Transcript Study 3 - Jean

French Sarcoma Group
CTOS meeting, Nov 2004
FNCLCC Sarcoma Group
• Started from a multicentric work of pathologists
since 1980’s (JM Coindre)  FNCLCC grading
•
Established in 1980’s by the FNCLCC to coordinate
clinical research on sarcomas among the 20 french
cancer centers (BN Bui).
• Open to other public and private structures treating
cancer patients since 2000 : French Sarcoma Group
• 2004 : n=37 institutions
– (comprehensive cancer ctrs, Univ. Hospitals, private
clinics... + CHUV Lausanne)
FNCLCC
Lille
Rouen
Paris
Nancy
Caen
(Curie, IGR, Reims
Strasbourg
St-Cloud)
Rennes
Angers
Nantes
Dijon
ClermontFerrand Lyon
Bordeaux
Nice
Toulouse
Marseille
Montpellier
French Sarcoma Group
Objectives
• Education and improvement of the quality of
patient care
• Basic, translational and clinical research
• Intergroup collaborations (EORTC…)
Pathology
(coord. : J.M .Coindre)
FNCLCC soft tissue sarcoma database
(2500 patients 1985  2004)
-
all pathologies collegially reviewed monthly
Patient recorded from initial diagnosis
all cases documented with patients and tumors
characteristics, treatment data and evolution
FNCLCC Grading
Frozen tissue bank
(1000 sarcomas, 300 benign tumors)
 to allow diagnostic and prognostic studies on
homogenous groups by tumor types or localizations
Molecular biology
(coord. : A. Aurias)
Chromosomal and genomic abnormalities
of sarcomas
- Diagnostic and prognosis of sarcomas (eg :
MFH and undifferentiated sarc) (A. Aurias)
- Arraying of STS to define new entities and
molecular pathways (A. Aurias)
- Gene expression and response to
chemotherapy (J. Robert)
Clinical trials
(JY Blay, A. Le Cesne, BN Bui)
Soft tissue sarcomas
-
PAC 02 : phase III study of intensification after remission
induction in advanced STS (Palsar II) (BN Bui); n=127
-
Randomized phase II study of dose reduction (0.5 vs 1 vs 2 vs 4
mg) of TNF in isolated limb perfusion (S.Bonvalot); n=102
-
A phase II trial of imatinib in locally advanced non resectable
aggressive fibromatosis (JY Blay); n=9
-
A phase II trial of weekly paclitaxel in advanced angiosarcomas
(N Penel)
Visceral sarcomas
Uterine sarcomas
- A prospective randomized phase II trial of Surgery+RT
vs Surgery +APIx3+ RT in high grade uterine
sarcomas (P. Pautier); n=34
- A prospective randomized phase II trial of Gemcitabin
vs Gemcitabine + docetaxel in relapsed uterine
sarcomas (F. Duffaud & P. Pautier)
Visceral sarcomas
GIST:
- BFR14 prospective phase III trial testing Glivec
maintenance vs interuption after 3 years (Blay & Le Cesne)
- Participation to the EORTC 62024 adjuvant imatinib trial in
GIST (P. Casali)
- Phase II trials of a new KIT inhibitor AB1010 in front line
and in imatinib refractory patients (Le Cesne & Blay)
Clinical trials
Soft tissue sarcomas : future studies
- A prospective randomized phase III trial of
Surgery+EBRT vs Surgery alone in
retroperitoneal sarcomas (C.Le Péchoux)
- A prospective randomized phase III trial of
Surgery+EBRT vs Surgery alone in limb
sarcomas R0 margins>1 cm
Bone sarcomas: clinical trials
Ewing sarcoma
- PAC 01 : protocol Euro-E.W.I.N.G 99 (with SFOP,
UKCCSG, SIAK, GPOH) (O. Oberlin)
- Phase II trial of CDDP + VP16 in relapsed
ES/PNET (O. Oberlin)
Bone sarcomas: clinical trials
Osteosarcoma
-
OSAD 1993. Phase II of IP as induction chemotherapy in
localized osteosarcomas (JY Blay)
-
OSAD 2000 (PAC 04). Phase II of API-AI as induction
chemotherapy (A. Le Cesne)
-
Followed by: A prospective randomized phase III trial testing HDCT in
poor histological responders to preoperative regimen in first line
treatment of osteosarcomas (with SFOP)
Education and improvement of primary care
•CME for the management of the pathology of STS
since 1980’s
•Pathology review since 1989
•Internet presentation of clinical cases
•CME in different french regions through cancer
networks
•Clinical practice guidelines (SOR project)
(Br J Cancer, Bull Cancer, www.fnclcc.fr...)
FNCLCC S.O.R. Project
•Guidelines for the management of patients with cancer at the first
treatment.
•SOR for osteosarcomas and adult soft tissue sarcomas
- First issue in 1995 (Bull Cancer 1995)
- Updates: osteosarcoma (1999, Br J Cancer), adult STS (2004)
•Retrospective and prospective evaluation of the adhesion to
CPGs in regional cancer Network (Ann Oncol 2004)
Conclusions: FSG
-Clinical and Public Health research
-Education
-Intergroup studies