Programme foR Improved management of Elders with cancer
Despite the prevalence of cancers in the elderly and advances in biomedical and technological research on the subject, it remains difficult to propose a treatment adapted to this patient population. Indeed, many clinical trials exclude older adults from their cohort given the higher number of risk factors or comorbidities that this population concentrates. This exclusion leads to a lack of data and recommendations in oncogeriatric treatments, so that under- or over-treatment of these patients is common. The French population is aging, these issues become a major public health issue.
The goal of the PrIME program is to combine multidisciplinary approaches to improve the management of geriatric cancers through individualized methods and treatments.
Pierre Soubeyran, Muriel Rainfray and Carine Bellera are co-coordinating all the research projects of the PrIME project within BRIO, in constant link with the manager program. They set up the main strategic axes of the clinical and preclinical research of the PrIME program, in accordance with the budgets, the competitive and medical environment. They co-lead the 2 annual program progress meetings as well as the preparatory meetings of the International Scientific Committee (SAB).
As part of the PrIME program, several clinical studies are underway, such as
* PREPARE, a multicentre phase III including a total of 1500 patients in France comparing the conventional care of elderly patients with cancer to that of a geriatric intervention, and the PRIORITY study, which assesses the evolution of priorities of patients taken in charge by chemotherapy treatment before and after three months of treatment. (NCT02704832)
* PRIORITY (observational phase IV, elderly patients with cancer NCT02821793)
* BANCO (clinico-biological collection of elderly patients with cancer NCT02704832)
Bordeaux has a UCOG (Coordination Unit in OncoGériatrie, geriatric evaluation unit common to the CHU and the Bergonié Institute) since 2007, renewed with more precise objectives and an extension of territory in 2013 (addition of Guadeloupe, Réunion and Mayotte). This UCOG is coordinated by a geriatrician (Prof. Muriel Rainfray MD) and an oncologist (Prof. Pierre-Louis Soubeyran MD) and includes 3 doctors (Dr. Cécile Mertens, Dr. Sophie Duc, Dr. Carine Foucaud), qualified nurses and an administrative assistant. As a reference center, Institut Bergonié and CHU treat many elderly patients. Patients are identified by a screening questionnaire (G8) and an analysis of patient records. Oncologists (medical oncologists, surgeons, anesthesiologists or radiation therapists) refer selected patients to UCOG for feasibility of treatment and complete geriatric evaluation.
In addition to the members of the UCOG, several doctors involved in the daily practice of geriatric oncology, are proactive to conduct research in geriatric oncology: – Isabelle Bourdel-Marchasson and Sophie Duc (geriatric department of the university hospital), – Antoine Italiano, Guilhem Roubaud, Camille Chakiba and Thomas Grellety (Department of Medical Oncology, Institut Bergonié), – Alain Ravaud and Amaury Daste (Department of Medical Oncology, CHU) – Grégoire Desolneux (Department of Surgery, Institut Bergonié).
BRIO referrals: Pierre Soubeyran (Medical oncologist, Research Director, Inserm U1218, Bergonié Institute) – Frédéric Delom (Biologist, Inserm U1218, Bergonié Institute)
Expertise: Translational Research
The Inserm Unit U1218 ACTION relies on its integration into the Bergonié Institute to develop translational research through its fundamental researchers in connection with the clinical teams. Three themes are developed:
– SARCOTARGET TEAM: Sensitivity and resistance to sarcomas
– MLO TEAM: Genetic diversity and treatment response: mammary and leukemic oncogenesis
– VINTAGE TEAM: Validation and Identification of new targets for cancer and aging. Each of these groups has biological and clinical assets that will enable them to complete their projects. Located in a Cancer Control Center with privileged access to tumor samples and clinical data and well integrated in the university context, this unit has the resources needed to develop a competitive research at French and European level.
BRIO referee: David Santamaria (Group Leader, European Institute of Chemistry and Biology)
Expertise: Biology, Chemistry
The European Institute of Chemistry and Biology (IECB) is an incubator of international and interdisciplinary research teams, under the joint supervision of the CNRS, Inserm and the University of Bordeaux. David Santamaria’s team is working on the development of mouse models and tissue organoids to study the early stages of lung adenocarcinoma, associated signaling pathways and oncogenic functions that regulate the onset of adenocarcinoma of the lung. lung to determine new therapeutic targets.
BRIO referee: Rodrigue Rossignol (Research Director, Cellomet CEO, Inserm U1211, University of Bordeaux)
This team has recognized international expertise in the study of energy metabolism in physiology and pathology. Rodrigue Rossignol is also CEO of Cellomet, a CRO technology platform dedicated to the study of metabolic remodeling triggered by tumor development, drug resistance and anticancer drug activity. At the preclinical stage, the team is developing precision bioenergetic medicine strategies for lung cancer that combine the inhibition of molecular oncology targets with the bioenergetic stratification of tumors. CELLOMET provides pharmaceutical companies with services to decipher the metabolic impact and toxicity of various anti-cancer compounds.
BRIO referrals: Benjamin Faustin (Immunologist, CNRS UMR5164, ImmunoConcEpT, University of Bordeaux), Julie Dechanet-Merville (CNRS Research Director, Director of UMR 5164, ImmunoConcept, University of Bordeaux), Nicolas Larmonier (Immunologist, ImmunoConcept, University de Bordeaux), Vanja Sisirak (Immunologist, ImmunoConcept, University of Bordeaux), Thomas Pradeu (Philosopher, ImmunoConcept, University of Bordeaux).
This team is dedicated to studying the physiological and pathological role of the immune system by performing fundamental and translational research. She has extensive experience in immunomonitoring normal or pathological specimens and has developed in vitro and in vivo models of cancer. She has expertise in the generation of monoclonal antibodies as well as phenotyping using high throughput multiparametric flow cytometry. This unit has long-standing expertise in cohort analysis of patients through relationships with several clinical departments and blood bank of Bordeaux University Hospital and with the EFS of Aquitaine. Their laboratory includes all the technologies needed to develop their research program (flow cytometry, viral vectorology, histology, qPCR, ELISPOT).
Thomas Pradeu’s group deals with the philosophy of biology, medicine and conceptual-theoretical biology.
BRIO references: Pr Simone Mathoulin-Pélissier (Professor of Public Health and Epidemiology, Director of the EPICENE team, Inserm U1219, Institute of Public Health Epidemiology and Development, University of Bordeaux, Bergonié Institute), Dr Carine Bellera (Biostatistician, Inserm U1219, University of Bordeaux).
The EPICENE team mainly develops research on the relationship between exposures to environmental and occupational nuisances with the occurrence of cancers. Through innovative epidemiological and statistical methods it studies the occurrence of cancer and the future of populations. Through multidisciplinary approaches, she develops specific methods for measuring exposures. The research fields of this team are:
– Develop and validate statistical methods to assess the future of populations with cancer, including survival.
– Propose methods for estimating recent individual or lifetime exposures to environmental and / or occupational nuisances.
– Evaluate the role of certain environmental and / or occupational nuisances in the occurrence of rare cancers (sarcomas, mesotheliomas, tumors of the central nervous system, blood disorders, …).
Referee BRIO: Béatrice Jacques (Sociologist in Health, Emile Durkheim Center, University of Bordeaux)
Expertise: Sociology of Health
This laboratory brings together political scientists and sociologists from Sciences Po Bordeaux, the CNRS and the University of Bordeaux. Their research works are structured around questions of identification, vulnerability, inequalities and pathways, legitimacy, organizations and representations, knowledge and finally sociologies of the international.
BRIO referee: Géraldine Goulinet (Sociologist, MICA Research Laboratory, University of Bordeaux-Montaigne)
Expertise: Mediations, Information, Communication, Arts
MICA is the research laboratory in Information and Communication Sciences and Arts of Bordeaux-Montaigne University. MICA’s “Communication, Organization, Society” axis develops a scientific program based on a critical approach to new injunctions to cooperate and communicate in organizations and society, in the context of globalization and the development of digital technologies.
The researchers developed work on communication practices in a work context – individuals, professional groups and collectives – as well as communication practices institutionalizing the outlines, norms and organizational frameworks. The last collective research projects focused on organizational temporalities, communication phenomena related to precariousness. The members of the COS axis, associated with foreign researchers, animate the editorial committee of the journal Communication & Organization (published by the university ores of Bordeaux, the portals Revues.org and Cairn.)
Clinical Research & Translational Studies
+ Multidisciplinary Development of a Geriatric COre DatasEt (G-CODE) for clinical research in older patients with cancer: a French initiative with international survey.
European journal of cancer, Nov.2018
E. Paillaud, et al.
+ Bendamustine and rituximab in elderly patients with low-tumour burden follicular lymphoma. Results of the LYSA phase II BRIEF study.
British journal of haematology, Oct. 2018
Gyan et al.
+ Patterns of use, safety and effectiveness of targeted therapies in first-line treatment of metastatic colorectal cancer according to age : the STROMBOLI cohort study.
Clinical colorectal cancer, Mar 2019
Gouverneur et al.
+ Inclusion of elderly or frail patients in randomized controlled trials of targeted therapies for the treatment of metastatic colorectal cancer: A systematic review.
Journal of geriatric oncology , Jan 2018
Gouverneur et al
+ ESMO Consensus Conference on malignant lymphoma : General perspectives and recommendations for the clinical management of elderly patients with malignant lymphoma.
Annals of oncology : official journal of the European Society for Medical Oncology, Mar 2018
Buske et al.
+ R-CHOP 14 with or without Radiotherapy in non-bulky limited-stage diffuse large B-cell lymphoma (DLBCL): results of the prospective randomized phase III 02-03 trial from the LYSA/GOELAMS
T. Lamy et al.
+ Impact of geriatric assessment for the therapeutic decision-making of breast cancer: results of a French survey. AFSOS and SOFOG collaborative work.
Breast cancer research and treatment, Apr 2018
Falandry et al.
+ Rituximab after Autologous Stem-Cell Transplantation in Mantle-Cell Lymphoma.
The new England journal of medicine, Sep 2017
Le Gouill et al.
+ Rituximab plus Lenalidomide in Advanced Untreated Follicular Lymphoma.
The new England journal of medicine, Sep 2018
Morschhauser et al.
+ The prognostic value of G8 for functional decline.
Journal of geriatric oncology, Jan 2019
Chakiba et al.
+ Treatment Modalities and Survival in Older Adults with Metastatic Colorectal Cancer in Real Life
Journal of the american geriatrics society, May 2019
A.Gouverneur et al.
+ The role of protein disulphide isomerase AGR2 in the tumour niche
Biology of the cell, Dec 2018
F.Delom et al.
+ mTOR Inhibition via Displacement of Phosphatidic Acid Induces Enhanced Cytotoxicity Specifically in Cancer Cells
Cancer research, Sep 2018
Nguyen et al.
+ Calcium independent effect of Orai1 and STIM1 in non-Hodgkin B cell lymphoma dissemination.
Cancers, Oct 2018
Latour et al.
+ Modulation of the ATM/autophagy pathway by a G-quadruplex ligand tips the balance between senescence and apoptosis in cancer cells
Nucleic acids research, Apr 2019
Beauvarlet et al.
+ The role of protein disulphide isomerase AGR2 in the tumour niche.
Biology of the cell, dec 2018
F.Delom et al.
Humanities & Social Sciences / Epidemiology / Public Health
+ Alterations in Comprehensive Geriatric Assessment decreases survival of elderly patients with cancer.
European journal of cancer, Feb 2018
Frasca et al.
+ Determinants of cancer treatment and mortality in older cancer patients using a multi-state model: Results from a population-based study (the INCAPAC study).
Cancer epidemiology , Aug 2018
A.Galvin et al.
+ Sociodemographic, socioeconomic and clinical determinants of survival in cancer patients: a systematic review of the literature focused on the elderly
Journal of geriatric oncology , Jan 2018
F.Galvin et al.
+ Determinants of functional decline in older adults experiencing cancer (the INCAPAC study).
Journal of geriatric oncology , Mar 2019
A.Galvin et al.