Publications by authors named "Jean-Pierre Lotz"
Background: The onset of hematological malignancies can lead to acute and critical situations. It can also result in adverse outcome despite the significant advancements made in their therapeutic management. In this context, advance care planning and, in particular, advance directives (AD) play an essential role.
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- * Researchers aimed to determine the role of antibody-dependent cell-mediated cytotoxicity (ADCC) in avelumab's effectiveness and whether variations in the FcγR3A receptor can predict patient responses.
- * Findings confirmed the presence of FcγR3A+ natural killer (NK) cells in PD-L1-expressing GTN, and that avelumab enhances NK cell activity, further suggesting higher affinity FcγR3A variants may
Atezolizumab Combined With Platinum and Maintenance Niraparib for Recurrent Ovarian Cancer With a Platinum-Free Interval >6 Months: ENGOT-OV41/GEICO 69-O/ANITA Phase III Trial.
J Clin Oncol
December 2024
Purpose: To evaluate atezolizumab combined with platinum-based chemotherapy (CT) followed by maintenance niraparib for late-relapsing recurrent ovarian cancer.
Methods: The multicenter placebo-controlled double-blind randomized phase III ENGOT-OV41/GEICO 69-O/ANITA trial (ClinicalTrials.gov identifier: NCT03598270) enrolled patients with measurable high-grade serous, endometrioid, or undifferentiated recurrent ovarian cancer who had received one or two previous CT lines (most recent including platinum) and had a treatment-free interval since last platinum (TFIp) of >6 months.
Article Synopsis
- * Out of 410 oncologists surveyed in France, 75% viewed AD as relevant, but only 36% regularly inform their patients about them, often due to concerns that AD discussions may cause anxiety.
- * There is a notable division among oncologists regarding the usefulness and safety of AD, with many preferring to designate a "person of trust" over formal AD.
Updated progression-free survival and final overall survival with maintenance olaparib plus bevacizumab according to clinical risk in patients with newly diagnosed advanced ovarian cancer in the phase III PAOLA-1/ENGOT-ov25 trial.
Int J Gynecol Cancer
April 2024
Objective: In the PAOLA-1/ENGOT-ov25 trial (NCT02477644), adding maintenance olaparib to bevacizumab provided a substantial progression-free survival benefit in patients with newly diagnosed advanced ovarian cancer and homologous recombination deficiency (HRD)-positive tumors, irrespective of clinical risk. Subsequently, a clinically meaningful improvement in overall survival was reported with olaparib plus bevacizumab in the HRD-positive subgroup. We report updated progression-free survival and overall survival by clinical risk and HRD status.
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- The study investigates outcomes and risks for women experiencing a multiple pregnancy where one fetus has a complete hydatidiform mole (a type of abnormal pregnancy) alongside a normal fetus, acknowledging the potential for serious complications and cancer transformation following birth.* -
- From a review of 11,411 pregnancies between 2001 and 2022, only 141 represented this dual-condition, with 23% opting to terminate, while a significant portion faced complications, miscarriages, or premature delivery, indicating high risks associated with such pregnancies.* -
- Notably, the study found that lower levels of a specific hormone (free beta human chorionic gonadotropin) in pregnant women correlated with better chances of reaching 24 weeks gestation and
Purpose: Platinum-based doublets with concurrent and maintenance bevacizumab are standard therapy for ovarian cancer (OC) relapsing after a platinum-free interval (PFI) >6 months. Immunotherapy may be synergistic with bevacizumab and chemotherapy.
Patients And Methods: ATALANTE/ENGOT-ov29 (ClinicalTrials.
Background: Liver metastases of gestational trophoblastic neoplasia (GTN) are rare, but associated with poor prognosis. The additional concomitant presence of brain or intra-abdominal metastases, with liver metastases has been described as worsening factors, but the literature on this topic is reduced.
Objective: To estimate the overall mortality, specific hepatic morbidity, and mortality, and to identify prognostic factors for patients with GTN and liver metastases.
Background: Sarcoma is a heterogeneous group of diseases with few treatment options. Immunotherapy has shown little activity in studies including unselected sarcomas, but immune checkpoint blockers have shown activity in specific histotypes. We evaluated the activity of pembrolizumab in rare and ultra-rare sarcomas.
View Article and Find Full Text PDFAim: The oral anti-angiogenic therapy nintedanib prolongs progression-free survival (PFS) when combined with chemotherapy after primary surgery for advanced epithelial ovarian cancer. The randomized phase II CHIVA trial evaluated the impact of combining nintedanib with neoadjuvant chemotherapy (NACT) for epithelial ovarian cancer.
Methods: Patients with newly diagnosed unresectable FIGO stage IIIC-IV epithelial ovarian cancer received 3-4 cycles of carboplatin plus paclitaxel every 3 weeks as NACT before interval debulking surgery (IDS), followed by 2-3 post-operative cycles.
Article Synopsis
- The study utilized the NETSARC database to analyze management and outcomes of adolescents and young adults (AYAs) with sarcoma in France from 2010 to 2017, focusing on surgical cases.
- Findings showed significant discrepancies in adherence to treatment guidelines between patients treated at reference sarcoma centers (RSC) and non-reference centers (non-RSC), with RSC having better rates of crucial pre-treatment procedures.
- Despite similar overall survival rates (OS) for AYAs in both settings, those treated in RSC had notably better locoregional recurrence-free survival (LRFS) and progression-free survival (PFS), underscoring the benefits of multidisciplinary care in specialized centers.
Article Synopsis
- The TROPHIMMUN trial aimed to evaluate the effectiveness of avelumab for women suffering from gestational trophoblastic tumors (GTT) that resisted chemotherapy, specifically focusing on a group (cohort B) who had already undergone polychemotherapy.
- Avelumab was administered to 7 patients every two weeks, with an emphasis on normalizing a hormone called human chorionic gonadotropin (hCG), but only one patient showed significant improvement, leading to treatment discontinuation.
- The study ended early due to limited efficacy in cohort B, indicating a need for new, innovative immunotherapy approaches, as most patients still faced poor outcomes after polychemotherapy.
Patients living with cancer often experience serious adverse events due to their condition or its treatments. Those events may lead to a critical care unit admission or even result in death. One of the most important but challenging parts of care is to build a care plan according to the patient's wishes, meeting their goals and values.
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- GCT patients with brain metastases treated with high-dose chemotherapy were studied to evaluate their outcomes, revealing a low 2-year survival rate of 36.9% and a median overall survival of just 12 months.
- Among the 35 patients, 11 responded positively to treatment, with most of these favorable responses seen in those with metachronous brain metastases, typically isolated and without prior local therapy.
- The findings suggest that even GCT patients with brain metastases can achieve long-term survival, and certain biological responses may indicate better outcomes with high-dose chemotherapy.
Background: The risk of malignant transformation of molar pregnancies after human chorionic gonadotropin levels return to normal is low, roughly 0.4%, but may justify an adaptation of monitoring strategies for certain patients.
Objective: This study aimed to determine the risk of gestational trophoblastic neoplasia after human chorionic gonadotropin normalization in women with molar pregnancy and identify risk factors for this type of malignant transformation to optimize follow-up protocols after human chorionic gonadotropin normalization.
Article Synopsis
- * In a phase II trial with 89 patients, the treatment included two cycles of paclitaxel and ifosfamide, followed by three cycles of HD carboplatin and etoposide, with dosage adjustments based on carboplatin clearance to achieve a target area under the curve (AUC) of 24 mg.min/mL.
- * Results showed a 44.3% complete response rate and a median progression-free survival (PFS) of 12
Introduction: Mainstreamed genetic testing (MGT) obviates the need for a cancer genetics consultation, since trained oncologists (O) and gynaecologists (G) provide counseling, prescribe testing and deliver results. We report results from our MGT program and emphasize its utility during the COVID-19 lockdown, when cancer genetics clinics had suspended their activity.
Methods: An MGT pathway for breast and ovarian cancer (BC/OC) patients was established in Jan-2018 between the Assistance Publique - Hôpitaux de Paris.
Introduction: Oral anticancer drugs have raised the question of how to follow-up these patients and how to coordinate this follow-up. The CHIMORAL study evaluated the involvement of primary care providers and a coordination by territorial health networks. Training/information tools were provided, as well as weekly nursing follow-up at home.
View Article and Find Full Text PDFPurpose: Women with gestational trophoblastic tumors (GTT) resistant to single-agent chemotherapy receive alternative chemotherapy regimens, which, although effective, cause considerable toxicity. All GTT subtypes express programmed death-ligand 1 (PD-L1), and natural killer (NK) cells are involved in trophoblast immunosurveillance. Avelumab (anti-PD-L1) induces NK cell-mediated cytotoxicity.
View Article and Find Full Text PDFBackground: Etoposide dosing is based on body surface area. We evaluated if further dose individualization would be required for high dose (HD) etoposide within the TI-CE (taxol, ifosfamide, carboplatin, and etoposide) protocol.
Methods: Eighty-eight patients received 400 mg/m/day of etoposide as a 1-hour IV infusion on 3 consecutive days over 3 cycles as part of a phase II trial evaluating efficacy of therapeutic drug monitoring (TDM) of carboplatin in the TI-CE HD protocol.
Background: Trabectedin and pegylated liposomal doxorubicin (PLD) is an effective combination therapy for platinum-sensitive recurrent ovarian cancer (ROC), particularly for disease relapsing within 6-12 months of platinum therapy. The non-interventional PROSPECTYON study evaluated trabectedin/PLD in French clinical practice.
Patients And Methods: Patients with ROC after at least one platinum-based regimen received 1.
Article Synopsis
- - COVID-19 is a new infectious disease that has led to 2.5 million cases and 165,000 deaths globally, significantly impacting healthcare systems, especially in oncology departments.
- - In response to the pandemic, healthcare providers have created new guidelines and therapeutic options for cancer care to optimize treatment delivery for patients with chronic illnesses.
- - The review focuses on summarizing international cancer care recommendations and assessing their applicability in low- and middle-income countries, where resources and healthcare infrastructures may differ significantly.
Purpose: In a low-risk gestational trophoblastic neoplasia (GTN) treated with methotrexate (MTX), the modeled hCG (human chorionic gonadotropin) residual concentration (hCGres), calculated with NONMEM program® (NM) during the first 50 treatment days, is a predictor of MTX-resistance risk. This model was implemented with another algorithm on https://www.biomarker-kinetics.
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