Publications by authors named "Cecile Pages"
Background: Despite the clear therapeutic benefits of neoadjuvant treatment (NT) with immune checkpoint inhibitors (ICIs) in clinical trials, the efficacy of NT ICIs (NT-ICI) and the optimal regimen for patients (pts) with resectable metastatic melanoma (RMM) remain to be confirmed in real life.
Objective: To assess the efficacy and safety of NT-ICI among pts with RMM in real life.
Methods: NEOMEL is a French retrospective multicentric cohort study.
Purpose: The dermatological management of cancer patients with cutaneous adverse events occurring during and after oncologic treatment is known as supportive oncodermatology. This includes prevention, early identification, and mitigation of dermatologic toxicities. The aim of the international RESCUE (Residents' survey on training of dermatology residents in supportive oncodermatology) study was to ascertain the current level of expertise in supportive oncodermatology among dermatology residents.
View Article and Find Full Text PDFA 76-year-old man managed for stage IV advanced melanoma was treated with nivolumab-ipilimumab, complicated by corticotropic insufficiency, hypothyroidism, and rash. At first evaluation, 18F-FDG PET/CT clearly showed complete metabolic response allowing continued treatment with nivolumab alone. At 6 months, 18F-FDG PET/CT fully confirmed the persistence of complete metabolic response but showed the appearance of cutaneous focal uptakes of both lateral thighs and a cutaneous diffuse uptake on lower limbs.
View Article and Find Full Text PDFResistance to immune checkpoint inhibitors (ICI) in cancer patients is not fully understood, and predictive biomarkers are lacking. MELANFα (NCT03348891) is an open-label, prospective, multicenter cohort of 60 patients with advanced melanoma receiving ICI (bitherapy: ipilimumab + nivolumab; monotherapy: pembrolizumab or nivolumab). The primary objective was to evaluate whether changes in plasma TNF between baseline (W0) and week 12 (W12) identified patients with non-progressive disease at W12.
View Article and Find Full Text PDFWhen to stop immunotherapy for advanced melanoma: the emulated target trials.
EClinicalMedicine
December 2024
Background: Immune checkpoint inhibitors (ICIs) have demonstrated their efficacy with a 7.5-year overall survival (OS) close to 50% for advanced stages. The design of clinical trials provides for treatment until progression or toxicity, or for a maximum duration of two years.
View Article and Find Full Text PDFBackground: Nivolumab obtained approval in advanced melanoma (AM) with weight-adjusted dose (WAD) administration (3 mg/kg/2 weeks). In 2018, the dosage regimen was changed to flat dose (FD) administration (240 mg/2 weeks or 480 mg/4 weeks) based on a modeling study, without clinical data.
Methods: AM patients have been prospectively included in the French national multicenter MelBase database since 2013.
Background: The Checkmate 067 randomized controlled trial, published in 2015, demonstrated improved progression-free survival (PFS) and numerically, although not statistically, superior overall survival (OS) for ipilimumab + nivolumab (I + N).
Objectives: The objective of this study was to compare the efficacy and safety of N with I + N as first-line treatment for metastatic melanoma in a real-world setting.
Methods: Patients were prospectively included in the French MelBase cohort from 2013 to 2022.
Article Synopsis
- Immunological checkpoint inhibitors, used in treating various cancers, can cause toxic side effects, particularly dermatological disorders.
- Common skin issues like maculopapular erythema and pruritus often occur, but rarer conditions such as fasciitis and scleroderma can also arise.
- Recognizing these unusual manifestations is crucial for internists, as they may mimic other diseases or paraneoplastic syndromes, requiring specific diagnostic and treatment approaches related to ICI toxicity.
The prognostic value of tumor-infiltrating lymphocytes in vulvovaginal melanoma.
Int J Gynecol Cancer
December 2024
Article Synopsis
- The study aimed to investigate the relationship between the immune microenvironment and survival outcomes in patients with vulvovaginal melanoma.
- It involved a retrospective analysis of 42 patients, examining tumor-infiltrating lymphocytes and genetic mutations, with significant findings on immune cell presence related to better disease-free survival.
- The researchers concluded that specific types of tumor-infiltrating lymphocytes could indicate disease progression and response to treatments, suggesting the need for further multicenter studies to confirm these results.
Article Synopsis
- * It introduces modern analysis techniques that factor in the timing and recurrence of immune-related AEs (irAEs) in cancer patients treated with immune checkpoint inhibitors, based on the MOTIVATE prospective study findings.
- * Results showed variations in the prevalence and timing of irAEs between melanoma and non-small cell lung cancer (NSCLC) patients, leading to more comprehensive safety assessments that can guide clinical and regulatory decisions.
Article Synopsis
- - The study investigates the effectiveness of high-dose-rate (HDR) brachytherapy as an alternative treatment for localized cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) on the face, focusing on local control, survival rates, and quality of life from 2015 to 2021.
- - Out of 67 patients treated, with a majority having early-stage tumors, the local control rate after three years was 87.05%, and most patients experienced only mild side effects like acute radio-mucositis.
- - Quality of life feedback from patients indicated that 77.8% would recommend HDR brachytherapy, underscoring its effectiveness, tolerance, and positive impact on functional outcomes in
Article Synopsis
- Immune checkpoint inhibitors (ICIs) have transformed cancer treatment by helping the immune system attack tumors, but they can lead to immune-related adverse events (irAEs), which are serious side effects.
- IrAEs can affect various organs and account for a significant portion of treatment interruptions, impacting patients' well-being and quality of life.
- This manuscript aims to review autoimmune skin diseases linked to ICIs, providing healthcare professionals with a comprehensive overview of these conditions.
Article Synopsis
- Metastatic melanoma patients have a high risk of brain metastases, which significantly affect survival rates.
- A study evaluated the impact of local treatment (surgery or radiotherapy) on overall survival in patients receiving novel therapies like immune checkpoint inhibitors or anti-BRAF therapy.
- Results showed that local treatment greatly improved overall survival, with patients who received it living a median of 17.3 months compared to just 3.6 months for those who did not.
Article Synopsis
- A retrospective study in Paris evaluated the effectiveness of neoadjuvant therapy with imatinib or pazopanib for patients with locally advanced dermatofibrosarcoma protuberans (DFSP) over a decade from 2007 to 2017.
- Among the 27 patients, treatment resulted in a 38.5% rate of complete or partial responses and an 85% disease-free rate after a median follow-up of about 65 months.
- Most patients underwent successful surgical removal of the tumor, although 85% experienced treatment-related adverse events, with few requiring significant treatment interruptions.
Article Synopsis
- This study examined the clinical progression and treatment factors of classic/endemic Kaposi's Sarcoma (KS) by analyzing 160 patients diagnosed between 1990 and 2013.
- It found that 41.2% of these patients required systemic treatment (ST), with key risk factors for ST initiation including long time to diagnosis, type of KS, and lesion characteristics.
- Additionally, there was no significant difference in efficacy between treatment types, suggesting treatment decisions can be made based on the patient's overall health instead of specific medication effectiveness.
Article Synopsis
- TNF blockers, specifically infliximab and certolizumab, are being tested for their ability to manage gastrointestinal side effects in patients with advanced melanoma receiving nivolumab and ipilimumab therapies.
- The TICIMEL clinical trial enrolled 14 patients and aimed to evaluate both the safety and effectiveness of these drug combinations, revealing that adverse effects were generally lower with infliximab treatment.
- Results indicated that while both combinations were safe, the certolizumab group demonstrated a high objective response rate, warranting further research into its clinical benefits.
Article Synopsis
- Brain metastases are a serious and common issue in metastatic melanoma, which can lead to death, but immunotherapy and targeted therapy have improved survival rates.
- A study analyzed 293 patients with metastatic melanoma to see if immunotherapy could lower the occurrence of brain metastases, finding that those treated with immune checkpoint inhibitors (ICI) had a significantly lower incidence compared to others.
- Specifically, patients receiving anti-PD-1 therapy saw nearly a 70% reduction in brain metastasis risk, indicating that immunotherapy may provide protective benefits against the development of brain metastases in advanced melanoma.
Article Synopsis
- The study focuses on the poor outcomes for patients with brain metastases (BM) from melanoma, despite advancements in immunotherapies and targeted therapies like BRAF inhibitors.
- Researchers conducted an external validation of the Melanoma molecular graded prognostic assessment (Melanoma-molGPA) score to predict survival in these patients.
- Results showed that the Melanoma-molGPA score is a reliable tool for estimating overall survival, with median survival rates significantly differing between score groups, highlighting its utility in guiding treatment decisions.
Multiple Keratoacanthoma-like Lesions in a Patient Treated with Pembrolizumab.
Acta Derm Venereol
December 2019
Article Synopsis
- The study focused on advanced cutaneous squamous cell carcinoma (A-cSCC) by analyzing a cohort of 109 patients to uncover epidemiological factors impacting this condition.
- The median age of patients was 83, with many having a history of cardiac disease and living in rural or nursing home settings, while a significant percentage were diagnosed at advanced stages of the disease.
- The findings suggest that inadequate initial treatment may be due to limited dermatological access, particularly in elderly patients from rural areas, leading to underestimating the severity of cSCC.
Discoidin domain receptors: A promising target in melanoma.
Pigment Cell Melanoma Res
September 2019
Article Synopsis
- The study investigates the role of discoidin domain receptor 1 (DDR1) in human melanoma, noting its high expression in melanoma cases and its link to worse patient outcomes.
- High DDR1 levels are associated with specific clinical factors like Clark level, ulceration, and BRAF mutations in melanoma patients.
- Reducing DDR1 expression through techniques like siRNA inhibited melanoma cell growth and movement, while a DDR1 inhibitor showed promise in decreasing melanoma cell proliferation in lab settings and tumor models.
Article Synopsis
- Diagnosis involves recognizing clinical symptoms and confirming them through lab tests, with disease severity varying by subtype.
- Treatment focuses on controlling the disease, including local therapies for localized cases and systemic treatments like pegylated liposomal doxorubicin for more aggressive forms.
Article Synopsis
- * In a study of 119 stage IV and unresectable stage III melanoma patients treated with MEK inhibitors, 32.7% experienced some digestive side effects, while 5% had severe complications like colitis and gastrointestinal perforation.
- * Although these severe toxicities are rare and not fully understood, they were reversible with treatment cessation or dose adjustments, and no fatalities occurred, though one patient required a permanent ileostomy.
Osteopenia and fractures associated with long-term therapy with MEK inhibitors.
Melanoma Res
December 2018
Article Synopsis
- Targeted therapies for melanoma, specifically MEK inhibitors and BRAF/MEK combinations, have improved patient survival but may lead to adverse side effects like osteopenia.
- Two patients with advanced melanoma developed fractures due to severe osteopenia after long-term treatment, despite having no typical risk factors for osteoporosis.
- The study suggests that MEK inhibitors could be linked to the development of osteopenia, highlighting the need for further investigation into their long-term effects on bone health and patient quality of life.