical or non-invasive ventilation (including high-flow oxygen) at day 14. All analyses were done on an intention-to-treat basis. The trial is registered with ClinicalTrials.gov, NCT04341584, and is now closed to accrual.Findings: Between April 8 and April 26, 2020, we screened 153 patients. The study was stopped early following the recommendation of the data and safety monitoring board, after the recruitment of 116 patients: 59 were assigned to the anakinra group, and 57 were assigned to the usual care group. Two patients in the usual care group withdrew consent and were not analysed. In the analysable population, the median age was 66 years (IQR 59 to 76) and 80 (70%) participants were men. In the anakinra group, 21 (36%) of 59 patients had a WHO-CPS score of more than 5 at day 4 versus 21 (38%) of 55 in the usual care group (median posterior absolute risk difference [ARD] -2·5%, 90% credible interval [CrI] -17·1 to 12·0), with a posterior probability of ARD of less than 0 (ie, anakinra better than usual care) of 61·2%. At day 14, 28 (47%; 95% CI 33 to 59) patients in the anakinra group and 28 (51%; 95% CI 36 to 62) in the usual care group needed ventilation or died, with a posterior probability of any efficacy of anakinra (hazard ratio [HR] being less than 1) of 54·5% (median posterior HR 0·97; 90% CrI 0·62 to 1·52). At day 90, 16 (27%) patients in the anakinra group and 15 (27%) in the usual care group had died. Serious adverse events occurred in 27 (46%) patients in the anakinra group and 21 (38%) in the usual care group (p=0·45).Interpretation: Anakinra did not improve outcomes in patients with mild-to-moderate COVID-19 pneumonia. Further studies are needed to assess the efficacy of anakinra in other selected groups of patients with more severe COVID-19.Funding: The Ministry of Health, Programme Hospitalier de Recherche Clinique, Foundation for Medical Research, and AP-HP Foundation.
Published: 2021
Full Text: View/download PDF

31. Real-world treatment outcomes with brigatinib in patients with pretreated ALK+ metastatic non-small cell lung cancer

Author: Sanjay Popat, Jacques Cadranel, Enriqueta Felip, Christian Kruhl, Marina Chiara Garassino, Odd Terje Brustugun, Frank Griesinger, Nawal Bent-Ennakhil, Åslaug Helland, Maurice Pérol, Maximilian Hochmair, Silvia Novello, The institute of cancer research [London], Theranoscan [CHU Tenon] (GRC 4), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Vall d'Hebron University Hospital [Barcelona], IRCCS Istituto Nazionale dei Tumori [Milano], University of Oldenburg, University of Oslo (UiO), Klinik Floridsdorf [Wien], Centre Léon Bérard [Lyon], Takeda Pharmaceuticals International GmbH, Università degli studi di Torino (UNITO), Institut Català de la Salut, [Popat S] Royal Marsden Hospital and The Institute of Cancer Research, London, UK. [Brustugun OT] Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway. [Cadranel J] Chest Department and Thoracic Oncology, AP-HP Hôpital Tenon and GRC#4 Theranoscan Sorbonne Université Paris, Service de Pneumologie et Oncologie Thoracique, Assistance Publique Hôpitaux de Paris, Paris 75970, France. [Felip E] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Garassino MC] Division of Medical Oncology, Thoracic Oncology Unit, Fondazione IRCCS – Istituto Nazionale dei Tumori, 20126 Milan, Italy. The University of Chicago, Department of Medicine Section Hematology/Oncology Knapp Center For Biomedical Discovery, Illinois 60637, USA. [Griesinger F] Department of Hematology and Oncology, University Dept. Internal Medicine-Oncology, Innere Medizin-Onkologie, Koordinator Cancer Center Oldenburg, Pius Hospital, University Medicine Oldenburg, Medizinischer Campus Universität Oldenburg, D-26121 Oldenburg, Germany, and Vall d'Hebron Barcelona Hospital Campus
Subjects: 0301 basic medicine, Alectinib, Oncology, Male, Cancer Research, Lung Neoplasms, [SDV]Life Sciences [q-bio], Tyrosine kinase inhibitor, Other subheadings::Other subheadings::/drug therapy [Other subheadings], NSCLC, 0302 clinical medicine, hemic and lymphatic diseases, Carcinoma, Non-Small-Cell Lung, Anaplastic lymphoma kinase, Medicine, Anaplastic Lymphoma Kinase, Real-world evidence, Norway, Neoplasms::Neoplastic Processes::Neoplasm Metastasis [DISEASES], Neoplasms::Neoplasms by Site::Thoracic Neoplasms::Respiratory Tract Neoplasms::Lung Neoplasms::Bronchial Neoplasms::Carcinoma, Bronchogenic::Carcinoma, Non-Small-Cell Lung [DISEASES], Middle Aged, 3. Good health, Treatment Outcome, Tolerability, Italy, 030220 oncology & carcinogenesis, medicine.drug, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, medicine.drug_class, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], 03 medical and health sciences, Organophosphorus Compounds, Metàstasi, Internal medicine, Humans, Protein Kinase Inhibitors, Retrospective Studies, Crizotinib, Ceritinib, business.industry, ALK, Brigatinib, diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], neoplasias::neoplasias por localización::neoplasias torácicas::neoplasias del tracto respiratorio::neoplasias pulmonares::neoplasias de los bronquios::carcinoma broncogénico::carcinoma de pulmón de células no pequeñas [ENFERMEDADES], Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Lorlatinib, ALK inhibitor, 030104 developmental biology, Pyrimidines, neoplasias::procesos neoplásicos::metástasis neoplásica [ENFERMEDADES], Spain, Expanded access, Avaluació de resultats (Assistència sanitària), business, Pulmons - Càncer - Tractament
Abstract: Brigatinib; NSCLC; Inhibidor de la tirosina quinasa Brigatinib; NSCLC; Inhibidor de la tirosina quinasa Brigatinib; NSCLC; Tyrosine kinase inhibitor Background The next-generation ALK inhibitor brigatinib is approved for use in patients with ALK inhibitor-naïve ALK-positive advanced NSCLC and in patients previously treated with crizotinib. A phase II trial showed that brigatinib is active in patients with ALK-positive metastatic NSCLC (mNSCLC) who had progressed on prior crizotinib (response rate 56 %, median PFS 16.7 months, median OS 34.1 months). We report final data from the UVEA-Brig study of brigatinib in ALK inhibitor-pretreated ALK-positive mNSCLC in clinical practice. Methods UVEA-Brig was a retrospective chart review of patients treated with brigatinib in Italy, Norway, Spain and the UK in an expanded access program. Adults with ALK-positive mNSCLC, including those with brain lesions, resistant to or intolerant of ≥1 prior ALK inhibitor and ECOG performance status ≤3 were eligible. Patients received brigatinib 180 mg once daily with a 7-day lead-in at 90 mg. The objectives were to describe patient characteristics, clinical disease presentation, treatment regimens used and clinical outcomes. Results Data for 104 patients (male: 43 %; median age: 53 [29–80] years; ECOG performance status 0/1/2/3: 41/41/10/5 %; brain/CNS metastases: 63 %) were analyzed. Patients had received a median of 2 (1–6) lines of systemic therapy prior to brigatinib (37.5 % received ≥3) and a median of 1 (1–5) lines of prior ALK inhibitor-containing therapy (crizotinib 83.6 %; ceritinib 50.0 %; alectinib 6.7 %; lorlatinib 4.8 %). At the time of analysis, 77 patients had discontinued brigatinib. Overall, the response rate was 39.8 %, median PFS was 11.3 (95 % CI:8.6–12.9) months and median OS was 23.3 (95 % CI: 16.0–NR) months. Four patients discontinued brigatinib treatment due to adverse events. 53 patients received systemic therapy after brigatinib, 42 with an ALK inhibitor (lorlatinib, n = 34). Conclusions These real-world data indicate the activity and tolerability of brigatinib in patients with ALK-positive mNSCLC who were more heavily pretreated than patients included in clinical trials. This study was funded by Takeda Pharmaceuticals International AG, Zurich, Switzerland.
Published: 2021
Full Text: View/download PDF

32. Low income and outcome in idiopathic pulmonary fibrosis: An association to uncover

Author: Lucile Sesé, Julien Caliez, Isabella Annesi-Maesano, Vincent Cottin, Giancarlo Pesce, Morgane Didier, Zohra Carton, Dominique Israel-Biet, Bruno Crestani, Stéphanie Guillot Dudoret, Jacques Cadranel, Benoit Wallaert, Abdellatif Tazi, Bernard Maître, Grégoire Prévot, Sylvain Marchand-Adam, Sandrine Hirschi, Sandra Dury, Violaine Giraud, Anne Gondouin, Philippe Bonniaud, Julie Traclet, Karine Juvin, Raphael Borie, Jean François Bernaudin, Dominique Valeyre, Catherine Cavalin, Hilario Nunes, Diane Bouvry, Pierre Yves Brillet, Philippe Camus, Juliette Chabrol, Jean François Cordier, Christophe Cracco, Philippe Delaval, Boris Duchemann, Sevrine Feuillet, Olivia Freynet, Frédéric Gagnadoux, Patrick Germaud, Louise Gindre, André Guetta, Patrick Haussman, Stephane Jouneau, Marianne Kambouchner, Chahera Khouatra, Jacques Lacronique, Anita Molard, Clément Picard, Carole Planes, Paul Andrés Rosental, Olivier Sanchez, Thomas Similowski, Luc Thiberville, Yurdagül Uzuhnan, Service de pneumologie [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre de référence maladies rares des maladies pulmonaires rares de l’adulte (CHU Dijon) (CRMR des maladies pulmonaires rares de l’adulte), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Pneumologie, soins intensifs (Pneumo - HEGP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie A [Paris], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Pneumologie et Immuno-Allergologie [CHU LIlle], Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Service de physiologie, explorations fonctionnelles [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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), Service de pneumologie [Toulouse], CHU Toulouse [Toulouse], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies respiratoires [CHU de Dijon], Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: Pulmonary and Respiratory Medicine, Low income, medicine.medical_specialty, Prognostic factor, Vital Capacity, Air pollution, Idiopathic pulmonary fibrosis, Disease-Free Survival, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Socioeconomic status, Biosimilar Pharmaceuticals, Poverty, Proportional Hazards Models, business.industry, 1. No poverty, Environmental Exposure, Occupational exposure, medicine.disease, Prognosis, Annual income, 030228 respiratory system, Income, Particulate Matter, France, business
Abstract: International audience; BackgroundLow income, a known prognostic indicator of various chronic respiratory diseases, has not been properly studied in idiopathic pulmonary fibrosis (IPF). We hypothesize that a low income has an adverse prognostic impact on IPF.MethodsPatients were selected from the French national prospective cohort COFI. Patients’ income was assessed through the median city-level income provided by the French National Institute of Statistics and Economic Studies according to their residential address. Patients were classified in two groups as “low income” vs. “higher income” depending on whether their annual income was estimated to be < or ≥18 170 €/year (the first quartile of the income distribution in the study population). The survival and progression-free survival (PFS) of the groups were compared by a log-rank test and a Cox model in multivariate analysis.Results200 patients were included. The average follow-up was 33.8 ± 22.7 months. Patients in the low income group were significantly more likely to be of non-European origin (p < 0.006), and to have at least one occupational exposure (p < 0.0001), and they tended to have a higher cumulative exposure to fine particles PM2.5 (p = 0.057). After adjusting for age, gender, forced vital capacity at inclusion, geographical origin, and occupational exposure having a low-income level was a factor associated with a worse PFS (HR: 1.81; CI95%: 1.24–2.62, p = 0.001) and overall survival (HR: 1.49; CI95%: 1.0006–2.23, p = 0.049).ConclusionsLow income appears to be a prognostic factor in IPF. IPF patients with low incomes may also be exposed more frequently to occupational exposures.
Published: 2021
Full Text: View/download PDF

33. Targeted adjuvant therapy in non-small cell lung cancer : trick or treat?

Author: Jan P. van Meerbeeck, Lizza E.L. Hendriks, Jacques Cadranel, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Pulmonologie, and MUMC+: MA Med Staf Spec Longziekten (9)
Subjects: Pulmonary and Respiratory Medicine, Oncology, OSIMERTINIB, PD-L1, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, EGFR, VINORELBINE, Improved survival, Targeted therapy, Internal medicine, Carcinoma, Non-Small-Cell Lung, Antineoplastic Combined Chemotherapy Protocols, Adjuvant therapy, TYROSINE KINASE INHIBITORS, Medicine, Humans, BENEFIT, IMMUNOTHERAPY, Lung cancer, Pneumonectomy, SURVIVAL ANALYSIS, Neoplasm Staging, business.industry, Early disease, PLUS CISPLATIN, CHEMOTHERAPY, medicine.disease, Combined Modality Therapy, Chemotherapy, Adjuvant, Non small cell, Human medicine, business
Abstract: Immuno- and targeted therapy improved survival in metastatic NSCLC, but before their implementation in early disease, several challenges need to be overcome. Adequate staging is important, and molecular testing must be incorporated in early disease.https://bit.ly/3heLe6W
Published: 2021

34. Pyogenic Lung Abscess in an Infectious Disease Unit, a 20-year Retrospective Study

Author: Vichita Ok, Ana Canestri, Jacques Cadranel, Ruxandra Calin, Charlotte Verdet, Antoine Parrot, Gilles Pialoux, Michel Denis, Mohammed Hamidi, Ludovic Lassel, Sebastian Tavolaro, and Thomas Maitre
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, abscess, Lung abscess, lung, 03 medical and health sciences, Diseases of the respiratory system, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Infectious disease (athletes), Abscess, Retrospective Studies, Original Research, hematogenous, Lung, RC705-779, business.industry, pyogenic, Retrospective cohort study, medicine.disease, medicine.anatomical_structure, 030228 respiratory system, Liver Abscess, Pyogenic, bronchogenic, business, Hospital Units
Abstract: Background: Pyogenic lung abscesses are rare and poorly described infections. This study aimed to describe their prognostic factors. Methods: We retrospectively included all patients hospitalized between 1 January 1998 and 1 June 2018, with an International Classification of Diseases, version 10 (IDC-10) diagnosis of pyogenic lung abscess, from the Diamm based medical records (Micro6, Nancy, France). Parasitic, fungal, or mycobacterial lung abscesses were excluded. Results: A total of 64 patients were included. Abscesses were associated with immunosuppression in 28 patients, including HIV infection and immunosuppressive therapy for eight and 12 patients, respectively. Bacterial identification was obtained for 36 patients. Nine patients (14%) developed lung abscesses after hematogenous dissemination. They differed from bronchogenic abscesses by their younger age ( p = 0.03), the absence of smoking or emphysema ( p = 0.05), Staphylococcus aureus ( p = 0.001) or Streptococcus spp. ( p = 0.05) isolation, and the smaller size of their abscess ( p = 0.02). Overall, evolution was marked by radiological sequelae (46.9%), relapse (12.5%), and death (4.8%). Radiological sequelae occurred more frequently during the course of bronchogenic abscesses ( p = 0.02), particularly when they spontaneously discharged ( p = 0.04). Relapses were more frequent in patients with emphysema ( p = 0.04) and when Haemophilus influenzae was isolated ( p = 0.04). In multivariate analysis, poor outcomes, including death, sequelae, and relapse occurred more frequently in patients who had bronchogenic abscess ( p = 0.02), and in those who received antibiotics during less than 6 weeks ( p = 0.05). Conclusion: A duration of antibiotic treatment of less than 6 weeks and bronchogenic presentation were globally associated with poor outcome of pyogenic lung abscesses. These data should be considered when proposing guidelines for the care of pyogenic lung abscesses. The reviews of this paper are available via the supplemental material section.
Published: 2020
Full Text: View/download PDF

35. Randomised trial of first-line bronchial artery embolisation for non-severe haemoptysis of mild abundance

Author: Benjamin Planquette, Vincent Labbe, Tabassome Simon, Alexandra Rousseau, Jacques Cadranel, Antoine Khalil, Emmanuel Bergot, Gérard Zalcman, Guy Meyer, Philippe Cluzel, Vincent Jounieaux, Alexandre Demoule, Muriel Fartoukh, Aude Gibelin, Olivier Sanchez, THOMAS SIMILOWSKI, Claire Andrejak, Valérie Chabbert, Michel Djibré, Sophie Tuffet, Cendrine Godet, Sandrine Pontier-Marchandise, Julien Mayaux, Marc Sapoval, Vincent Le Pennec, Clarisse Blayau, Guillaume Voiriot, Alexandre Duguet, Hélène Prodanovik, Guillaume Briend, Anne Roche, Costantino Del Giudice, Olivier Pellerin, Marie-Pierre Revel, Patrick Courtheoux, Jean Claude Meurice, Elise Antone, Alexandre Remond, Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumologie - R3S [CHU Pitié-Salpêtrière] (SPMIR-R3S), CHU Pitié-Salpêtrière [AP-HP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Unité de Recherche Clinique de l’Est Parisien [CHU Saint-Antoine] (URC-EST), Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Rothschild [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pneumologie [CHU Caen], 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 hospitalier universitaire de Poitiers (CHU Poitiers), Université de Picardie Jules Verne (UPJV), Service de pneumologie [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Service d'Anesthésie réanimation [CHU Tenon], Service de radiologie cardiovasculaire et interventionnelle [CHU Pitié-Salpêtrière], Service de Radiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Radiologie [CHU Caen], Service de Radiologie [CHU Tenon], Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), Service de Radiothérapie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP]
Subjects: Adult, Pulmonary and Respiratory Medicine, Hemoptysis, medicine.medical_specialty, Standard of care, First line, Bronchial Arteries, Imaging/CT MRI etc, Pulmonary Vasculature, 030218 nuclear medicine & medical imaging, Diseases of the respiratory system, 03 medical and health sciences, 0302 clinical medicine, Primary outcome, Bronchoscopy, medicine.artery, medicine, Humans, Adverse effect, Trial registration, Retrospective Studies, RC705-779, medicine.diagnostic_test, Adult patients, business.industry, Embolization, Therapeutic, 3. Good health, Surgery, Treatment Outcome, 030228 respiratory system, Medicine, business, Bronchial artery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Massive Haemoptysis
Abstract: BackgroundWhereas first-line bronchial artery embolisation (BAE) is considered standard of care for the management of severe haemoptysis, it is unknown whether this approach is warranted for non-severe haemoptysis.Research questionTo assess the efficacy on bleeding control and the safety of first-line BAE in non-severe haemoptysis of mild abundance.Study design and methodsThis multicentre, randomised controlled open-label trial enrolled adult patients without major comorbid condition and having mild haemoptysis (onset ResultsBleeding recurrence at day 30 after randomisation (primary outcome) occurred in 4 (11.8%) of 34 patients in the BAE strategy and 17 (44.7%) of 38 patients in the medical strategy (difference −33%; 95% CI −13.8% to −52.1%, p=0.002). The 90-day bleeding recurrence-free survival rates were 91.2% (95% CI 75.1% to 97.1%) and 60.2% (95% CI 42.9% to 73.8%), respectively (HR=0.19, 95% CI 0.05 to 0.67, p=0.01). No death occurred during follow-up and no bleeding recurrence needed surgery.Four adverse events (one major with systemic emboli) occurred during hospitalisation, all in the BAE strategy (11.8% vs 0%; difference 11.8%, 95% CI 0.9 to 22.6, p=0.045); all eventually resolved.ConclusionIn non-severe haemoptysis of mild abundance, BAE associated with medical therapy had a superior efficacy for preventing bleeding recurrences at 30 and 90 days, as compared with medical therapy alone. However, it was associated with a higher rate of adverse events.Trial registration numberNCT01278199
Published: 2020
Full Text: View/download PDF

36. Evaluation of efficacy and safety of rituximab in combination with mycophenolate mofetil in patients with nonspecific interstitial pneumonia non-responding to a first-line immunosuppressive treatment (EVER-ILD): A double-blind placebo-controlled randomized trial

Author: Jacques Cadranel, Raphael Borie, Vincent Cottin, Bruno Crestani, OrphaLung, Agnès Caille, Marion Ferreira, Theodora Bejan-Angoulvant, Hilario Nunes, J-Marc Naccache, Sylvain Marchand-Adam, Service de Pneumologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Hôpital Avicenne [AP-HP], Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CCSD, Accord Elsevier
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Drug Resistance, Placebo, law.invention, Pulmonary fibrosis, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Superiority Trial, Quality of life, Randomized controlled trial, Double-Blind Method, law, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Idiopathic Interstitial Pneumonias, Adverse effect, Aged, Aged, 80 and over, Interstitial lung desease, business.industry, Mycophenolate mofetil, Nonspecific interstitial pneumonia, Middle Aged, Mycophenolic Acid, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, 030228 respiratory system, Tolerability, Rituximab, Drug Therapy, Combination, Female, France, business, Immunosuppressive Agents, medicine.drug
Abstract: Introduction Nonspecific interstitial pneumonia (NSIP) are rare but severe diseases, with high mortality and morbidity, with no effective pharmacological treatment allowing for long-term remission, and therefore no clear therapeutic recommendations. Classic immunosuppressants are used as first-line treatment, with only one third of patients being responders and no clear recommendations exist for the choice of the second-line therapy. The EvER-ILD study is the first one to prospectively evaluate the efficacy and safety of rituximab and mycophenolate mofetil (MMF) versus placebo and MMF in a broad range of NSIP patients that did not respond to a first-line therapy. A pharmacokinetic-pharmacodynamic analysis based on rituximab serum concentrations will allow identification of potential factors associated with therapeutic response and/or adverse effects. Methods EvER-ILD study is a French multicenter, prospective, randomized, double blind, placebo-controlled, superiority trial. Patients with severe and progressive NSIP non-responding to a first line immunosuppressive treatment will be randomized in 2 groups of treatment: one course of rituximab plus 6 months MMF (RTX-MMF group) and one course of placebo plus 6 months MMF (Placebo-MMF group). The primary outcome is the change in Forced Vital Capacity (FVC, % of predicted) from baseline to 6 months. Several clinical, biological, and quality of life secondary outcomes will be measured at 3, 6 and 12 months. A sample size of 122 patients (61 patients per group) would allow to show a point difference between groups in the change of FVC at 6 months, based on a common standard deviation for FVC change of 8% with a power of 90%, alpha 5% two-sided, and anticipating an extreme 10% drop-out rate. Ethics and dissemination The protocol was approved by the French Research Ethics Committee (CPP Tours Ouest 1 2016-R28) on November 10, 2016, and by the French competent authority (ANSM, reference 160771A-22) on December 1st, 2016. This article refers to protocol V2, dated November 18, 2016. An independent data safety monitoring board will review safety and tolerability data for the duration of the trial. Results will be disseminated via peer reviewed publication and presentation at international conferences. Trial registration number NCT02990286 (clinicaltrials.gov), EudraCT 2016-003026-16 (European Medicines agency).
Published: 2020
Full Text: View/download PDF

37. The DIAMORFOSIS (DIAgnosis and Management Of lung canceR and FibrOSIS) survey. International survey and call for consensus

Author: Torsten Blum, Francesco Bonella, Paolo Spagnolo, Demosthenes Bouros, Daniel A. Culver, Katerina M. Antoniou, Venerino Poletti, Jacques Cadranel, Ganesh Raghu, Theodoros Karampitsakos, Athol U. Wells, Carlo Vancheri, Stefano Elia, Matthew Evison, Maria Molina-Molina, Elisabeth Bendstrup, Argyris Tzouvelekis, Bogdan Grigoriu, Nesrin Mogulkoc, Michael Kreuter, University of Patras, School of Medicine, University of Crete [Heraklion] (UOC), University of Heidelberg, Medical Faculty, Manchester University NHS Foundation Trust (MFT), HELIOS Klinikum Emil von Behring, Ospedale G.B.Morgagni-L. Pierantoni, Partenaires INRAE, Université libre de Bruxelles (ULB), Università degli studi di Catania [Catania], Azienda Ospedaliera di Padova, University of Duisburg-Essen, Royal Brompton and Harefield NHS Foundation Trust, University of Washington [Seattle], Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Cleveland Clinic, Aarhus University Hospital, Ege university, Department of Physics, University of Rome Tor Vergata, Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Athens Medical School [Athens], and Ege Üniversitesi
Subjects: squamous cell carcinoma, bronchoscopy, positron emission tomography, Medizin, lcsh:Medicine, diffusing capacity for carbon monoxide, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, chemoradiotherapy, computer assisted tomography, cystic fibrosis, low drug dose, Idiopathic pulmonary fibrosis, 0302 clinical medicine, DLCO, Diffusing capacity, thoracic surgeon, platinum, high resolution computer tomography, endobronchial ultrasonography, pulmonologist, multidisciplinary team, papillomavirus infection, Pulmonologists, tidal volume, Fibrosi pulmonar, respiratory system, Idiopathic pulmonary fibrosis (IPF) Lung Cancer Consensus statement, mass fragmentography, 3. Good health, drug therapy, medicine.anatomical_structure, female, Streptococcus pneumoniae, 030220 oncology & carcinogenesis, immunotherapy, Lung cancer, Pulmonary and Respiratory Medicine, medicine.medical_specialty, lobectomy, palliative therapy, Mediastinal lymphadenopathy, stereotactic radiosurgery, [SDV.CAN]Life Sciences [q-bio]/Cancer, carbon monoxide, Article, Pulmonary fibrosis, 03 medical and health sciences, Interstitial and orphan lung disease, breast cancer, male, forced vital capacity, Internal medicine, lymphadenopathy, medicine, human, oncologist, Lung, non small cell lung cancer, business.industry, hypoxia, lcsh:R, lung fibrosis, Cancer, noninvasive ventilation, dyspnea, medicine.disease, Original articles, Lung cancer and IPF, major clinical study, respiratory tract diseases, fibrosing alveolitis, 030228 respiratory system, [No Keyword], consensus, Settore MED/21, Càncer de pulmó, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, chronic obstructive lung disease
Abstract: Background Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue. Methods This was a joint-survey by European Respiratory Society (ERS) Assemblies 8, 11 and 12. The survey consisted of 25 questions. Results Four hundred and ninety-four (n=494) physicians from 68 different countries and five continents responded to the survey. Ninety-four per cent of participants were pulmonologists, 1.8% thoracic surgeons and 1.9% oncologists; 97.7% were involved in multidisciplinary team approaches on diagnosis and management. Regular low-dose high-resolution computed tomography (HRCT) scan was used by 49.5% of the respondents to screen for lung cancer in IPF. Positron emission tomography (PET) scan and endobronchial ultrasound (EBUS) is performed by 60% and 88% to diagnose nodular lesions with mediastinal lymphadenopathy in patients with advanced and mild IPF, respectively. Eighty-three per cent of respondents continue anti-fibrotics following lung cancer diagnosis; safety precautions during surgical interventions including low tidal volume are applied by 67%. Stereotactic radiotherapy is used to treat patients with advanced IPF (diffusing capacity of the lung for carbon monoxide (DLCO), The diagnosis and management of IPF-LC is heterogeneous with most survey respondents calling for a consensus statement https://bit.ly/2Smie0o
Published: 2020
Full Text: View/download PDF

38. Gender differences in idiopathic pulmonary fibrosis: are men and women equal or not?

Author: Violaine Giraud, Philippe Bonniaud, Abdellatif Tazi, Julie Traclet, Karine Juvin, Sandrine Hirschi, Bruno Crestani, Carole Planès, Vincent Cottin, Dominique Valeyre, S. Guillot Dudoret, Lucile Sesé, Hilario Nunes, Sandra Dury, Raphael Borie, G. Prévot, Benoit Wallaert, Bernard Maitre, Sylvain Marchand-Adam, Yurdagul Uzunhan, Jacques Cadranel, Thomas Gille, Olivia Freynet, Dominique Israel-Biet, Zohra Carton, Anne Gondouin, and Julien Caliez
Subjects: Pulmonary and Respiratory Medicine, education.field_of_study, medicine.medical_specialty, Proportional hazards model, business.industry, medicine.medical_treatment, Population, medicine.disease, respiratory tract diseases, Log-rank test, FEV1/FVC ratio, Idiopathic pulmonary fibrosis, Internal medicine, Cohort, medicine, Lung transplantation, Prospective cohort study, education, business
Abstract: Background Few studies analyzed gender-related outcomes and characteristics differences of patients with idiopathic pulmonary fibrosis (IPF). The aim of the study was to explore gender differences in a French IPF cohort. Methods 236 patients with incident IPF were included in the multicentric longitudinal prospective cohort COhorte FIbrose (COFI), and followed for 5 years. Men and women were compared for characteristics atinclusion (t-test, Chi2 or ANOVA) and survival (Log rank, Cox model). Results The population consisted of 51 (22%) women and 185(78%) men. At inclusion women significantly differed from men for an older age (> 65 years, 78 vs. 61%, P = 0.028), a lower proportion of smokers (P Conclusions At diagnosis women appear to have a distinct imaging pattern and a better FVC, which may be due to less exposure history compared to men. However, outcomes remain comparable in both sexes. Less access to lung transplantation in women may be due to age and comorbidities.
Published: 2020
Full Text: View/download PDF

39. Low income and progression free survival in idiopathic pulmonary fibrosis: an association to uncover

Author: Julie Traclet, Dominique Valeyre, Sandra Dury, Benoit Wallaert, Abdellatif Tazi, Hilario Nunes, Julien Caliez, Morgane Didier, Catherine Cavalin, Jean-François Bernaudin, Vincent Cottin, Bernard Maitre, Karine Juvin, Violaine Giraud, Dominique Israel-Biet, Bruno Crestani, Zohra Carton, Anne Gondouin, Lucile Sesé, Raphael Borie, Philippe Bonniaud, S. Guillot Dudoret, G. Prévot, Sylvain Marchand-Adam, Sandrine Hirschi, Giancarlo Pesce, Isabella Annesi-Maesano, and Jacques Cadranel
Subjects: Pulmonary and Respiratory Medicine, Low income, Idiopathic pulmonary fibrosis, Prognostic factor, medicine.medical_specialty, business.industry, Internal medicine, medicine, Cumulative Exposure, Progression-free survival, medicine.disease, business, Prospective cohort study
Abstract: Background Low income is a known prognostic indicator of various chronic respiratory diseases but has not been studied in idiopathic pulmonary fibrosis (IPF). We hypothesize that a low income has an adverse prognostic impact on IPF. Methods Patients were selected from the French national prospective cohort COFI. Patient's income was assessed through the median city-level income provided by the French National Institute of Statistics and Economic Studies according to his/her residential address. Patients were classified in two groups as “low income” vs. “higher income” depending on whether their annual city-level income was estimated to be Results 200 patients were included. The average follow-up was 33.8 ± 22.7 months. Patients in the low income group were more likely to be of non-European origin (42 vs. 17%, P Conclusions Low income appears to be a prognostic factor of progression free survival in IPF. And patients with low incomes may also be exposed more frequently to occupational exposures and to higher cumulative exposure to fine particles.
Published: 2020
Full Text: View/download PDF

40. Prevalence of tobacco and cannabis use in a prospective cohort of spontaneous pneumothorax and cessation rate at 6 months

Author: M. Giol, Valérie Gounant, Jalal Assouad, Fatima Amrioui, Jacques Cadranel, Anne-Marie Ruppert, Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de chirurgie thoracique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d’oncologie thoracique et essais précoces [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Smoking cessation, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Tobacco, medicine, Prevalence, Humans, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Cannabis, biology, business.industry, Pneumothorax, Cannabis use, biology.organism_classification, medicine.disease, 3. Good health, Spontaneous pneumothorax, business
Abstract: International audience
Published: 2020
Full Text: View/download PDF

41. Perceptions et connaissances sur le cancer du poumon en France : une enquête en regards croisés auprès du grand public et des médecins

Author: Christos Chouaid, I. de la Porte, C. Mascaux, M. Urbieta, L. Guery, J.B. Stern, S. Sauvajon, Jacques Cadranel, Maurice Pérol, C. Cortot, A. Vergnenegre, and K. Belkhiria
Subjects: Pulmonary and Respiratory Medicine
Abstract: Introduction De recentes etudes ont montre un manque de connaissances et des idees recues sur le cancer du poumon aupres du grand public et des medecins. Nous avons voulu approfondir ce sujet en France. Methodes Une enquete en ligne a ete menee aupres de la population francaise (n = 6001), et des medecins (generalistes, n = 273 ; pneumologues, n = 97 ; oncologues, n = 67). Le grand public a ete interroge sur la prevalence du cancer du poumon, sa severite, son diagnostic, sa prise en charge, sa dimension sociale tandis que les questions posees aux medecins concernaient leur perception des connaissances des Francais. Resultats Les medecins surevaluent les connaissances du grand public concernant les facteurs de risques du cancer du poumon (81 % estiment que les Francais sont bien informes a ce sujet [n = 354], alors que seulement 56 % des Francais [n = 3361] declarent l’etre). A l’inverse, les medecins sous-evaluent les connaissances du grand public concernant les symptomes du cancer du poumon : selon eux, une majorite de Francais identifie surtout les crachats de sang (82 % ; n = 358) et l’apparition d’une toux (54 % ; n = 236) alors que 27 % des Francais (n = 1620) citent egalement les bronchites a repetition ou l’asthenie (n = 1620 ; 27 %) et 21 % (n = 1260) des douleurs importantes dans la poitrine. Les medecins (91 % ; n = 398) surevaluent aussi la stigmatisation des patients souffrant d’un cancer du poumon au sein de la societe : alors que 85 % des Francais (n = 5101) estiment que ces patients sont comme les autres patients atteints d’un cancer, seuls 55 % des medecins (n = 240) estiment qu’une majorite de Francais serait d’accord avec cette affirmation. Interroges sur la qualite de la prise en charge de ce cancer en France, grand public comme medecins l’evaluent satisfaisante (respectivement 71 % ; n = 4261 et 88 % ; n = 385). L’etude montre aussi des perceptions differentes concernant les differents types de therapies : si 46 % des medecins (n = 201) citent le cancer du poumon parmi les trois dans lesquels il y a eu le plus de progres medicaux, seuls 21 % (n = 1260) des Francais le citent. Interroges sur les principales innovations therapeutiques dans le cancer du poumon, les medecins citent avant tout l’immunotherapie (68 % ; n = 297), les Francais citant avant tout les chimiotherapies (52 % ; n = 3120). Conclusion Notre etude met en lumiere de substantielles differences entre les connaissances du grand public concernant le cancer du poumon et la perception de cette connaissance par les professionnels de sante.
Published: 2020
Full Text: View/download PDF

42. Invited editorial: Q and A on hereditary lung cancer

Author: Patrick R, Benusiglio, Vincent, Fallet, and Jacques, Cadranel
Subjects: Pulmonary and Respiratory Medicine, Lung Neoplasms, Pulmonary Emphysema, Carcinoma, Non-Small-Cell Lung, Humans, Genetic Predisposition to Disease, Lung
Abstract: Advances in the field of genetic susceptibility to respiratory diseases (e.g. pulmonary fibrosis, emphysema, cystic fibrosis, pulmonary hypertension) have led pneumologists to integrate the familial risk dimension and work with genetics clinical teams and laboratories. Paradoxically, while thoracic oncologists look on a daily basis for acquired oncogenic alterations in non small cell lung cancer (NSCLC), they know little about inherited, genetic susceptibility to the disease. As a result, collaboration networks with clinical cancer geneticists are poorly developed in thoracic oncology. Faced with this observation, it seemed important to us to address this issue in a very practical way with this "Q and A on Hereditary Lung Cancer" editorial.
Published: 2022
Full Text: View/download PDF

43. Les principes de l’analyse médico-économique appliqués au cancer du poumon

Author: Jacques Cadranel, Sandrine Loubière, Fabrice Barlesi, and Pascal Auquier
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030212 general & internal medicine
Abstract: Resume L’interet des approches economiques dans le domaine de la sante reside dans la possibilite de hierarchiser, sur la base de deux criteres (efficacite medicale et couts), les programmes medicaux susceptibles d’etre menes et d’aider a fixer des objectifs de sante publique, a moyen ou a long terme, compatibles avec les ressources disponibles. Cet article propose un rappel des elements cles de l’evaluation economique et presente une revue de la litterature specifique des principaux travaux d’evaluation economique qui se sont efforces de contribuer a la definition de politiques optimales en matiere de prise en charge du cancer du poumon, dans un contexte ou la medecine de precision se developpe. Les resultats de ces evaluations economiques montrent d’une part que, malgre un cout economique immediat important, la medecine de precision associant la recherche de biomarqueurs avec des therapies ciblees est source d’economies par rapport a une prise en charge standard, et suggerent d’autre part que les traitements, y compris les plus couteux et performants, aboutissent a sauver des annees de vie pour des rapports qui ne sont jamais superieurs a ceux generalement admis comme limite pour les interventions dans le domaine de la sante.
Published: 2018
Full Text: View/download PDF

44. Classification histomoléculaire des cancers pulmonaires

Author: M. Georges, F. Kebir, M. Wislez, J Moroch, Anne-Marie Ruppert, Martine Antoine, and Jacques Cadranel
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis
Abstract: Resume Ces dernieres annees ont vu l’emergence d’une nouvelle classification histologique des cancers pulmonaires integrant des donnees moleculaires. Des alterations moleculaires agissant comme des drivers oncogeniques et conferant une sensibilite a des traitements cibles sont recherchees dans les CBNPC diagnostiques a un stade avance. Ces therapies adaptees transforment le pronostic des patients. Si certaines cibles sont bien connues comme EGFR, KRAS, ALK, ROS, HER2 et BRAF mais pas toujours associees a un succes therapeutique (KRAS), d’autres nombreuses mais peu frequentes font l’objet de tests recents comme pour la voie MET (mutation de l’exon 14 et amplification), et les rearrangements de RET, NRG1, et NTRK. S’il existe certaines correspondances cliniques, morphologiques et phenotypiques avec le type d’alterations moleculaires, celles-ci n’ont que valeur d’orientation et ces tests doivent etre pratiques chez tous les patients presentant un CBNPC non epidermoide de stade avance. Le carcinome epidermoide reste toujours le parent pauvre de cette strategie moleculaire, mais est le candidat des therapies immunitaires meme si le biomarqueur predictif : molecule, cellule ou signature immunitaire, ou charge mutationnelle n’est pas defini. Enfin, nombre d’entites rares caracterisees par une anomalie moleculaire specifique diagnostique sont decrites dans le thorax, parfois communes a d’autres organes, mais ne beneficient pas d’un traitement cible.
Published: 2018
Full Text: View/download PDF

45. Évaluation, prévention et gestion des toxicités de la chimiothérapie, des anti-angiogéniques et de l’immunothérapie

Author: Vincent Fallet, Marie Wislez, Jacques Cadranel, A. Canellas, Perrine Créquit, Armelle Lavolé, and B. Duchemann
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030212 general & internal medicine
Abstract: Resume Les complications liees aux chimiotherapies cytotoxiques et aux anti-angiogeniques sont globalement bien connues des cliniciens. A l’inverse, les inhibiteurs de points de controle immunitaire (ICI) ont fait emerger de nouveaux profils de toxicite, notamment les effets indesirables d’origine immunologique. Les toxicites tous grades confondus sont globalement moins importantes avec les ICI qu’avec les chimiotherapies. Toutefois, une bonne connaissance de ces toxicites permettra de mieux les depister et les traiter. Avec une prise en charge therapeutique adequate, la plupart des toxicites d’origine immunologique est reversible, en dehors de certaines atteintes endocriniennes, et les deces imputables sont exceptionnellement rares. La generalisation de l’utilisation des ICI en vie reelle s’accompagnera a l’avenir de l’emergence de plus en plus d’effets indesirables, ce qui impliquera d’optimiser leur prise en charge. Le traitement de ces toxicites repose sur l’arret du medicament en cause, la corticotherapie dont la posologie est adaptee en fonction du grade de severite des toxicites, et parfois pour certains grades 4 au recours a des immunosuppresseurs. Des recommandations europeennes et americaines ont ete publiees et sont facilement accessibles. La grande variete des effets indesirables immunologiques rend necessaire une approche multidisciplinaire avec une prise en charge collaborative entre les differents specialistes afin de permettre une gestion optimale de ces toxicites tout en poursuivant les ICI dans la grande majorite des cas.
Published: 2018
Full Text: View/download PDF

46. Le sevrage tabagique : éviter le cancer, réduire la toxicité des traitements et le risque de rechute

Author: Vincent Fallet, F. Amrioui, Jacques Cadranel, and Anne-Marie Ruppert
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030212 general & internal medicine
Abstract: Resume En France, le nombre de deces lies au tabac est estime a 73 000/an, dont 44 000 par cancer et plus de 20 000 par cancer bronchique (CB). L’arret du tabac est la mesure la plus efficace pour limiter l’epidemie du CB mais est aussi un element important dans la prise en charge des patients atteints de CB quel que soit le stade. Dans les cancers localises, la poursuite du tabac est associee a une diminution de la survie par augmentation du risque de recidive et de developper un deuxieme cancer. En periode peri-operatoire, le sevrage tabagique permet de limiter les complications infectieuses et la duree d’hospitalisation. Quel que soit le stade du cancer, le sevrage permet d’ameliorer la dyspnee, l’appetit et de reduire l’asthenie ; ceci se traduit par une amelioration de la qualite de vie. Le tabac entraine une addiction forte avec une dependance physique, psychologique et comportementale. La substitution nicotinique et la varenicline sont indiquees en cas de dependance physique a la nicotine. Les therapies cognitives - comportementales permettent d’aider le fumeur a se debarrasser de son comportement, ont une place dans la prevention de la rechute.
Published: 2018
Full Text: View/download PDF

47. Le patient douloureux

Author: N. Chaabane, Jacques Cadranel, Marie Wislez, Vincent Fallet, and Y. Raffray
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030217 neurology & neurosurgery
Abstract: Resume La douleur est tres frequente chez les patients suivis pour un cancer. La douleur cancereuse est source de handicap dans la vie quotidienne. Son evaluation initiale et continue a tout stade de la maladie cancereuse permet de proposer au patient plusieurs strategies antalgiques efficaces. Ces strategies sont notamment basees sur les trois paliers d’antalgiques de l’OMS allant des medicaments non-opioides, aux opioides faibles jusqu’aux opioides forts. Les antalgiques opioides peuvent etre associes a des medicaments non-opioides ainsi qu’a des adjuvants (antidepresseur, antiepileptique, corticoide). Les procedures interventionnelles sont recemment devenues une partie integrante de l’analgesie multimodale dans le traitement de la douleur cancereuse.
Published: 2018
Full Text: View/download PDF

48. Impact de l’amélioration de la filière diagnostique sur le pronostic

Author: Vincent Fallet, Jacques Cadranel, Marie Wislez, F. Millet, and Armelle Lavolé
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030212 general & internal medicine
Abstract: Resume Les cancers du poumon (CP) sont des cancers frequents et de mauvais pronostic. Leur prise en charge diagnostique et therapeutique est complexe et multidisciplinaire. Dans le cadre du Plan cancer 2009-2013, l’Institut national du cancer (INCa) a publie une etude sur les delais de prise en charge du CP confirmant des variations en fonction de facteurs lies a la maladie mais egalement des variations liees a la structure de soins et la presence de disparites geographiques. Le Plan cancer 2014-2019 a dans ses objectifs de maitriser les delais de prise en charge et de fluidifier le parcours du patient atteint de CP. L’impact des delais de prise en charge du CP sur le pronostic des patients n’est pas clairement demontre. Il semblerait que dans les stades avances, un delai court entre la premiere imagerie suspecte et le premier traitement soit associe a un plus mauvais pronostic et qu’a l’inverse, des delais longs sont associes a une survie plus courte dans les stades localises. Les stades localises et la necessite d’examens complementaires sont des facteurs d’allongement des delais de prise en charge. Des parcours structures de diagnostic du CP et des postes d’infirmiere de coordination ont ete instaures pour fluidifier la filiere diagnostique. S’ils permettent de diminuer les delais de prise en charge, leur impact sur la survie n’a pas ete etudie.
Published: 2018
Full Text: View/download PDF

49. New drugs in thoracic oncology: needs and knowledge – an online ERS Lung Cancer Assembly survey

Author: Matthew Evison, Nir Peled, Thierry Berghmans, Torsten Gerriet Blum, and Jacques Cadranel
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, biology, business.industry, medicine.medical_treatment, Lung Cancer, Original Articles, Immunotherapy, medicine.disease, Systemic therapy, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Thoracic Oncology, medicine, biology.protein, Anaplastic lymphoma kinase, 030212 general & internal medicine, Epidermal growth factor receptor, Intensive care medicine, business, Lung cancer, Reimbursement, Pulmonologists
Abstract: In the last decade, systemic therapy for advanced lung cancer has become diverse, complex and personalised. These new therapies (monoclonal antibodies, tyrosine kinase inhibitors (TKIs) and immunotherapy) have a far different toxicity profile compared to chemotherapy. Furthermore, clinical indications and reimbursement criteria can vary across Europe. The aim of the present online survey was to assess the knowledge, views and challenges facing the European respiratory community in this rapidly changing field. A 15-question web survey was sent to all European Respiratory Society members through the Society's monthly electronic communication. A total of 315 questionnaires were completed. Most of the respondents were male (59.1%), were above 40 years of age (52.9%) and were working in university/academic hospitals (74.8%), the majority as pulmonologists (90%). Only 55% of the participants were aware of the legal processes for drug recognition. Except for epidermal growth factor receptor TKI, up to 38% did not know about the specific toxicities of anaplastic lymphoma kinase/ROS proto-oncogene 1 TKIs, monoclonal antibodies and immune checkpoint inhibitors. Of the respondents, 92% showed an interest in an online platform reporting new drugs' toxicities. Despite a large amount of publicity and integration of new drugs into therapeutic algorithms and clinical guidelines, physicians taking care of lung cancer patients have a need for up-to-date information on systemic therapy toxicity management and legal constraints., Physicians have a need for up-to-date information on new drug toxicity management in thoracic oncology http://ow.ly/j3YA30kOtBz
Published: 2018
Full Text: View/download PDF

50. Lung cancer and interstitial lung disease: a literature review

Author: Martine Antoine, Jacques Cadranel, Isabelle Monnet, Christos Chouaid, Quentin Gibiot, Marie Wislez, and Jean-Marc Naccache
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Exacerbation, medicine.medical_treatment, Review Article, behavioral disciplines and activities, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Pulmonary fibrosis, medicine, Lung cancer, Pneumonitis, business.industry, Incidence (epidemiology), Interstitial lung disease, Cancer, respiratory system, medicine.disease, respiratory tract diseases, body regions, Radiation therapy, 030228 respiratory system, 030220 oncology & carcinogenesis, business
Abstract: The association between lung cancer (LC) and interstitial lung disease (ILD) can be explained by the shared risk factors like smoking and physiopathology of fibrogenesis and cancerogenesis. The relative LC risk is shown to be 3.5- to 7.3-times higher in ILD, with LC occurrence estimated at 10–20% in ILD, with >15% of ILD patients likely to die from LC. ILD incidence upon LC diagnosis varied from 2.4–10.9%. Primary radiological presentations consist of peripheral lesions, mostly in the inferior pulmonary lobes, either close to or within the ILD areas. There is a trend towards inverted proportion of adenocarcinomas and squamous-cell carcinomas, with EGFR mutations very rarely found. ILD negatively impacted LC prognosis, with surgery associated with increased morbidity-mortality, particularly due to acute exacerbation (AE) of ILD. Limited resection reduced this risk, whilst increasing that of cancer mortality. Studies on radiotherapy that can induce AE-ILD are scarce. Chemotherapy was associated with similar response rates to those in LC patients without ILD, yet worse survival. This difference may be accounted for by ILD patients’ poorer health and higher risk of drug-induced pneumonitis. Further studies are warranted to better understand cancer physiopathology within the fibrotic areas, along with the therapeutic strategies required.
Published: 2018
Full Text: View/download PDF

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Journal

Database

Publisher

369 results on '"Jacques, Cadranel"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources