PRIME

Programme foR Improved management of Elders with cancer

Presentation

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)

Research teams

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)

Expertise: Metabolism

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.

Consult the CELLOMET website

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).

Expertise: Immunology

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.

Consult the website of the ImmunoConcEpT laboratory

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).

Expertise: Epidemiology

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.)

Publications

Clinical Research & Translational Studies

Fundamental Sciences

+ 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