Nicolas Magné

Université Jean Monnet, Saint-Étienne, Rhône-Alpes, France

Are you Nicolas Magné?

Claim your profile

Publications (150)519.81 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: For patients with cervical cancer, intensity-modulated radiation therapy (IMRT) improves target coverage and allows dose escalation while reducing the radiation dose to organs at risk (OARs). In this study, we compared dosimetric parameters among 3-dimensional conformal radiotherapy (3D-CRT), "step-and-shoot" IMRT, and volumetric intensity-modulated arc radiotherapy (VMAT) in a series of patients with cervical cancer receiving definitive radiotherapy. Computed tomography (CT) scans of 10 patients with histologically proven cervical cancer treated with definitive radiation therapy (RT) from December 2008 to March 2010 at our department were selected for this study. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated following the guidelines of the Gyn IMRT consortium that included cervix, uterus, parametrial tissues, and the pelvic nodes including presacral. The median age was 57 years (range: 30 to 85 years). All 10 patients had squamous cell carcinoma with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB. All patients were treated by VMAT. OAR doses were significantly reduced for plans with intensity-modulated technique compared with 3D-CRT except for the dose to the vagina. Between the 2 intensity-modulated techniques, significant difference was observed for the mean dose to the small intestine, to the benefit of VMAT (p < 0.001). There was no improvement in terms of OARs sparing for VMAT although there was a tendency for a slightly decreased average dose to the rectum: - 0.65Gy but not significant (p = 0.07). The intensity modulation techniques have many advantages in terms of quality indexes, and particularly OAR sparing, compared with 3D-CRT. Following the ongoing technologic developments in modern radiotherapy, it is essential to evaluate the intensity-modulated techniques on prospective studies of a larger scale. Copyright © 2015 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
    Medical dosimetry: official journal of the American Association of Medical Dosimetrists 07/2015; DOI:10.1016/j.meddos.2015.06.002 · 0.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lung cancer is a major public health concern worldwide. Progress in improving 5-year survival is lagging behind comparable survival rates in other common cancers. The majority of patients with locally advanced non-small cell lung cancer (NSCLC) are not suitable for surgical resection, hence the major role of radical radiotherapy. Advances in radiotherapy techniques allow targeted treatment of the disease, whilst minimizing the dose to organs at risk. Recent research into fractionation schedules, with hyperfractionated and accelerated radiotherapy regimens has been promising. Platinum-based chemotherapy has long been the standard of care for the initial treatment of advanced NSCLC. However, if radical radiotherapy remains the cornerstone of treatment for patients with unresectable advanced NSCLC either as single modality treatment or with concomitant chemotherapy, advances in understanding of tumor molecular biology and targeted drug development should bring targeted agents into the NSCLC management. The development of numerous therapeutic approaches has made the locally advanced NSCLC world change. An up-to-date overview of the current literature on updated chemotherapeutic agents, targeted therapy, immunotherapy, radiotherapy in stage III NSCLC is provided. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Critical reviews in oncology/hematology 06/2015; DOI:10.1016/j.critrevonc.2015.05.020 · 4.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intravenous vinflunine 320 mg/m(2) every 3 weeks plus best supportive care resulted in better overall survival in comparison with best supportive care alone for eligible patients with failure of prior therapy with locally advanced or metastatic transitional cell cancer of urothelial tract (TCCU). The objective of the present study was to describe our real-life experience of vinflunine for treatment of patients with TCCU. We retrospectively investigated all patients with TCCU who received at least 1 cycle of vinflunine. Nineteen patients were treated between May 2010 and March 2014 in a compassionate-use program. Performance status was poor in our real-life cohort, with 6 patients (32%) with an Eastern Cooperative Oncology Group performance status of 2. Median duration of vinflunine treatment was 2.4 months (range, 0-4.3 months), and median number of cycles was 3 (range, 1-6). Total response rate was 32%, with partial responses only. Disease control rate was 53%, with a median duration of 7.7 months (range, 6.0-9.4 months). Median progression-free survival was 87 days, or 2.9 months (range, 0.7-11.7 months). After vinflunine treatment, 42% of patients received from 1 to 3 additional lines of chemotherapy. The most frequent grade 4 toxicities were constipation (26%), with 3 intestinal obstructions (16%) and 1 mechanical ileus (5%); and asthenia and fatigue (21%). Vinflunine, as a TCCU second-line chemotherapy, brings benefits, particularly in cases where there is no alternative treatment. Copyright © 2015 Elsevier Inc. All rights reserved.
    Clinical Genitourinary Cancer 06/2015; DOI:10.1016/j.clgc.2015.05.008 · 1.69 Impact Factor
  • Bulletin du cancer 05/2015; 102(6). DOI:10.1016/j.bulcan.2015.04.020 · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report the case of an 80-year-old patient who presented with a progressive prostate metastatic cancer with poor performance status. The patient had already benefitted from docetaxel and abiraterone. A new line of chemotherapy by cabazitaxel was started with good response, and there was a dramatic improvement in general status and pain symptoms. Age and performance status alone should not be limiting decision factors for elderly cancer patients. © 2015 S. Karger AG, Basel.
    Chemotherapy 05/2015; 60(5):300-301. DOI:10.1159/000377620 · 1.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are only scarce data on the optimal management of patients who present with a bladder carcinoma and who are aged 90 years and older. We retrospectively reviewed records from radiotherapy departments from two university hospitals, two private centers and one public center to identify patients who underwent radiotherapy for bladder cancer over the past decade and who were aged 90 years or older. From 2003 to 2013, 14 patients aged 90 years or older receiving RT for bladder malignant tumors were identified. Mean age was 92.7 years. Ten patients (71 %) had a general health status altered (PS 2-3) at the beginning of RT. A total of 14 RT courses were delivered, including six treatments (43 %) with curative intent and eight treatments (57 %) with palliative intent. Palliative intent mainly encompassed hemostatic RT (36 %). At last follow-up, two patients (14 %) experienced complete response, one patient (7 %) experienced partial response, three patients (21 %) had their disease stable, and three patients (21 %) experienced tumor progression, of whom two patients with the progression of symptoms. There was no reported high-grade acute local toxicity in 14 patients (100 %). One patient experienced delayed grade 2 toxicity with pain and lower urinary tract symptoms. At last follow-up, seven patients (50 %) were deceased. Cancer was the cause of death for five patients. Hypofractionated radiotherapy remains feasible for nonagenarians with bladder cancer. Further investigations including analysis of geriatric comorbidities and impact of treatments on quality of life should be conducted.
    International Urology and Nephrology 05/2015; 47(7). DOI:10.1007/s11255-015-0999-8 · 1.29 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Une dérégulation de la voie FGF (fibroblast growth factor)/FGFR (fibroblast growth factor receptor) entraîne la promotion de mécanismes protumoraux : prolifération, transition épithélio-mésenchymateuse, modifications du cytosquelette, migration, angiogenèse. La dérégulation de cette voie à un stade précoce est rapportée dans de nombreux cancers et peut être responsable de l’acquisition du phénotype tumoral. Il est nécessaire de préciser les voies d’aval et les interconnexions de la signalisation FGF/FGFR pour mieux comprendre son potentiel oncogénique. Nous décrirons l’implication de cette voie dans les différents types tumoraux concernés. Les mécanismes de carcinogenèse seront étudiés en prenant l’exemple du mélanome, pour lequel une dérégulation de la voie FGF/FGFR est présente et considérée comme driver dans près de 90 % des cas. La dérégulation de FGF/FGFR est une cible thérapeutique potentielle. De nombreux agents sont en développement, inhibant cette voie de manière sélective ou dans le cadre d’un ciblage multiple. Les essais récents montrent des résultats décevants chez des patients non sélectionnés, mais prometteurs sur des tumeurs présentant des altérations de la voie FGF/FGFR. Une sélection soigneuse des patients est donc primordiale pour une évaluation pertinente de ces nouveaux traitements.
    Bulletin du cancer 05/2015; 102(6). DOI:10.1016/j.bulcan.2015.04.010 · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: La infección por el virus del papiloma humano es un evento inicial importante del proceso tumoral en el carcinoma de cuello uterino. La presencia del virus del papiloma humano de tipo 16 (HPV- 16), se ha reportado como un factor que incide negativamente en la respuesta a la radioterapia. Se conoce la variación en la secuencia del genoma del HPV-16 en diferentes poblaciones étnicas y hay datos científicos que sugieren que las variantes no europeas tienen un mayor potencial oncogénico, aunque aún no hay reportes sobre la presencia de variantes del HPV-16 y su relación con la respuesta al tratamiento. El objetivo de este estudio fue detectar la presencia de variantes del HPV-16 y analizar su relación con la respuesta al tratamiento. La detección y el estudio de variantes del HPV-16 se hizo mediante el análisis de las regiones E6 y LCR con PCR-SSCP y secuenciación directa en biopsias tomadas antes del tratamiento. La respuesta completa a la radioterapia tres meses después de terminado el tratamiento se definió como ausencia de enfermedad residual. De un grupo de 59 pacientes con cáncer cervical en estadios IIB a IVB, 34 (57,6 %) fueron positivas para HPV-16 y se identificaron dos grupos de variantes: un primer grupo de 30 (88,2 %) pacientes presentaron la variante europea, y un segundo grupo de cuatro pacientes presentó la variante no europea, y de estas, tres correspondían a la variante asiático-americana. De las 34 pacientes, 15 recibieron radioterapia completa, ocho con respuesta completa, cuatro con respuesta parcial y en tres persistió el tumor. La distribución de las variantes europeas y no europeas fue similar en las pacientes que respondieron a la radioterapia y en aquellas que no; sin embargo, es importante tener en cuenta que la variante natural L83V (E-350G), entre otras, contribuye a la formación de tumores por degradación del gen p53, y que la variante E R10G acorta significativamente la vida media de p53, interrumpiendo su acción en la apoptosis después de la irradiación.
    Biomédica: revista del Instituto Nacional de Salud 05/2015; 35:24. · 0.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Le vieillissement de la population française impose aux radiothérapeutes le défi de traiter des patients de plus en plus âgés et ainsi d’adapter leur traitement. Inenvisageable il y a 30 ans, la radiothérapie concerne aussi aujourd’hui des patients âgés de plus de 90 ans. Des outils d’évaluation oncogériatrique se sont développés ces dernières années, sans pour autant totalement changer, en pratique, les décisions thérapeutiques : si l’évaluation oncogériatrique influence la décision finale de RCP, elle ne définit pas de nouveaux volumes cibles, de nouvelles doses, ou des fractionnements différents. Hormis quelques localisations, il n’existe actuellement aucun consensus sur les traitements adaptés à la population gériatrique, ce qui complique la prise en charge. La présente revue a pour objectif de réaliser un tour d’horizon des publications étudiant l’efficacité et la tolérance de la radiothérapie chez le sujet âgé (> 70 ans) ou très âgé (> 90 ans).
    Bulletin du cancer 03/2015; 102(6). DOI:10.1016/j.bulcan.2015.03.001 · 0.64 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pulsed-dose-rate (PDR) brachytherapy is a recent brachytherapy modality combining the radiobiological advantages of low-dose-rate (LDR) brachytherapy with increased possibilities of dose optimization and radiation safety. However, treatment duration remains protracted, as the prescribed dose is typically delivered through pulses that do not exceed 0.5 Gy/h for critical organs. It is frequently used for the treatment of gynaecological malignancies. Although, the relationship between thrombosis and cancer is well known, specific data on thromboembolic events during brachytherapy are scarce. We report two cases of major thromboembolic events during brachytherapy treatment for gynaecological malignancies. We discuss the possible causal relationship between brachytherapy procedures and the occurrence of thromboembolic events, drawing a preventive practical attitude.
    Journal of Contemporary Brachytherapy 02/2015; 7(1):76-8. DOI:10.5114/jcb.2015.48580
  • Bulletin du cancer 01/2015; 102(1). DOI:10.1016/j.bulcan.2014.11.002 · 0.64 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is accumulating evidence that TrkA and its ligand Nerve Growth Factor (NGF) are involved in cancer development. Staurosporine derivatives such as K252a and lestaurtinib have been developed to block TrkA kinase signaling, but no clinical trial has fully demonstrated their therapeutic efficacy. Therapeutic failures are likely due to the existence of intrinsic signaling pathways in cancer cells that impede or bypass the effects of TrkA tyrosine kinase inhibitors. To verify this hypothesis, we combined different approaches including mass spectrometry proteomics, co-immunoprecipitation and proximity ligation assays. We found that NGF treatment induced CD44 binding to TrkA at the plasma membrane and subsequent activation of the p115RhoGEF/RhoA/ROCK1 pathway to stimulate breast cancer cell invasion. The NGF-induced CD44 signaling was independent of TrkA kinase activity. Moreover, both TrkA tyrosine kinase inhibition with lestaurtinib and CD44 silencing with siRNA inhibited cell growth in vitro as well as tumor development in mouse xenograft model; combined treatment significantly enhanced the antineoplastic effects of either treatment alone. Altogether, our results demonstrate that NGF-induced tyrosine kinase independent TrkA signaling through CD44 was sufficient to maintain tumor aggressiveness. Our findings provide an alternative mechanism of cancer resistance to lestaurtinib and indicate that dual inhibition of CD44 and TrkA tyrosine kinase activity may represent a novel therapeutic strategy.
    Oncotarget 01/2015; · 6.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nanoparticles have emerged in oncology as new therapeutic agents of distinct biochemical and physical properties, and pharmacokinetics. Current rationale and clinical applications in combination with radiation therapy were analyzed. A review of the literature was conducted on nanoparticles as radiosensitizers, with a focus on metallic nanoparticles and radiosensitization mechanisms. Nanoparticles are mainly used as vectors for drugs or to potentiate dose deposit selectively in irradiated tissues. Preclinical data suggest a predominating effect in the kilovoltage range through a photoelectric effect and a potential in the megavoltage range under a combination of physical and biochemical (diameter, concentration, site of infusion etc) conditions. Several clinical trials are ongoing with metallic/crystalline nanoparticles. Nanoparticles have shown a potential for better therapeutic index with radiation therapy, which is being increasingly investigated clinically. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
    Bulletin du cancer 01/2015; 102(1). DOI:10.1016/j.bulcan.2014.10.002 · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We retrospectively assessed the outcome of patients receiving emergency spinal radiation therapy (RT) concurrently with bevacizumab. Clinical records of 18 consecutive patients receiving emergency spinal RT for symptomatic vertebral metastases during the course of bevacizumab-based therapy were examined. Patients were receiving biweekly bevacizumab combined with paclitaxel (n=17) or with docetaxel/carboplatin (n=1) or as a single agent (n=1) for advanced metastatic carcinoma. RT was delivered at doses of 30 Gy in 10 fractions (n=8), 20 Gy in five fractions (n=9) or 18 Gy in nine fractions (n=1). In 10 patients (56%), irradiation field encompassed the thoracic vertebrae. The median time interval between the bevacizumab infusion and the RT course was 1.5 days (0-8 days). The median follow-up was 8.3 months (2 days-42 months). A clinical benefit of RT was reported in 13 patients (72%), including four patients with complete pain relief. Two of the three patients with neurological impairment at the time of RT experienced a partial improvement in their symptoms. No pain recrudescence was reported within the irradiated field after RT completion. All toxicities were mild to moderate, with no acute toxicity reported in 13 patients (72%). No RT disruption was necessary because of acute toxicity. No delayed toxicity was reported within RT fields among 11 patients with at least 6 months of follow-up. Spinal RT during the course of bevacizumab-based therapy was not associated with the occurrence of unexpected adverse effects. This suggests that emergency RT should not be contraindicated in these patients, provided that doses and treatment volumes are defined carefully.
    Anti-Cancer Drugs 01/2015; 26(4). DOI:10.1097/CAD.0000000000000204 · 1.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rare cancers represent about a quarter of all cancers diagnosed in Europe, and their incidence is increasing. Meanwhile, scientific advances provide techniques, which become more and more sophisticated in the domain of radiotherapy. Treatment options for radiotherapy rare cancers are increasing, but are not yet evaluated. The question of the appropriateness of treatment by modern radiotherapy techniques in rare cancers remains. There are a lot of cases reported in the literature for treating rare cancers by modern technology. These techniques are often used when anatomical and dosimetric constraints do not achieve optimal treatment by surgery or standard radiotherapy. In contrast, standard radiotherapy techniques also provide good results in terms of overall survival and tolerance. They are also less expensive and less complex in terms of dosimetry. The establishment of specialized centers in rare cancers seems essential to evaluate the appropriateness of the use of modern techniques in these cases. Currently, data from the literature does not provide an answer to this question. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
    Bulletin du cancer 12/2014; 102(1). DOI:10.1016/j.bulcan.2014.12.001 · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The number of nonagenarian people in the world is steadily growing. This phenomenon will increase in future years: in 2050, world population prospects estimate 71.16 million people aged 90 years or older. The two main causes of death among people aged 85 years or more in Europe in 2003 were cardiovascular and cerebrovascular diseases and cancers. However, the elderly are often excluded from clinical trials; they are underrepresented in clinical registries and especially nonagenarians. Care (medical, surgical, oncology) of these very elderly is currently insufficiently based on scientific recommendations. For the physician, the choice to treat or not to treat very elderly patients (for fear of side effects) is difficult. Oncology is particularly affected by this problem. Here we review these different fields of internal medicine management of nonagenarian patients with a special focus on oncology and on comprehensive geriatric assessment as a base for all care decision taking.
    Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology 12/2014; 144:w14059. DOI:10.4414/smw.2014.14059 · 1.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to analyze the medical and economic interest of OSNA molecular technique, compared to conventional postoperative histopathologic evaluation for sentinel lymph node exploration in breast cancer patients. This retrospective cost-benefit study was conducted in the French Universitary Hospital of Saint Etienne on patients who received sentinel lymph node exploration between July 1, 2007 and December 31, 2009. Lymph nodes were analyzed by conventional postoperative histological evaluation in group 1 (82 patients) and OSNA in group 2 (86 patients). Costs were analyzed in three different ways: surgery cost, hospitalization cost and histopathologic cost. Average operating time was slightly shorter for group 1 (histology) [71.9 vs. 76.8 min for group 2 (OSNA)]. Time and operating costs were not significantly different (p = 0.293). The average cost of pathological examination was significantly higher in group 2 (35.04 euros per node in group 1 vs. 291.84 euros per node in group 2 p < 10(-3)). The average length of hospital stay was significantly longer in group 1 (5.4 days in group 1 vs. 4.2 days in group 2, p = 0.0065). The total costs were not significantly different between both groups (3,774.6 euros in group 1 vs. 3,393.9 euros in group 2 p = 0.055). The sentinel lymph node analysis with OSNA technique does not lead to higher expenses. It also avoids another surgery for 20 % of patients. A prospective multicentric medico-economic study made with a larger effective would probably confirm these results.
    Medical Oncology 12/2014; 31(12):322. DOI:10.1007/s12032-014-0322-z · 2.06 Impact Factor
  • 26th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer; 11/2014
  • [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 11/2014; 92(2). DOI:10.1016/j.critrevonc.2014.05.006 · 4.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Invasive fungal infections (IFIs) remain one of the worrying complications in patients with acute myeloid leukemia (AML) due to their incidence and high level of attributable mortality. In light of these risks, antifungal prophylaxis has always been debated. We conducted a single-center retrospective study of two prophylactic antifungal agents (fluconazole/posaconazole) in 91 consecutive patients receiving induction chemotherapy for AML between 2005 and 2009, in order to evaluate the impact on the incidence of IFI and on the mycological flora of the patients. Methods: In total, 39 patients received prophylactic fluconazole versus 52 who received posaconazole. The baseline characteristics of the two groups were comparable. Results: Overall, 17 patients developed an IFI, with no difference in frequency between the two groups. Utilization of empirical or pre-emptive therapy was similar irrespective of the type of prophylaxis used. Mycological examination of stools revealed an increase in non-albicans Candida colonization in the fluconazole group during hospitalization and the appearance of Saccharomyces cerevisiae colonization in patients receiving posaconazole. Conclusion: The present study does not distinguish between fluconazole and posaconazole as a primary effective prevention against fungal infections. More prospective studies and meta-analyses are warranted.
    10/2014; DOI:10.4103/2319-4170.143491

Publication Stats

2k Citations
519.81 Total Impact Points


  • 2015
    • Université Jean Monnet
      Saint-Étienne, Rhône-Alpes, France
  • 2012–2015
    • Institut de cancérologie Lucien-Neuwirth
      La Fouillouse, Rhône-Alpes, France
  • 2014
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2013
    • Institut National d'Oncologie, Rabat
      Rabat, Rabat-Salé-Zemmour-Zaër, Morocco
    • Université Paris-Sud 11
      Orsay, Île-de-France, France
  • 2012–2013
    • University of Lyon
      Lyons, Rhône-Alpes, France
  • 2007–2012
    • Institut de Cancérologie Gustave Roussy
      • Department of Radiotherapy
      Villejuif, Île-de-France, France
  • 2004–2011
    • Institut Jules Bordet
      • Department of Nuclear Medicine
      Bruxelles, Brussels Capital Region, Belgium
  • 2009–2010
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      Lutetia Parisorum, Île-de-France, France
  • 2006
    • Université Libre de Bruxelles
      • Bordet Institute
      Bruxelles, Brussels Capital Region, Belgium
  • 2000–2006
    • Centre Antoine-Lacassagne
      Nice, Provence-Alpes-Côte d'Azur, France