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Master Thesis

Évolution des métastases osseuses chez les patients traités par inhibiteurs de checkpoint immunitaire

Abstract : Objectives: to investigate the evolution of bone metastases in patients with cancer treated by immune checkpoint inhibitors (ICI). Patients and Methods: we conducted a single-center retrospective study including cancer patients with bone metastases treated with ICI at our institution between January 2014 and September 2019, with available imaging data. Clinical and biological data were collected from medical records and independent expert review of imaging was performed. Targeted and non-targeted lesions were identified and followed as bone responder or non-responder. Comparisons between groups were performed with Student’s t-test or Mann-Whitney test. Results: 48 patients were included in the final analysis, with lung cancer (n=23), renal carcinoma (n=11) and melanoma (n=9) as most represented cancer type. Half of the patients experienced stability, condensation or peripheral sclerosis of bone lesions without difference between cancer type. We observed an initial progression before stabilization with or without sclerosis of bone lesion for 19% of patients (pseudoprogression). There was an association between bone response and global oncological outcomes (RECIST tumor responses, overall survival and progression free survival). Bone responder patients had a significant decrease in morphine and co-analgesic prescription as well as a significant decrease of alkaline phosphatases compared to non-responder patients. Conclusion: bone response was observed in half of patients with available imaging and follow-up after 3 months of ICI treatment, with often a sclerosis observed from month 3, in all tumor types. Some patients experienced a pseudoprogression of bone lesions such as previously described in primary tumor and other metastatic sites. Response was associated with improvement of pain and survival.
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https://dumas.ccsd.cnrs.fr/dumas-03411686
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Submitted on : Tuesday, November 2, 2021 - 2:37:11 PM
Last modification on : Wednesday, December 8, 2021 - 3:55:31 AM

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  • HAL Id : dumas-03411686, version 1

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Émilie Gefard. Évolution des métastases osseuses chez les patients traités par inhibiteurs de checkpoint immunitaire. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03411686⟩

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