Publications by authors named "Jf Blanc"
Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis. The POLO trial showed that olaparib (PARP inhibitor) improved progression-free survival (PFS) but not overall survival (OS), when used as maintenance therapy after ≥ 16 weeks of disease control with first-line platinum-based chemotherapy in patients with germline (g) BRCA 1 or 2 pathogenic variants (PV) metastatic PDAC. However, real-world data on the effectiveness of olaparib are missing.
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- - The study aims to improve the non-invasive classification of hepatocellular adenomas (HCA) using a diagnostic model that combines basic clinical features (age and sex) with MRI-radiomics data.
- - Researchers analyzed MR images of HCA to extract textural features and tested their model against both qualitative and automatic analysis, resulting in varying accuracies for subtyping HCA.
- - Findings suggest that machine learning can enhance HCA subtyping accuracy, particularly when more patients are included in future studies, indicating a promising direction for improved diagnosis and management.
Article Synopsis
- * The French Association for the Study of the Liver created guidelines to summarize the best practices for managing iCCA and pCCA, based on comprehensive expert analysis and voting.
- * These guidelines cover the epidemiology of cholangiocarcinoma and outline management strategies from diagnosis to treatment, emphasizing advancements in personalized medicine and targeted therapies.
Combining CD40 agonist mitazalimab with mFOLFIRINOX in previously untreated metastatic pancreatic ductal adenocarcinoma (OPTIMIZE-1): a single-arm, multicentre phase 1b/2 study.
Jean-Luc Van Laethem Ivan Borbath Hans Prenen Karen Paula Geboes Aurélien Lambert Jean-Frédéric Blanc
Lancet Oncol
July 2024
Article Synopsis
- Current treatments for metastatic pancreatic ductal adenocarcinoma yield very low survival rates, prompting research into new therapies like mitazalimab combined with a modified chemotherapy regimen called mFOLFIRINOX.
- The OPTIMIZE-1 study enrolled 70 patients across 14 hospitals in Belgium, France, and Spain to evaluate the safety and effectiveness of this combination therapy, focusing on determining the optimal dose of mitazalimab as well as measuring tumor response.
- The trial successfully determined 900 μg/kg of mitazalimab as the recommended dose for the next phase and gathered data on the initial outcomes for the patients treated within the study timeframe from September 2021 to March 2023.
Article Synopsis
- The TOPAZ-1 study investigated the effectiveness of durvalumab, a PD-L1 inhibitor, in combination with gemcitabine and cisplatin for treating advanced biliary tract cancer, showing significant survival benefits over the placebo.
- Participants aged 18 or older were randomly assigned to receive either the treatment or placebo, with their quality of life measured using specific questionnaires during the study.
- Findings from patient-reported outcomes are discussed, highlighting how the treatments impacted their quality of life based on decline metrics.
Introduction: This document is a summary of the French intergroup guidelines of the management of biliary tract cancers (BTC) (intrahepatic, perihilar and distal cholangiocarcinomas, and gallbladder carcinomas) published in September 2023, available on the website of the French Society of Gastroenterology (SNFGE) (www.tncd.org).
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- The study investigates the effectiveness of percutaneous radiofrequency ablation (RFA) for treating intrahepatic cholangiocarcinomas (iCCA) by analyzing patient data from 2000 to 2022.
- It finds that multibipolar RFA has a lower local recurrence rate compared to monopolar RFA (22% vs. 55%) and suggests that tumor size and liver health significantly impact survival outcomes.
- The results indicate that patients with iCCA experience shorter overall survival than those with hepatocellular carcinoma (26 vs. 68 months), and highlight the importance of considering adjuvant chemotherapy due to high rates of distant metastases.
Article Synopsis
- This study investigates the effectiveness of tepotinib, a MET inhibitor, in treating hepatocellular carcinoma (HCC) with gene amplification (amp), specifically in patients showing high levels of amp (≥10). * -
- Preclinical tests on patient-derived tumor models showed tepotinib caused nearly complete tumor regression in cases with high-level amp, while clinical trials indicated that 11 out of 15 patients with amp experienced disease control. * -
- The findings suggest that high-level amp might drive cancer growth in HCC and that tepotinib could be an effective treatment option for these patients. *
Article Synopsis
- Hepatocellular carcinoma (HCC) is linked to inflammation and can arise from liver diseases, leading to an increase in immunosuppressive myeloid cells, which complicates immunotherapy effectiveness.
- A detailed study of innate immune cells in HCC patients revealed an influx of inflammatory and myeloid cells, particularly a distinct type of THBS1 regulatory myeloid cells, which are associated with poor patient outcomes.
- THBS1 M cells, marked by specific gene expressions and characterized by their role in promoting tumor growth and immunosuppression, suggest that targeting these myeloid subsets could improve HCC immunotherapy strategies.
Article Synopsis
- - Pemigatinib is used for treating advanced or metastatic cholangiocarcinoma (CCA) in patients with FGFR2 rearrangements, and a study evaluated its effectiveness and safety in real-world settings across multiple centers in France and Italy.
- - A total of 72 patients were assessed, revealing an overall response rate (ORR) of 45.8% and disease control rate (DCR) of 84.7%, with a median overall survival (OS) of 17.1 months over a follow-up period of about 19.5 months.
- - Common side effects included fatigue, ocular issues, and skin toxicity, primarily mild, with 22.2% experiencing severe adverse events (Grade
Article Synopsis
- Hepatocellular adenomas (HCAs) are rare benign liver tumors with different subtypes linked to various mutation risks for malignant transformation, particularly the β-catenin-activated subtypes.
- * A study revealed that the tumor rim exhibits increased glutamine synthetase and distinct vascular features compared to the tumor center, potentially indicating tumor heterogeneity.
- * Using advanced imaging and analysis techniques, researchers found that while both tumor regions share the same mutations, their protein expressions differ significantly, suggesting that factors other than mutational status contribute to their varied characteristics.
Article Synopsis
- - Hepatocellular carcinoma (HCC) is a major global health issue, being one of the most common cancers and a leading cause of cancer deaths, with intra-arterial therapies like TACE and SIRT being key treatment options for non-resectable cases.
- - TACE is typically used for patients with stage B HCC, while SIRT has shown promising results in patients previously treated with TACE, despite not having an official role in treatment guidelines.
- - A study involving 23 patients indicated that SIRT post-TACE resulted in a 73.8% objective response rate, with 56.5% achieving complete response, highlighting SIRT's potential effectiveness despite the complications associated with TACE.
Article Synopsis
- Sonic hedgehog hepatocellular adenoma (shHCA) presents a unique challenge due to its high risk of hemorrhage and specific associations such as obesity and female gender.
- This study examined MRI scans from 29 patients, identifying potential imaging characteristics linked to shHCA, including the presence of fluid-filled cavities.
- Results indicate that MRI can help in diagnosing shHCA, revealing that nearly half of the cases displayed fluid-filled cavities, a finding that could enhance future diagnostic strategies.
Article Synopsis
- This study investigated the safety and effectiveness of abemaciclib, both alone and in combination with other treatments, for patients with previously treated metastatic pancreatic ductal adenocarcinomas (PDAC).
- The trial compared abemaciclib to standard chemotherapy and found that it did not provide significant improvements in disease control rates (DCR) or progression-free survival (PFS).
- Ultimately, no treatment combinations moved to the next phase of testing, confirming that abemaciclib is still considered investigational for this type of cancer.
Article Synopsis
- Surgical resection (SR) is a potential cure for hepatocellular carcinoma (HCC), but high recurrence rates pose a challenge, necessitating the development of better risk stratification tools for predicting recurrence.
- A new scoring system, called the Early Recurrence Score (ERS), was created from data of 2359 patients who underwent SR for HCC, evaluating factors like alpha-fetoprotein levels and tumor characteristics to forecast 2-year recurrence risk.
- The ERS effectively stratified patients into four risk categories with good accuracy and can help personalize surveillance and therapy plans post-surgery.
Article Synopsis
- The ELITor study analyzed real-world data from the CHIEF cohort to understand treatment patterns and patient characteristics for unresectable hepatocellular carcinoma in France, focusing on sociodemographic, clinical, and quality of life factors.
- A total of 367 patients were included, with most presenting at advanced BCLC C stage and a high prevalence of cirrhosis; alcohol was identified as the main cause of the disease.
- Results showed that tyrosine-kinase inhibitors were the most common systemic treatment, and patients receiving atezolizumab plus bevacizumab demonstrated better health statuses, although many experienced a decline in health quality post-treatment.
Article Synopsis
- The analysis aimed to describe the demographics, treatment patterns, and outcomes of patients with newly diagnosed hepatocellular carcinoma (HCC) in France from 2015-2017.
- Out of 20,083 patients studied, most were male (82.4%) with a mean age of 69.2 years, and 87% had identifiable risk factors, primarily alcohol-related liver disease and metabolic diseases.
- Only 32.7% received curative treatment, leading to a high 1-year survival rate of 89.5%, while 38% received supportive care with only a 12.9% survival rate, indicating that HCC is often diagnosed late and has poor prognosis, especially among those with non
Article Synopsis
- Transcatheter arterial chemoembolisation (TACE) is used for treating liver cancer patients who can't undergo curative therapies; this study compared TACE alone with TACE combined with external conformal radiotherapy (CRT).
- The trial involved 120 participants, mostly older males with alcohol-related liver issues, and aimed to assess liver progression-free survival (PFS) over 12 and 18 months.
- Results indicated that while the combined treatment (TACE + CRT) showed better local control, it did not significantly improve PFS or overall survival compared to TACE alone, and led to more serious liver-related side effects.
Article Synopsis
- Tislelizumab, an antibody targeting the PD-1 protein, showed some effectiveness and safety for treating advanced hepatocellular carcinoma (HCC) in patients who had received prior therapies.
- In a phase 2 study involving 249 patients, the objective response rate (ORR) was 13%, with a disease control rate of 53% and a median overall survival of 13.2 months.
- Side effects were mostly manageable, with only 15% of patients experiencing severe treatment-related adverse events, and no treatment-related deaths reported.
Article Synopsis
- The study investigates the calculation of yttrium-90 microspheres activity essential for selective internal radiotherapy (SIRT).
- Using dosimetry software, researchers analyzed the absorbed doses to both tumors and healthy liver tissue before and after treatment phases.
- Results indicated significant correlations in dose distribution and suggested that optimizing microsphere dosages could enhance treatment effectiveness for some patients while reducing it for others.
Article Synopsis
- * The TRIPLET-HCC trial is a phase II-III study that aims to evaluate the efficacy and safety of adding ipilimumab to the current double therapy of atezolizumab and bevacizumab for patients with specific types of HCC.
- * The trial's primary goals are to compare the objective response rates and overall survival between the triple and double therapy groups, while also examining progression-free survival, patient tolerance, quality
Article Synopsis
- The IMbrave150 trial shows that the atezolizumab-bevacizumab combination is more effective than sorafenib for first-line treatment of advanced hepatocellular carcinoma (HCC), marking a significant shift in over 10 years.
- Other promising immunotherapy combinations (like durvalumab-tremelimumab and lenvatinib-pembrolizumab) may also challenge this new standard of care.
- The review will cover these treatment combinations, dilemmas in choosing first-line therapies, second-line treatment recommendations, and future challenges in drug development for advanced HCC.
Article Synopsis
- The study evaluates the efficacy of first-line systemic treatments, specifically tyrosine kinase inhibitors (TKIs) and platinum-based chemotherapy, for patients with unresectable hepatocellular-cholangiocarcinoma (cHCC-CCA) in comparison to hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA).
- A total of 83 male-dominated patients (72%) with cHCC-CCA were analyzed; many had cirrhosis (55%) and a significant portion presented with extrahepatic metastases (67%).
- The overall survival for patients with cHCC-CCA was similar to that of HCC and iCCA after adjusting for factors like liver function
Hepatocellular carcinoma treatments: A new hope, but a headache for clinicians and researchers.
Clin Res Hepatol Gastroenterol
August 2022