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CTOS meeting, Nov 2004. French Sarcoma Group. 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).
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CTOS meeting, Nov 2004 French Sarcoma Group
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 (Curie, IGR, St-Cloud) Nancy Caen Reims Strasbourg Rennes Angers Nantes Dijon Clermont- Ferrand Lyon Bordeaux Nice Toulouse Marseille Montpellier
French Sarcoma GroupObjectives • 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