Cécile Guillemet

Centre Henri Becquerel, Rouen, Haute-Normandie, France

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Publications (25)111.53 Total impact

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    ABSTRACT: Acquired estrogen receptor gene (ESR1) mutations have been recently reported as a marker of resistance to aromatase inhibitors in hormone receptor positive metastatic breast cancer. We retrospectively considered 7 patients treated for metastatic breast cancer with available samples from the primary tumor before any treatment, cryopreserved metastasis removed during progression and concomitant plasmas. All these 7 patients were in disease progression after previous exposure to aromatase inhibitors for at least 6 months, and were assessed for ESR1 mutations detection in tumor and circulating DNA. For these patients, Sanger sequencing identified 4 metastases with clear ESR1 mutation and one possible, whereas digital PCR identified 6 mutated metastases. Then, under blind conditions and using digital PCR, corresponding circulating ESR1 mutations were successfully detected in 4 of these 6 metastatic breast cancer patients. Moreover, in 2 patients with serial blood samples following treatments exposure, the monitoring of circulating ESR1 mutations clearly predicted disease evolution. In the context of high interest for ESR1 mutations, our results highlight that these acquired recurrent mutations may be tracked in circulating tumor DNA and may be of clinical relevance for metastatic breast cancer patient monitoring. This article is protected by copyright. All rights reserved. © 2015 UICC.
    International Journal of Cancer 05/2015; DOI:10.1002/ijc.29612 · 5.09 Impact Factor
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    ABSTRACT: Metastatic leiomyosarcomas of uterine or soft-tissue origin have poor prognosis and moderate chemosensitivity. Trabectedin has shown activity in pretreated leiomyosarcoma. We did a single-group, multicentre, phase 2 trial (LMS-02) to assess the effect of first-line doxorubicin and trabectedin combination on disease control and survival. Adults (18 years to physiological age ≤70 years) with measurable metastatic or unresectable uterine leiomyosarcoma or soft-tissue leiomyosarcoma who had not received any previous chemotherapy were enrolled at 19 centres in France. Treatment consisted of 60 mg/m(2) intravenous doxorubicin followed by 1·1 mg/m(2) trabectedin in a 3 h intravenous infusion on day 1, both by the central venous route, and 6 mg subcutaneous pegfilgrastim on day 2, repeated every 3 weeks for up to six cycles. Surgery for residual disease was permitted. The primary endpoint was the proportion of patients achieving disease control, defined as complete or partial response or stable disease. Stratification was done by anatomical site and analyses were per protocol. This study is registered with ClinicalTrials.gov, number NCT02131480. Between July 28, 2010, and May 10, 2013, 109 patients were enrolled and treated, of whom 108 were assessable for response: 47 in the uterine leiomyosarcoma group and 61 in the soft-tissue leiomyosarcoma group. 32 (68%) patients in the uterine leiomyosarcoma group and 45 (74%) in the soft-tissue leiomyosarcoma group received all six cycles of treatment. Of 47 patients with uterine leiomyosarcoma, 28 (59·6%, 95% CI 44·3-73·6) achieved a partial response and 13 (27·7%, 15·6-42·6) stable disease; 41 (87·2%, 74·3-95·2) patients achieved disease control. Of 61 patients with soft-tissue leiomyosarcoma, two (3·3%, 95% CI 0·4-11·7) achieved a complete response, 22 (36·1%, 25·0-50·8) had a partial response, and 32 (52·5%, 40·8-67·3) had stable disease; 56 (91·8%, 81·9-97·3) of patients achieved disease control. The most common grade 3-4 treatment-associated adverse events were neutropenia (84 [78%] of 108 patients), increased alanine aminotransferase concentration (42 [39%]), thrombocytopenia (40 [37%]), anaemia (29 [27%]), febrile neutropenia (26 [24%]), and fatigue (21 [19%]). Despite expected but manageable toxic effects, these results support the activity of doxorubicin plus trabectedin as first-line treatment for uterine leiomyosarcoma and soft-tissue leiomyosarcoma. This combination should be developed further in a phase 3 trial against the present standard of care. Pharmamar and Amgen. Copyright © 2015 Elsevier Ltd. All rights reserved.
    The Lancet Oncology 03/2015; 16(4). DOI:10.1016/S1470-2045(15)70070-7 · 24.69 Impact Factor
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    ABSTRACT: The French Sarcoma Group performed this retrospective analysis of the 'RetrospectYon' database with data of patients with recurrent advanced soft tissue sarcoma (STS) treated with trabectedin 1.5mg/m(2) as a 24-h infusion every three weeks. Patients who achieved non-progressive disease after six initial cycles could receive long-term trabectedin treatment until disease progression. Overall, 885 patients from 25 French centres were included. Patients received a median of four trabectedin cycles (range: 1-28). The objective response rate was 17% (six complete/127 partial responses) and 50% (n=403) of patients had stable disease for a disease control rate of 67%. After a median follow-up of 22.0months, median progression-free survival (PFS) and overall survival (OS) were 4.4 and 12.2months, respectively. After six cycles, 227/304 patients with non-progressive disease received trabectedin until disease progression and obtained a significantly superior median PFS (11.7 versus 7.6months, P<0.003) and OS (24.9 versus 16.9months, P<0.001) compared with those who stopped trabectedin treatment. Deaths and unscheduled hospitalisation attributed to drug-related events occurred in 0.5% and 9.4% of patients, respectively. The results of this real-life study demonstrate that treatment with trabectedin of patients with STS yielded comparable or improved efficacy outcomes versus those observed in clinical trials. A long-term treatment with trabectedin given until disease progression is associated with significantly improved PFS and OS. Copyright © 2015. Published by Elsevier Ltd.
    European journal of cancer (Oxford, England: 1990) 02/2015; 51(6). DOI:10.1016/j.ejca.2015.01.006 · 5.42 Impact Factor
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    ABSTRACT: To assess the additional value of density measurement using contrast-enhancement sequences (Choi assessment) in a real-life cohort of adult soft tissue sarcoma patients treated with trabectedin. Eligibility criteria included adults (age ⩾18) treated between 01/2007 and 12/2011, with at least two trabectedin cycles after failure or intolerance to doxorubicin/ifosfamide. Baseline and first computed tomography (CT)-scans were centrally reviewed by an experienced radiologist. The retrospective cohort consists of 134 (73 female) patients treated with trabectedin 1.5mg/m(2) given as a 24-h infusion every 3weeks. Patients received a median of five trabectedin cycles (range: 2-33) and the main cause of discontinuation was progressive disease (PD) (n=105, 78.4%). Response Evaluation Criteria in Solid Tumours (RECIST) assessment was feasible in 128 (95.5%) patients, with Choi assessment performed in 92 (68.7%) patients, generally due to inadequate sequences or exclusive lung metastases. Concordance between both methods was fair (Kappa=0.290). We identified five patients with false PD (i.e. PD according to RECIST but stable disease/partial response as per Choi). Univariate analysis did not identify any predictive factors for false PD. Median overall survival (OS) of patients with PD as per RECIST but stable disease/partial response (SD/PR) according to Choi was better than for patients with PD according to both RECIST and Choi (14months versus 8months; p=0.052). Choi assessment may identify patients with false PD who achieved improved efficacy outcomes, suggesting that trabectedin may delay tumour progression even in the case of non-dimensional response. Dual size and tumour density assessment may be more suitable to evaluate responses to trabectedin in sarcoma patients as well as to improve the decision-making strategies for the continuation of trabectedin therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.
    European journal of cancer (Oxford, England: 1990) 12/2014; 51(2). DOI:10.1016/j.ejca.2014.11.008 · 5.42 Impact Factor
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    ABSTRACT: Background This retrospective multicenter study assessed the clinical, radiological and pathological presentation, treatment and outcome of 26 patients with Ewing-like sarcoma harboring BCOR-CCNB3 gene fusion transcript. Tumor samples had been collected between 1994 and April 2012.ProcedureEligibility criteria included assessment of a BCOR-CCNB3 transcript-positive tumor after molecular analysis and availability of minimal clinical and pathological data. Radiological data were also retrieved when possible. Data were analyzed by descriptive statistics and methods for survival analysis.ResultsMedian age at diagnosis was 13.1 years (5.9 to 25.6 years). Most patients (24/26) had localized tumors. All tumors but five were localized to bone. CCNB3 immunochemistry showed strong nuclear staining on all samples. No specific radiological features were found. Most patients received chemotherapy (15 according to protocols designed for Ewing tumors), before and/or after local treatment (surgery and/or radiotherapy, with 46.2% receiving both). Local and metastatic relapses were of poor prognosis. Induction chemotherapy and treatment according to an Ewing protocol might influence survival for patients with localized tumors. Sixteen patients are alive in complete remission with a median follow-up of 86 months. Five year overall survival and disease-free survival were respectively 76.5% (95% CI, 58%–95%) and 67.9% (95% CI, 48%–88%).ConclusionsBCOR-CCNB3 transcript-positive Ewing-like sarcoma diagnosis should be discussed for a transcript-negative small round cell sarcoma in a child, adolescent or young adult patient. Diagnosis needs to be stated through CCNB3 immunochemistry or transcript identification. The exquisite chemosensitivity of these tumors should encourage the use of polychemotherapy for appropriate care, associated with best local tumor control. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
    Pediatric Blood & Cancer 12/2014; 61(12). DOI:10.1002/pbc.25210 · 2.39 Impact Factor
  • ML Fontoura · C Lee · O Cassuto · C Guillemet · O Rigal · H Tilly · A Stamatoullas
    Klinische Pädiatrie 03/2014; 226(02). DOI:10.1055/s-0034-1371155 · 1.06 Impact Factor
  • Oncologie 01/2014; 16(1):42-54. DOI:10.1007/s10269-014-2364-9 · 0.06 Impact Factor
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    ABSTRACT: Primary cardiac sarcomas (PCS) are rare tumours of dismal prognosis. Data of 124 patients with PCS referred to institutions of the French Sarcoma Group (FSG) from 1977 and 2010 were reviewed. Median age was 48.8years. PCS were poorly-differentiated sarcomas (N=45, 36.3%), angiosarcomas (N=40, 32.3%), leiomyosarcomas (N=16, 12.9%) and others (N=23, 18.6%). At diagnosis, 100 patients (80.6%) were localised and 24 (19.4%) metastatic. Tumours were located in the right (N=47, 38.8%), left atrial cavities (N=45, 37.2%) or encompassed several locations in nine cases (7.4%). Surgery was performed in 81 cases (65.3%). Heart transplant was performed in five patients. Radiotherapy adjuvant (N=18, 14.5%) or alone (N=6, 4.8%) was performed in non-metastatic patients only (N=24, 19.4%). With a median follow-up of 51.2months, median overall survival (OS) was 17.2months for the entire cohort, 38.8months after complete resection versus 18.2 after incomplete resection and 11.2months in non-resected patients. Radiotherapy was associated with improved progression-free survival (PFS) on multivariate analysis. Chemotherapy was significantly associated with better OS only in non-operated patients but not in operated patients. In non-metastatic patients, surgery (hazard ratio [HR]=0.42, p<0.001), male gender (HR=0.56, p=.032) was associated with better OS and surgery (HR=0.61; p=.076), radiotherapy (HR=0.43; p=.004) and chemotherapy (HR=0.30, p=.003) improved PFS. Only surgical resection is associated with a perspective of prolonged survival. Chemotherapy is associated with a better outcome in non-resected patients.
    European journal of cancer (Oxford, England: 1990) 10/2013; 50(1). DOI:10.1016/j.ejca.2013.09.012 · 5.42 Impact Factor
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    ABSTRACT: Background There is no proven benefit of adjuvant treatment of uterine sarcoma (US). SARCGYN phase III study compared adjuvant polychemotherapy followed by pelvic radiotherapy (RT) (arm A) versus RT alone (arm B) conducted to detect an increase ≥ 20% of 3-year PFS.Methods Patients with FIGO stage ≤ III US, physiological age ≤ 65 years; chemotherapy: four cycles of doxorubicin 50 mg/m&sup2; d1, ifosfamide 3 g/m&sup2;/day d1-2, cisplatin 75 mg/m&sup2; d3, (API) + G-CSF q 3 weeks. Study was stopped because of lack of recruitment.ResultsEighty-one patients were included: 39 in arm A and 42 in arm B; 52 stage I, 16 stage II, 13 stage III; 53 leiomyosarcomas, 9 undifferenciated sarcomas, 19 carcinosarcomas. Gr 3-4 toxicity during API (/37 patients): thrombopenia (76%), febrile neutropenia (22%) with two toxic deaths; renal gr 3 (1 patient). After a median follow-up of 4.3 years, 41/81 patients recurred, 15 in arm A, 26 in arm B. The 3 years DFS is 55% in arm A, 41% in arm B (P = 0.048). The 3-year overall survival (OS) is 81% in arm A and 69% in arm B (P = 0.41).ConclusionAPI adjuvant CT statistically increases the 3 year-DFS of patients with US.
    Annals of Oncology 11/2012; 24(4). DOI:10.1093/annonc/mds545 · 7.04 Impact Factor
  • Cancer/Radiothérapie 09/2012; 16(s 5–6):522. DOI:10.1016/j.canrad.2012.07.021 · 1.41 Impact Factor
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    ABSTRACT: Angiosarcomas are a rare but aggressive form of soft tissue sarcoma. At metastatic stage, the clinical benefit of therapeutic intervention remains debatable. We have carried a retrospective analysis of 149 cases treated between 1996 and 2009 in the French Sarcoma Group. The median age was 60; the sex ratio was 0.80. Sixty-two percentage of cases presented with metastasis at the diagnosis. About 20% arose in irradiated fields. The median overall survival was 11 months. Treatment consisted in metastasectomy (5.4%), doxorubicin-based regimen (46.9%), weekly paclitaxel (Taxol) (31.5%), other chemotherapy regimens (10.7%) or exclusive palliative care (10.9%). Clinical prognostic factors identified by univariate analysis were presence of bone metastasis (P = 0.0107), presence of other metastasis (P = 0.0327) and performance status (P < 0.0001). The Cox model retained a performance status of two or more as the sole independent prognostic factor (HR [hazard ratio] = 2.49, P < 0.0001). After adjustment to the performance status and compared with exclusive palliative care, the following treatments significantly improve the outcome: doxorubicin-based regimen as first-line chemotherapy (HR = 0.38, P = 0.0165), weekly paclitaxel as first-line regimen (HR = 0.36, P = 0.0146) and metastasectomy (HR = 0.09, P = 0.0221). This retrospective analysis indicates that some therapeutic interventions may significantly improve the outcome of this aggressive disease. Doxorubicin-based regimens and weekly paclitaxel seem to provide the same range of efficacy.
    Annals of Oncology 05/2011; 23(2):517-23. DOI:10.1093/annonc/mdr138 · 7.04 Impact Factor
  • O. Rigal · C. Guillemet
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    ABSTRACT: L’augmentation du nombre de malades âgés atteints de cancer et la prise en compte de leur qualité de vie ont conduit au développement, en parallèle des soins oncologiques, des soins de support, parfaitement complémentaires avec les objectifs de l’oncogériatrie. Les soins de support définissent l’ensemble des pratiques de soins et de soutiens destinées à la personne atteinte de cancer, prenant en compte à la fois les répercussions d’ordres physique, psychologique ou social de la maladie ainsi que les complications des traitements oncologiques spécifiques entrepris. Ils sont proposés tout au long de la maladie, depuis l’annonce du diagnostic de cancer: pendant la phase où sont réalisés les traitements carcinologiques spécifiques et en fonction de l’évolution, durant les phases de « rémission » ou de « guérison », comme en phase palliative lorsque celle-ci est engagée. Ils sont complémentaires de la prise en charge gériatrique, proposés notamment à l’issue d’une évaluation gériatrique standardisée (EGS). Les soins de support apportent une aide supplémentaire pour gérer le risque supérieur de complications liées à la maladie et aux traitements. Les soins oncologiques de support nécessitent une coordination multidisciplinaire des soins et des soutiens destinés aux malades et à leurs proches. Les développements futurs devront tenir compte d’un nombre de plus en plus important de malades âgés « survivants » à leur cancer. La nécessité de bénéficier d’un suivi et d’un accompagnement adaptés à distance des traitements tels que le prévoient les orientations stratégiques du second Plan cancer (2009–2013) figure aussi dans cette approche qualitative des soins en oncologie. Les soins oncologiques de support connaissent aussi un développement vers des soins et des médecines dits « complémentaires » qui ambitionnent, en association aux traitements « classiques » carcinologiques, l’amélioration durable de la qualité de vie des malades. The increase in the number of elderly patients affected by cancer and the consideration of their quality of life led to the development, in parallel to oncology care, to that of the perfectly complementary supportive care with the objectives of geriatric oncology. Supportive care in oncology defines a set of care and support intended for the person affected by cancer, taking into account at the same time, the physical, psychological and social repercussions of the disease and the possible complications of the undertaken specific cancer treatments. It is offered throughout the disease, from the announcement of the cancer diagnosis, to the phase where specific cancer treatments are realized. According to the evolution of cancer, they are necessary during the phases of “remission” or “cure”, until the palliative phase when this one is engaged. It is complementary to geriatric care, offered in particular at the conclusion of a standardized geriatric evaluation. Supportive care in oncology provides additional help to manage the higher risk of complications bound to the disease and its treatments. Supportive care in oncology requires a multidisciplinary coordination of care and support intended for the patients and their close relations. Future developments will have to take into account the increasing number of older patients who are “survivors” of cancer. The necessity of benefiting of a follow-up and caring adapted at a distance of treatments such as the strategic orientations of the cancer plan (2009–2013) it also appears in this qualitative approach of care in oncology. The supportive care in oncology also knows a development towards care and said “complementary” medicines, which aspire in association with the “classic” cancer treatments to the sustainable improvement of the quality of life of the patients. Mots clésCancer–Oncogériatrie–Soins de support–Personne âgée KeywordsCancer–Oncogeriatrics–Supportive care–Elderly
    Les cahiers de l année gérontologique 03/2011; 3(1):33-39. DOI:10.1007/s12612-011-0174-5
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    ABSTRACT: Imatinib evaluated as a new treatment option in patients with recurrent or established progressive aggressive fibromatosis/desmoid tumor (AF/DT). Forty patients with unresectable and progressive symptomatic AF/DT were treated with imatinib (400 mg/day for 1 year) in a Simon's optimal two-stage phase II study (P(0) = 10%, P(1) = 30%, α = 5%, β = 10%). The primary end point was non-progressive at 3 months (RECIST). The study population consisted of 28 women and 12 men, with a mean age of 41 (range 20-72 years). Most of the primary sites were extra-abdominal (24, 54.5%). Familial adenomatous polyposis was observed in six (15%) cases. The median follow-up was 34 months. Imatinib toxicity was similar to that previously reported in literature. Tumor assessment was validated by a central independent radiology committee for 35 patients At 3 months, one (3%) complete and three (9%) partial confirmed responses were observed. The non-progression rates at 3, 6 and 12 months were, respectively, 91%, 80% and 67%. The 2-year progression-free and overall survival rates were 55% and 95%, respectively. Two patients with mesenteric AF/DT died from progressive disease. Imatinib is active in the treatment of recurrent and progressive AF/DT, providing objective response and long-term stable disease in a large proportion of patients.
    Annals of Oncology 02/2011; 22(2):452-7. DOI:10.1093/annonc/mdq341 · 7.04 Impact Factor
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    ABSTRACT: Leptomeningeal meningitis occurs in approximately 5% of metastatic breast cancers, and there is no standard treatment for this complication. We retrospectively analyzed the clinical data and cerebrospinal fluid of 24 patients treated with high-dose intrathecal methotrexate for breast cancer leptomeningeal meningitis (BLM). Cytologic response (CSF cytology without neoplastic cells after treatment) was observed in 11 patients (46%) and related to survival (P = 0.005). In addition, clinical symptoms improved in all 11 patients who had a cytologic response and in 7 patients (54%) without cytologic response (P = 0.02). The predictive value of cytologic response needs further confirmation. Cytologic response could be helpful in the management of intrathecal chemotherapy in patients with BLM.
    Journal of Neuro-Oncology 07/2009; 95(3):421-6. DOI:10.1007/s11060-009-9940-2 · 3.07 Impact Factor
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    ABSTRACT: We report two cases of pneumocystis pneumonia in patients receiving chemotherapy for breast cancer. These case series emphasize the frailty of the patients as the causative role for occurrence of this uncommon complication of chemotherapy in breast cancer. We remind the importance of screening for unusual adverse events in frail patients receiving chemotherapy.
    La Revue de Médecine Interne 05/2009; 31(4):e1-3. DOI:10.1016/j.revmed.2009.03.354 · 1.07 Impact Factor
  • S Chourin · D Georgescu · C Gray · C Guillemet · A Loeb · C Veyret · J-P Basuyau
    Annals of Oncology 04/2009; 20(5):962-4. DOI:10.1093/annonc/mdp061 · 7.04 Impact Factor
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    ABSTRACT: Cisplatin (Cp) plus topotecan (Tc) is the first combination chemotherapy to demonstrate a survival advantage over cisplatin alone in advanced cervical cancer. Combining Cp and Tc with an epidermal growth factor receptor (EGFR) inhibitor such as cetuximab (Ce) may increase the activity of chemotherapy. Patients with advanced cervical squamous cell cancer or adenocarcinoma and at least one measurable target received intravenous Cp 50 mg/m(2) on day 1 plus Tc 0.75 mg/m(2)/day from days 1 to 3 every 3 weeks combined with Ce (initial dose of 400 mg/m(2) followed by subsequent weekly dose of 250 mg/m(2)). Objective response rate according to RECIST criteria was the primary end point; safety, progression free survival (PFS) and overall survival (OS) were secondary end points. Between April and July 2007, 19 out of the 44 planned patients were accrued before the study was stopped early due to excessive toxicity. The most frequent adverse event was severe myelosuppression with grades 3-4 neutropenia (72%), grades 3-4 thrombocytopenia (61%), and grade 3 anemia (44.5%). The main grades 3-4 non-hematologic toxicities were infection (39%) and febrile neutropenia (28%), skin reactions (22%), renal toxicity (11%), and pulmonary embolism (11%). Five (28%) patients died during the treatment including 3 deaths related to treatment toxicity. Six (32%) evaluable patients achieved a partial response. The median times of PFS and OS were 172 and 220 days, respectively. In this phase II trial, the combination Cp-Tc-Ce induced a high rate of serious adverse and/or fatal events at standard dose and schedule. Cetuximab plus platinum-based combination chemotherapy should be further explored with caution in the future in advanced cervix cancer.
    Gynecologic Oncology 03/2009; 113(1):16-20. DOI:10.1016/j.ygyno.2008.12.040 · 3.77 Impact Factor
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    ABSTRACT: Multidrug chemotherapy increases responses in advanced soft tissues sarcoma. Can a 20% increase of relative dose intensity of the MAID regimen, more improve responses? From 1994 to 1997, 162 patients were randomized in a phase III study to the conventional drug combination (6 cycles of MAID: 60, 7,500, 900 mg/m(2) for doxorubicin, ifosfamide and dacarbazine respectively), or at doses 20-33% higher per cycle (5 cycles of intensified MAID for similar cumulative doses) with systematic G-CSF. Primary endpoint was response rate; secondary were toxicity, event-free and overall survival. The objective response rate in assessable patients was 38% with intensified MAID and 35% with MAID (p = 0.72). Event-free and overall survivals were similar in both arms. Only grade 3-4 thrombocytopenia and anemia were significantly higher in intensified arm. Treatment with intensified MAID did not improve response rate neither survival and cannot be recommended for advanced or metastatic soft tissue sarcoma.
    Investigational New Drugs 02/2009; 27(5):482-9. DOI:10.1007/s10637-008-9217-1 · 2.92 Impact Factor
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    ABSTRACT: ContexteLa mise à jour de ces recommandations a été élaborée conjointement par la Fédération nationale des centres de lutte contre le cancer (FNCLCC) en partenariat avec les secteurs public, privé et l’Institut national du cancer. ObjectifActualiser les recommandations établies en 2003. MéthodesL’actualisation des Standards, Options: Recommandations (SOR) repose sur une revue et une analyse critique des données scientifiques disponibles et sur le jugement argumenté des experts au sein d’un groupe de travail représentatif des modes et lieux d’exercice et des disciplines concernées par la prise en charge des patients atteints de cancer. RésultatsCet article présente les recommandations SOR 2008 relatives à la place des traitements complémentaires médicaux de première ligne et de consolidation, établies à l’issue du processus d’actualisation. ContextThe Federation of French Comprehensive Cancer Centres (FNCLCC) initiated the update of these recommendations in collaboration with the French National Cancer Institute and specialists from French public universities, general hospitals and private clinics. ObjectivesTo update the recommendations established in 2003. MethodsThe guideline up-dating process is based on systematic literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Consequently, Standards, Options: Recommendations are based on the best available evidence and expert agreement. ResultsThis article presents the 2008 updated recommendations concerning medical first-line treatment and consolidation treatment of epithelial ovarian cancers.
    Oncologie 06/2008; 10(6):451-457. DOI:10.1007/s10269-008-0913-4 · 0.06 Impact Factor