Publications by authors named "Valery Attignon"

Background: Treatment of advanced estrogen receptor-positive HER-2-negative breast cancer is based on hormonal therapy with aromatase inhibitors for postmenopausal women. However, acquired endocrine resistance is unavoidable at some point in the advanced or metastatic stage, and its underlying molecular mechanisms remain to be fully elucidated. The study prospectively included patients with advanced or metastatic breast cancer who had relapsed or progressed following treatment with a non-steroidal aromatase inhibitor (AI) and were treated with exemestane (a steroidal AI) and everolimus.

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Large genomic programs have contributed to improving drug development in cancer. To assess the potential benefit of using larger gene panels to guide molecular-based treatments, we conducted a multicenter randomized trial in patients with advanced and/or metastatic solid cancer. Molecular alterations were determined using either a panel of 324 cancer-related genes (Foundation OneCDX (F1CDX)) or a limited panel of 87 single-nucleotide/indel genes and genome-wide copy number variations (CTL) and reviewed by a molecular tumor board to identify molecular-based recommended therapies (MBRTs).

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The epithelial-mesenchymal transition (EMT) is a dynamic transdifferentiation of epithelial cells into mesenchymal cells. EMT programs exhibit great diversity, based primarily on the distinct impact of molecular activities of the EMT transcription factors. Using a panel of cancer cell lines and a series of 71 triple-negative primary breast tumors, we report that the EMT transcription factor ZEB1 modulates site-specific chemical modifications of ribosomal RNA (rRNA).

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Background And Objectives: Breast cancers (BCs) of patients with paraneoplastic neurologic syndromes and anti-Yo antibodies (Yo-PNS) overexpress human epidermal growth factor receptor 2 (HER2) and display genetic alterations and overexpression of the Yo-onconeural antigens. They are infiltrated by an unusual proportion of B cells. We investigated whether these features were also observed in patients with PNS and anti-Ri antibodies (Ri-PNS).

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Background: Brain tumors are the deadliest solid tumors in children and adolescents. Most of these tumors are glial in origin and exhibit strong heterogeneity, hampering the development of effective therapeutic strategies. In the past decades, patient-derived tumor organoids (PDT-O) have emerged as powerful tools for modeling tumoral cell diversity and dynamics, and they could then help define new therapeutic options for pediatric brain tumors.

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Article Synopsis
  • - Pediatric diffuse midline gliomas (pDMG) are aggressive childhood cancers characterized by fatal outcomes and linked to specific genetic mutations, particularly K27M in histone H3.
  • - About 20 to 30% of these tumors have alterations in the BMP signaling pathway, specifically involving mutations in the BMP type I receptor ALK2, but the effects of BMP in non-mutated cases are not fully understood.
  • - Recent research reveals that BMP2 and BMP7 are active in both wild-type and mutant tumors, and they work with the K27M mutation to alter cell behavior, indicating that the BMP pathway could be a target for treatment in pDMG.
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Therapeutic options for synovial sarcoma (SyS) have not evolved for several decades and the efficacy of second-line treatments is very limited. The expression of a large family of proteins known as cancer testis antigens (CTAs) in SyS has spurred the development of targeted T-cell therapies currently in clinical trials, such as those aimed at melanoma-associated antigen (MAGE)-A4 and New York esophageal squamous cell carcinoma 1 (NY-ESO-1), which have shown promising clinical efficacy. Extensive knowledge of the prevalence of expression and coexpression of CTAs is critical to design T-cell therapies with optimal coverage of the patient population.

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Background: Copy number alterations (CNA) are acquired during the evolution of cancers from their early stage to metastatic stage. This study aims at analysing the clinical value of the identified metastasis-associated CNAs both in metastatic breast cancers (mBCs) and early breast cancers (eBCs).

Methods: Single-nucleotide polymorphism (SNP)-array was performed on 926 biopsies from mBC patients, enrolled in SAFIR02-BREAST prospective trial.

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Purpose: The study of cell-free DNA (cfDNA) enables sequential analysis of tumor cell-specific genetic alterations in patients with neuroblastoma.

Experimental Design: Eighteen patients with relapsing neuroblastoma having received lorlatinib, a third-generation ALK inhibitor, were identified (SACHA national registry and/or in the institution). cfDNA was analyzed at relapse for nine patients and sequentially for five patients (blood/bone marrow plasma) by performing whole-genome sequencing library construction followed by ALK-targeted ddPCR of the hotspot mutations [F1174L, R1275Q, and I1170N; variant allele fraction (VAF) detection limit 0.

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Introduction: The objective was to determine the added value of comprehensive molecular profile by whole-exome and RNA sequencing (WES/RNA-Seq) in advanced and refractory cancer patients who had no molecular-based treatment recommendation (MBTR) based on a more limited targeted gene panel (TGP) plus array-based comparative genomic hybridization (aCGH).

Materials And Methods: In this retrospective analysis, we selected 50 patients previously included in the PROFILER trial (NCT01774409) for which no MBT could be recommended based on a targeted 90-gene panel and aCGH. For each patient, the frozen tumor sample mirroring the FFPE sample used for TGP/aCGH analysis were processed for WES and RNA-Seq.

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Background: To identify patients most likely to respond to everolimus, a mammalian target of rapamycin (mTOR) inhibitor, a prospective biomarker study was conducted in hormone receptor-positive endocrine-resistant metastatic breast cancer patients treated with exemestane-everolimus therapy.

Methods: Metastatic tumor biopsies were processed for immunohistochemical staining (p4EBP1, PTEN, pAKT, LKB1, and pS6K). ESR1, PIK3CA and AKT1 gene mutations were detected by NGS.

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Rhabdomyosarcoma (RMS) is the main form of pediatric soft-tissue sarcoma. Its cure rate has not notably improved in the last 20 years following relapse, and the lack of reliable preclinical models has hampered the design of new therapies. This is particularly true for highly heterogeneous fusion-negative RMS (FNRMS).

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Objective: Small-cell lung cancer (SCLC) is the malignancy most frequently associated with paraneoplastic neurological syndromes (PNS) and can trigger different antibody responses against intracellular (Hu) or neuronal surface (GABA R) antigens. Our aim was to clarify whether the genomic and transcriptomic features of SCLC are different in patients with anti-GABA R or anti-Hu PNS compared with SCLC without PNS.

Methods: A total of 76 SCLC tumor samples were collected: 34 anti-Hu, 14 anti-GABA R, and 28 SCLC without PNS.

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Background: High-grade adult-type diffuse gliomas (HGGs) constitute a heterogeneous group of aggressive tumors that are mostly incurable. Recent advances highlighting the contribution of ribosomes to cancer development have offered new clinical perspectives. Here, we uncovered that isocitrate dehydrogenase (IDH)wt and IDHmut HGGs display distinct alterations of ribosome biology, in terms of rRNA epitranscriptomics and ribosome biogenesis, which could constitute novel hallmarks that can be exploited for the management of these pathologies.

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Article Synopsis
  • Liquid biopsies using cerebrospinal fluid (CSF) cell-free DNA (cfDNA) are explored for detecting genetic changes in pediatric brain tumors, potentially offering better diagnostic information than plasma cfDNA.
  • In a study involving various tumor types, sequencing of CSF cfDNA revealed informative results in 60% of samples, with significant findings related to single-nucleotide variations (SNVs) and copy number alterations (CNA).
  • The results highlight the effectiveness of CSF cfDNA sequencing for molecular diagnosis and tracking of residual disease in pediatric embryonal brain tumors, indicating the need for further implementation of these methods.
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Background: MOST-plus is a multicenter, randomized, open-label, adaptive Phase II trial evaluating the clinical benefit of targeted treatments matched to molecular alteration in advanced/metastatic solid tumors. Sorafenib was tested on patients with tumors harboring sorafenib-targeted genes.

Methods: The MOST-plus trial used a randomized discontinuation design.

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Purpose: Metastatic endocrine-resistant breast cancer (MBC) is a disease with poor prognosis and few treatment options. Low lymphocyte count is associated with limited overall survival. In a prospective cohort of lymphopenic patients with HER-2 negative MBC, we assessed the clinical and biological impact of pembrolizumab combined with metronomic cyclophosphamide.

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  • A specific type of metastatic triple-negative breast cancer (mTNBC) shows increased sensitivity to platinum-based chemotherapy due to homologous recombination deficiency (HRD), prompting a study to explore genetic alterations and their impact on treatment response.
  • In a study involving mTNBC patients, tumors were analyzed for mutations in 19 HRR genes, and patients were grouped based on their molecular status to evaluate responses to platinum therapy.
  • Results indicated that mutations in specific HRR genes and promoter methylation were linked to better disease control, suggesting that broader genetic evaluations could help identify more patients who might benefit from platinum treatment.
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  • Identifying tumors with an active immune profile could help select advanced HNSCC and NSCLC patients for immunotherapy treatments.
  • The study involved creating targeted gene expression profiles in different patient groups treated with PD-1/PD-L1 inhibitors, with comprehensive clinical information available for analysis.
  • Additional datasets were generated from paired HNSCC biopsies and surgical specimens, providing insights into biomarker stability during diagnosis and recurrence.
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Cancer progression is driven in part by genomic alterations. The genomic characterization of cancers has shown interpatient heterogeneity regarding driver alterations, leading to the concept that generation of genomic profiling in patients with cancer could allow the selection of effective therapies. Although DNA sequencing has been implemented in practice, it remains unclear how to use its results.

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Introduction: Identification of tumours harbouring an overall active immune phenotype may help for selecting patients with advanced head and neck squamous cell carcinomas (HNSCC) and non-small cell lung cancer (NSCLC) who may benefit from immunotherapies. Our objective was to develop a reliable and stable scoring system to identify those immunologically active tumours.

Methods: Using gene expression profiles of 421 HNSCC, we developed a score to identify immunologically active tumours.

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Article Synopsis
  • Targeted therapies (TT) and immune checkpoint blockers (ICB) are changing the treatment landscape for non-small cell lung cancer (NSCLC), but their effectiveness as maintenance therapies after first-line chemotherapy is unclear.
  • The SAFIR02-Lung trial involved 175 patients receiving various TT and 59 receiving standard care, showing no significant difference in progression-free survival (PFS) between the two groups.
  • The study concluded that while molecular profiling for treatment decisions can be managed, it didn’t show significant advantages for most patients, except those with a specific PD-L1 tumor score who benefited more from durvalumab treatment.
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Introduction: Epithelial-to-mesenchymal transition (EMT) is associated with tumor aggressiveness, drug resistance, and poor survival in non-small cell lung cancer (NSCLC) and other cancers. The identification of immune-checkpoint ligands (ICPLs) associated with NSCLCs that display a mesenchymal phenotype (mNSCLC) could help to define subgroups of patients who may benefit from treatment strategies using immunotherapy.

Methods: We evaluated ICPL expression in silico in 130 NSCLC cell lines.

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Article Synopsis
  • Chemotherapy and standard treatments like anti-HER2 and PD-1 antibodies show limited long-term effectiveness for patients with gastroesophageal cancers.
  • A study on 147 patients revealed that adenocarcinoma was the most common type, with significant genomic alterations found, including in genes like TP53 and ERBB2.
  • Genomic profiling can identify treatable alterations in many patients, suggesting that using matched therapies could enhance survival rates, particularly in those with stage IV disease.
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Immunohistochemistry and recent molecular technologies progressively guided access to personalized anti-tumoral therapies. We explored the feasibility, efficacy, and the impact of molecular profiling in patients with advanced brain tumors. This multicentric prospective trial ProfiLER enrolled patients with primary brain tumors, who have been pre-treated with at least one line of anti-cancer treatment, and for whom molecular profiles had been achieved using next-generation sequencing and/or comparative genomic hybridization on fresh or archived samples from tumor, relapse, or biopsies.

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