Nicolas Magné

University of Lyon, Lyons, Rhône-Alpes, France

Are you Nicolas Magné?

Claim your profile

Publications (226)609.24 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Carcinosarcoma, also known as mixed mesodermal tumor or malignant mixed Mullerian tumor (MMMT) is a pathological entity combining a sarcomatous and a carcinomatous component. Found in thoracic, digestive, genitourinary, liver or skin locations, the most common location is the female genital tract. In gynecological tumors, carcinosarcoma accounts for about 2-5% of endometrial cancers, and 1% of ovarian cancers. To date, there is no consensus on the therapeutic strategy. It relies mostly on maximum cytoreductive surgery. Adjuvant therapy remains controversial, and few prospective studies investigating its interest. Retrospective studies show the benefits of adjuvant chemotherapy based on platinum in most cases. Radiation therapy has a place in the adjuvant situations of endometrial and cervical carcinosarcoma. A more detailed pathological knowledge, and the use of targeted therapies may be promising in this histological subtype whose prognosis remains very poor. The objective of this study is to present the main principles of carcinosarcoma management in female genital tracts, describing pathological and prognostic features at the same time.
    Bulletin du cancer. 08/2014; 101(7-8):760-764.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of the present study is to report the pilot experience at the « Loire cardiorespiratory readaptation center » of re-entrainment of physical activity for patients suffering from breast cancer. Between January 2012 and February 2013, 63 patients took the program at the readaptation center. The program is composed of three sessions a week during seven weeks. During the care, a medical team intervenes. It is composed of a cardiologist, a physiotherapist, a sophrologist, a psychologist and a dietician who take part in turns and/or together. During the first session of the program, the warm-up power chosen on the exercise bike was on average of 14.72 watts (min = 5; max = 30), and it went up to 44.84 watts (min = 15; max = 85) on average during the last session. The maximal power used by the patient was on average of 39.08 watts (min = 10; max = 70) during the first session. On the last day of training, the average maximal power between the patients was of 76.03 watts (min = 30; max = 110). The tests used into practice tend to confirm a physical progression between the beginning and the end of the re-training program. This study particularly shows that it is possible today to propose this type of program to the patients in daily practice.
    Bulletin du cancer. 08/2014; 101(7-8):698-702.
  • [Show abstract] [Hide abstract]
    ABSTRACT: There is an increasing number of therapeutic options in breast cancer management. While prognosis improves, the cardiac toxicity related to treatments remains a significant issue. This toxicity has several clinical presentations and can be explained by complex and diverse molecular mechanisms. Systemic treatments (anthracyclines, inhibitors of HER2 signaling pathway, hormone therapy, antiangiogenic agents) and radiotherapy have their own cardiac toxicity. However, the toxicities associated with these treatments may potentiate together and the existence of pre-existing cardiovascular risk factors should be taken into account. The assessment of cardiac hazard evolves toward a multifactorial approach. Several possibilities exist to minimize the incidence of cardiac complications. Those include pharmacological and technological innovations, but also a more accurate selection of patients and a growing involvement of practitioners in the field of cardiac toxicity, which is prerequisite for an early management of cardiac events.
    Bulletin du cancer. 08/2014; 101(7-8):730-740.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Gadolinium based nanoparticles (GBNs, diameter 2.9±0.2nm), have promising biodistribution properties for theranostic use in-vivo. We aimed at demonstrating the radiosensitizing effect of these GBNs in experimental radioresistant human Head and Neck Squamous Cell Carcinoma (SQ20B, FaDu and Cal33 cell lines). Combining 0.6mM GBNs with 250kV photon irradiation significantly decreased SQ20B cell survival, associated with the increase in non-reparable DNA double-strand breaks, the shortening of G2/M phase blockage, the inhibition of cell proliferation, each contributing to the commitment of late apoptosis. Similarly, radiation resistance was overcome for SQ20B stem-like cells, as well as for FaDu and Cal33 cell lines. Using a SQ20B tumor-bearing mouse model, combination of GBNs with 10Gy irradiation significantly delayed tumor growth with an increase in late apoptosis and a decrease in cell proliferation. These results suggest that GBNs could be envisioned as adjuvant to radiotherapy for HNSCC tumors.
    Nanomedicine 06/2014; · 5.26 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Gadolinium based nanoparticles (GBNs, diameter 2.9±0.2nm), have promising biodistribution properties for theranostic use in-vivo. We aimed at demonstrating the radiosensitizing effect of these GBNs in experimental radioresistant human Head and Neck Squamous Cell Carcinoma (SQ20B, FaDu and Cal33 cell lines). Combining 0.6mM GBNs with 250kV photon irradiation significantly decreased SQ20B cell survival, associated with the increase in non-reparable DNA double-strand breaks, the shortening of G2/M phase blockage, the inhibition of cell proliferation, each contributing to the commitment of late apoptosis. Similarly, radiation resistance was overcome for SQ20B stem-like cells, as well as for FaDu and Cal33 cell lines. Using a SQ20B tumor-bearing mouse model, combination of GBNs with 10Gy irradiation significantly delayed tumor growth with an increase in late apoptosis and a decrease in cell proliferation. These results suggest that GBNs could be envisioned as adjuvant to radiotherapy for HNSCC tumors.
    Nanomedicine : nanotechnology, biology, and medicine. 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: In clinical practice and the literature, malignant melanoma usually appears in typical sites where melanocytes can be found: skin, eyes meninges and anal region. Malignant melanomas of the esophagus-gastrointestinal (EGI) tract are usually metastatic. Primary and diffuse EGI tract melanoma is rare and only a few descriptions of this presentation have been found in the literature. The prognosis of EGI tract melanoma is frightening because of late diagnosis and high malignancy potential. Treatment is based essentially on surgery. The objective of the present study is to specify the clinical and therapeutic aspects of primary digestive melanoma.
    Bulletin du cancer. 06/2014; 101(6):637-640.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Radiotherapy for epithelioid hemangioendothelioma (EHE) using volumetric intensity-modulated arc radiotherapy (VMAT). A 48-year-old woman was referred for curative irradiation of a vertebral EHE after failure of surgery. A comparison between VMAT and conventional conformal tridimensional (3D) dosimetry was performed and potential advantage of VMAT for sparing critical organs from irradiation׳s side effects was discussed. The total delivered dose on the planning target volume was 54Gy in 27 fractions. The patient was finally treated with VMAT. The tolerance was excellent. There was no acute toxicity, including no increase in pain. With a follow-up of 18 months, no delayed toxicity was reported. The clinical response consisted of a decrease in the dorsal pain. The Dmax for the spinal cord was reduced from 55Gy (3D-radiotherapy [RT]) (which would be an unacceptable dose to the spine because of the risk of myelopathy) to 42.8Gy (VMAT), which remains below the recommended dose threshold (45Gy). The dose delivered to 20% of organ volume (D20) was reduced from 47Gy (3D-RT) to 3Gy (VMAT) for the spinal cord. The study shows that VMAT allows the delivery of curative treatment for vertebral EHEs because of critical organ sparing.
    Medical dosimetry: official journal of the American Association of Medical Dosimetrists 05/2014; · 1.26 Impact Factor
  • The American journal of cardiology 04/2014; 113(8):1447-8. · 3.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are only scarce data on the management of nonagenarians with breast cancer, and more particularly on the place of radiation therapy (RT). We report a retrospective study on patients aged 90 years old or older, with breast cancer, receiving RT. Records from RT departments from five institutions were reviewed to identify patients 90 years old of age and older undergoing RT over past decade for breast cancer. Tumors' characteristics were examined, as well treatment specificities and treatment intent. 44 patients receiving RT courses were identified, mean age 92 years. Treatment was given with curative and palliative intent in 72.7% and 27.3% respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery, and tumor stage. Median total prescribed dose was 40 Gy (23-66). Hypo fractionation was used in 77%. Most toxicities were mild to moderate. RT could not be completed in 1 patient (2.3%). No long-term toxicity was reported. Among 31 patients analyzable for effectiveness, 24 patients (77.4%) had their diseased controlled until last follow-up, including 17 patients (54.8%) experiencing complete response. At last follow-up, 4 patients (12.9%) were deceased, cancer being cause of death for two of them. The study shows that breast/chest RT is feasible in nonagenarians. Although the definitive benefit of RT could not be addressed here, hypofractionated therapy allowed a good local control with acceptable side effects.
    Breast (Edinburgh, Scotland) 04/2014; · 2.09 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In the field of radiotherapy, there is very little scientific data on the management of nonagenarians, especially in patients aged 90 years or more and with head and neck cancer (HNC). We made one of the first retrospective study of the feasibility and safety of radiotherapy in this population with HNC. Records of radiotherapy coming from four health facilities were studied to include all nonagenarian patients with HNC in the last 10 years and who received radiation therapy. We analyzed patient characteristics and primary cancers, as well as objective of the treatment (curative or palliative), efficacy and toxicity. Twenty patients receiving radiotherapy were identified; mean age was 93.2 years (standard deviation 2.8). Treatment was given with curative and palliative intent in 40 and 60 % of cases, respectively. The most common primary tumors were tumors of the salivary glands (30 % of cases), oral cavity tumors (25 % of cases) and thyroid tumors (15 % of cases). Median total prescribed dose was 47.5 Gy (12-70 Gy). Median number of delivered fractions was 18.5 (2-35 fractions). All patients received intensive supportive care during radiotherapy. Toxicities were mild to moderate. Radiotherapy could not be completed for four patients (20 % of cases). One patient developed grade 1-2 delayed toxicities. At the last follow-up, only four patients (20 % of cases) were alive. Cancer was cause of death in most cases. Radiotherapy may be performed for the nonagenarians with HNC. The total dose and fractionation must be adjusted to optimize the tolerance. However, the prognosis remains very poor, cancer being the main cause of death. Research of geriatric vulnerabilities prior to any treatment, in the context of a comprehensive geriatric assessment, is still recommended to select patients for radiotherapy.
    Archives of Oto-Rhino-Laryngology 04/2014; · 1.29 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Trastuzumab is a standard treatment in breast cancer overexpressing Her2 oncogene. However, its administration carries the risk of severe immune adverse events which often lead to the discontinuation of trastuzumab. There is no clear guideline on how patients experiencing trastuzumab-related reaction should be rechallenged with the monoclonal antibody. Here, we present two case reports of patients who have presented severe anaphylactic reactions during trastuzumab infusion. Both of them have been successfully rechallenged in intensive care units with premedication, lower rate of infusion and vitals monitoring. Thereafter, trastuzumab could be continued without any serious adverse reaction. Given the positive impact of trastuzumab on patients' survival, treatment rechallenge should be carefully considered in patients who presented anaphylactic reactions.
    Investigational New Drugs 03/2014; · 3.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Melanoma of the female genital tract is a rare location (less than 2% of melanomas all sites combined). These cancers have a very poor prognosis, due to the delay in diagnosis. Vulvar location is about 1% of melanomas then the vaginal location, uterine and ovarian. There is no consensus to date regarding their care, due to the rarity of the lesions. Their treatment must however be based on the current data concerning gynaecological cancers as well as standard management of cutaneous melanoma. The treatment is often based on conservative surgery, because radical resection does not improve survival. For the vulva and vagina, reconstructive surgery is possible. Treatment is sometimes supplemented by chemotherapy or radiotherapy, which could improve local control. The interest in the use of targeted therapy in these locations is not well known because of their rarity, but the study of genes c-Kit and BRAF provides new prospects for treatment. The objective of this review is to describe and report the current state of knowledge about gynaecologic melanomas.
    Bulletin du cancer 01/2014; · 0.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Oral chemotherapies are increasingly prescribed. Yet wide variations in prescription practices and in monitoring of toxicity have been underlined despite existing guidelines. There is little recent information available as regard to these practices. We aimed to obtain exhaustive information on oral chemotherapy prescription practices and safety monitoring in French hospitals. A cross-sectional multicentre survey was carried out to collect information on drug prescription, administration and surveillance: prescribing practices, coordination and monitoring of adherence, safety monitoring and side-effects occurrence prevention. Participants were a large sample of the French oncologists prescribing oral chemotherapy (20%). One hundred and fifty-seven oncologists from 112 hospitals (public, comprehensive cancer centres and private) replied (23.7% of cancer hospitals). The majority (56.1%) of the prescriptions were hand-written on a blank sheet. Eighty-four physicians (53.5%) included dose information and 36 (23%) declared having no monitoring procedures for adherence. Only 84 responders (54%) provided education material at first prescription of oral chemotherapy in way to limit avoidable side-effects. Sixty-one (39%) responders stated that they recalled at least one serious adverse event in the previous year declared in their centre. In this 2012 study, the majority of prescribers followed no standards in prescription writing, safety monitoring and toxicity prevention. The implementation of the international recommendations for oral chemotherapy administration should be considered as a top priority-for both prescribers and health authorities-as regards to the dynamic of development of these molecules and their potential side-effects.
    Annals of Oncology 01/2014; · 7.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background There are only scarce data on the management of patients aged 90 years or older with cancer, and more particularly on the place of radiation therapy (RT). We report the first large study on patients (pts) aged 90 years or older receiving RT. Methods and materials Records from RT departments from five institutions were reviewed to identify pts 90 years of age and older who underwent RT for various malignant tumours treated between 2003 and 2012. Tumours’ characteristics were examined, as well as treatment specificities and treatment intent. Results 308 pts receiving 318 RT courses were identified, mean age was 93.2 years (standard deviation 2.8). Treatment was given with curative and palliative intent in 44% and 56%, respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery and tumour stage. Median total prescribed dose was 36 Gy (4–76 Gy). Hypofractionation and split course were used in 88% and 7.3%, respectively. Most toxicities were mild to moderate. RT could not be completed in 23 pts (7.5%). No long-term toxicity was reported. Median overall survival was 22.9 months (95CI: 15.5–42.7 months). Cancer was the cause of death in 8.7% and 46% of pts treated with curative and palliative intent, respectively. Conclusion This study shows that RT is feasible for patients aged 90 years or more. PS, place of life and tumour stage were factors of the therapeutic decision. There is no reason to withdraw pts with good general health condition from potentially curative RT, provided that careful attention is paid to factors of toxicity and to geriatric vulnerabilities.
    European journal of cancer (Oxford, England: 1990) 01/2014; · 4.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Radiotherapy for epithelioid hemangioendothelioma (EHE) using volumetric intensity-modulated arc radiotherapy (VMAT). A 48-year-old woman was referred for curative irradiation of a vertebral EHE after failure of surgery. A comparison between VMAT and conventional conformal tridimensional (3D) dosimetry was performed and potential advantage of VMAT for sparing critical organs from irradiation׳s side effects was discussed. The total delivered dose on the planning target volume was 54 Gy in 27 fractions. The patient was finally treated with VMAT. The tolerance was excellent. There was no acute toxicity, including no increase in pain. With a follow-up of 18 months, no delayed toxicity was reported. The clinical response consisted of a decrease in the dorsal pain. The Dmax for the spinal cord was reduced from 55 Gy (3D-radiotherapy [RT]) (which would be an unacceptable dose to the spine because of the risk of myelopathy) to 42.8 Gy (VMAT), which remains below the recommended dose threshold (45 Gy). The dose delivered to 20% of organ volume (D20) was reduced from 47 Gy (3D-RT) to 3 Gy (VMAT) for the spinal cord. The study shows that VMAT allows the delivery of curative treatment for vertebral EHEs because of critical organ sparing.
    Medical Dosimetry. 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Radiation therapy is a keystone treatment in cancer. Photon radiation has proved its benefits in overall survival in many clinical studies. However, some patients present local recurrences or metastases when cancer cells survive to treatment. Metastasis is a process which includes adhesion of the cell to the extracellular matrix, degradation of the matrix by proteases, cell motility, intravasation in blood or lymphatic vessels, extravasation in distant parenchyma and development of cell colonies. Several studies demonstrated that ionizing radiation might promote migration and invasion of tumor cells by intricate implications in the micro-environment, cell-cell junctions, extracellular matrix junctions, proteases secretion, and induction of epithelial-mesenchymal transition. This review reports various cellular pathways involved in the photon-enhanced cell invasion process for which potential therapeutic target may be employed for enhancing antitumor effectiveness. Understanding these mechanisms could lead to therapeutic strategies to counter the highly invasive cell lines via specific inhibitors or carbon-ion therapy.
    Critical Reviews in Oncology/Hematology 01/2014; · 4.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Many data are presented each year during the American Society of Clinical Oncology meeting and others international major meetings. This article is proposed by the editorial board of the Bulletin du Cancer as a synthesis of important new data. The purpose is to identify in these results those who may have an immediate impact on our clinical practices.
    Bulletin du cancer 01/2014; 101(1):75-92. · 0.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are only scarce data on the management of nonagenarians with breast cancer, and more particularly on the place of radiation therapy (RT). We report a retrospective study on patients aged 90 years old or older, with breast cancer, receiving RT. Records from RT departments from five institutions were reviewed to identify patients 90 years old of age and older undergoing RT over past decade for breast cancer. Tumors' characteristics were examined, as well treatment specificities and treatment intent. 44 patients receiving RT courses were identified, mean age 92 years. Treatment was given with curative and palliative intent in 72.7% and 27.3% respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery, and tumor stage. Median total prescribed dose was 40 Gy (23–66). Hypo fractionation was used in 77%. Most toxicities were mild to moderate. RT could not be completed in 1 patient (2.3%). No long-term toxicity was reported. Among 31 patients analyzable for effectiveness, 24 patients (77.4%) had their diseased controlled until last follow-up, including 17 patients (54.8%) experiencing complete response. At last follow-up, 4 patients (12.9%) were deceased, cancer being cause of death for two of them. The study shows that breast/chest RT is feasible in nonagenarians. Although the definitive benefit of RT could not be addressed here, hypofractionated therapy allowed a good local control with acceptable side effects.
    The Breast. 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Radiation therapy is a keystone treatment in cancer. Photon radiation has proved its benefits in overall survival in many clinical studies. However, some patients present local recurrences or metastases when cancer cells survive to treatment. Metastasis is a process which includes adhesion of the cell to the extracellular matrix, degradation of the matrix by proteases, cell motility, intravasation in blood or lymphatic vessels, extravasation in distant parenchyma and development of cell colonies. Several studies demonstrated that ionizing radiation might promote migration and invasion of tumor cells by intricate implications in the micro-environment, cell-cell junctions, extracellular matrix junctions, proteases secretion, and induction of epithelial-mesenchymal transition. This review reports various cellular pathways involved in the photon-enhanced cell invasion process for which potential therapeutic target may be employed for enhancing antitumor effectiveness. Understanding these mechanisms could lead to therapeutic strategies to counter the highly invasive cell lines via specific inhibitors or carbon-ion therapy.
    Critical reviews in oncology/hematology 01/2014; · 5.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The increased expression of GLUT1 and HKII CAIX in cervical cancer is associated with progression, metastasis, and poor survival rates. The aim of this study was to evaluate the predictive utility of GLUT1, CAIX, and HKII and hemoglobin levels versus tumor response to exclusive radiotherapy and concomitant chemoradiotherapy in patients with cervical carcinoma located. Methods: Sixty-six patients (FIGO IIB, IIIB) were included retrospectively for the period 2001-2007. Twenty-two of them received exclusive radiotherapy, and 44 received concurrent radiochemotherapy. The expression of GLUT1, CAIX, and HKII was studied by immunohistochemistry in paraffin-embedded biopsies taken before treatment. The expression levels of the proteins were correlated with clinical factors pathological, response to treatments (responders and non-responders), overall survival, and disease-free survival. Results: Of the 66 patients, 53 (80.3%) showed a complete response to treatment, of whom 16 received exclusive radiotherapy and 37 received concurrent radiochemotherapy. Protein expression levels of GLUT1, CAIX, and HKII were increased in cancer patients and as a particular feature of staining were observed that GLUT1 inmunostaining was frequently localized together to the blood vessels. Hemoglobin levels ≤ 11g/dl were statistically significant compared to the response to treatment (p=0.0127), with a trend of 4.3-fold risk of treatment failure in the group of nonresponders. We found that when expressed GLUT1, both the rate of overall survival and disease-free survival showed a trend risk of decrease of 1.1 times and 1.5 times respectively; when co-expressed GLUT1 and HKII was observed a trend risk of decrease of 1.6 times in the rate overall survival. Patients with hemoglobin levels ≤ 11g/dl had a risk 4.3-fold (p=0.02) decrease in both the overall survival rate as the rate of disease-free survival. Conclusion: The presence of anemic hypoxia (Hbg ≤ 11g/dl), expression of GLUT1, co-expression of GLUT1 and HKII, may influence the response to treatment, and therefore in overall and disease-free survival. The study and detection of these markers could contribute to infer the metabolic and hypoxic state of tumors, so that the therapeutic management may be optimized by considering such markers as predictive markers and/or as molecular targets.
    Molecular Cancer Therapeutics 11/2013; 12(11):C39. · 5.60 Impact Factor

Publication Stats

2k Citations
609.24 Total Impact Points

Institutions

  • 2013–2014
    • University of Lyon
      Lyons, Rhône-Alpes, France
    • Institut National d'Oncologie, Rabat
      Rabat, Rabat-Salé-Zemmour-Zaër, Morocco
    • Université Paris-Sud 11
      Orsay, Île-de-France, France
  • 2012–2014
    • Institut de cancérologie Lucien-Neuwirth
      Rhône-Alpes, France
    • Centre Léon Bérard
      Lyons, Rhône-Alpes, France
  • 2009–2013
    • Hôpital d'instruction des armées du Val-de-Grâce
      Lutetia Parisorum, Île-de-France, France
  • 2006–2012
    • Institut de Cancérologie Gustave Roussy
      • Department of Radiotherapy
      Villejuif, Ile-de-France, France
  • 2004–2011
    • Institut Jules Bordet
      Bruxelles, Brussels Capital Region, Belgium
  • 2009–2010
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      Lutetia Parisorum, Île-de-France, France
  • 2000–2006
    • Centre Antoine-Lacassagne
      Nice, Provence-Alpes-Côte d'Azur, France
  • 2002
    • Centre Hospitalier Universitaire de Nice
      Nice, Provence-Alpes-Côte d'Azur, France
  • 2001
    • University of Nice-Sophia Antipolis
      Nice, Provence-Alpes-Côte d'Azur, France