C. Letellier, S. K. Sasmal, C. Draghi, F. Denis & D. Ghosh,
A chemotherapy combined with an anti-angiogenic drug applied to a cancer model including angiogenesis,
Chaos, Solitons & Fractals, 99, 297-311, 2017. Onine
Combined therapy made of a chemotherapy and antiangiogenic agents is a clinical treatment recommended for its efficiency. Since the optimization of a treatment against cancer relasp is still mostly based on oncologist’s know-how, it is desirable to develop different approaches for such a task. Mathematical modelling is one of the promising ways. We here investigated the action of a combined therapy inserted to a mathematical cancer model in order to determine how the dynamics underlying tumor growth is governed by some key parameters. We here retained a chemotherapy (for instance, paclitaxel and carboplatin) combined with an antiangiogenic drug (as bevacizumab) applied to a cancer model describing the interactions between host, immune, tumor and endothelial cells. The effects of such a therapy are investigated and the relevant role played by the “normal” tissue of the tumor micro-environment is evidenced.
F. Denis, C. Lethrosne, N. Pourel, O. Molinier, Y. Pointreau, J. Domont, H. Bourgeois, H. Senellart, P. Trémolières, T. Lizée, J. Bennouna, T. Urban, C. El Khouri, A. Charron, A.-L. Septans, M. Balavoine, S. Landry, P. Solal-Céligny & C. Letellier
Randomized trial comparing a web-mediated follow-up with routine surveillance in lung cancer patients,
Journal of the National Cancer Institute, 109 (9), djx029, 2017. Online
Background : The use of web-based monitoring for lung cancer patients is growing in interest because of promising recent results suggesting improvement in cancer and resource utilization outcomes. It remains an open question whether the overall survival (OS) in these patients could be improved by using a web-mediated follow-up rather than classical scheduled follow-up and imaging.
Methods : Advanced-stage lung cancer patients without evidence of disease progression after or during initial treatment were randomly assigned in a multicenter phase III trial to compare a web-mediated follow-up algorithm (experimental arm), based on weekly self-scored patient symptoms, with routine follow-up with CT scans scheduled every three to six months according to the disease stage (control arm). In the experimental arm, an alert email was automatically sent to the oncologist when self-scored symptoms matched predefined criteria. The primary outcome was OS.
Results : From June 2014 to January 2016, 133 patients were enrolled and 121 were retained in the intent-to-treat analysis ; 12 deemed ineligible after random assignment were not subsequently followed. Most of the patients (95.1%) had stage III or IV disease. The median follow-up was nine months. The median OS was 19.0 months (95% confidence interval [CI] = 12.5 to noncalculable) in the experimental and 12.0 months (95% CI = 8.6 to 16.4) in the control arm (one-sided p = .001) (hazard ratio = 0.32, 95% CI = 0.15 to 0.67, one-sided p = .002). The performance status at first detected relapse was 0 to 1 for 75.9% of the patients in the experimental arm and for 32.5% of those in the control arm (two-sided p < .001). Optimal treatment was initiated in 72.4% of the patients in the experimental arm and in 32.5% of those in the control arm (two-sided p < .001).
Conclusions : A web-mediated follow-up algorithm based on self-reported symptoms improved OS due to early relapse detection and better performance status at relapse.