Prof. François Goldwasser

Presentation Roadmap/ Summary

An increasing number of patients have not only cancer but also other characteristics susceptible to influence the tolerability to anticancer treatments: elderly, obesity, cardiovascular disease, mellitus diabetes, malnutrition. As a result, a view of the cancer patient limited to the consultation of the oncologist may miss risks of toxicity. Conversely, the oncologist may also overestimate the risk and renounce to a feasible treatment. A step of multidisciplinary needs and risks assessment improves the quality of the prescription and reduces the anticancer treatment-related unscheduled hospitalizations.

Learning Objectives

At the conclusion of the presentation, the participant will be able to:

1. Identify patients at risk for increased toxicity
2. Identify human resources susceptible to reduce the risk of anticancer treatments
3. Define clinical complexity

Key Takeaways/ Fast Facts

• Most cancer patients have characteristics which justify to not apply automatically the data for clinical trials but require a time of personalization
• Risk assessment is optimally done by a multidisciplinary team
• A specific multidisciplinary team is warranted.

Key references

1. Ropert S, Vignaux O, Mir O, Goldwasser F. VEGF pathway inhibition by anticancer agent sunitinib and susceptibility to atherosclerosis plaque disruption. Invest New Drugs. 2011 Dec;29(6):1497-9
2. Goldwasser F, Vinant P, Aubry R, Rochigneux P, Beaussant Y, Huillard O, Morin L.Timing of palliative care needs reporting and aggressiveness of care near the end of life in metastatic lung cancer: A national registry-based study. Cancer. 2018 Jul 15;124(14):3044-3051.
3. Huillard O, Mir O, Peyromaure M, Tlemsani C, Giroux J, Boudou-Rouquette P, Ropert S, Delongchamps NB, Zerbib M, Goldwasser F. Sarcopenia and body mass index predict sunitinib-induced early dose-limiting toxicities in renal cancer patients. Br J Cancer. 2013 Mar 19;108(5):1034-41.
4. Antoun S, Baracos VE, Birdsell L, Escudier B, Sawyer MB. Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol. 2010 Aug;21(8):1594-8.
5. Bretagne M, Jouinot A, Durand JP, Huillard O, Boudou Rouquette P, Tlemsani C, Arrondeau J, Sarfati G, Goldwasser F, Alexandre J. Estimation of glomerular filtration rate in cancer patients with abnormal body composition and relation with carboplatin toxicity. Cancer Chemother Pharmacol. 2017 Jul;80(1):45-53.
6. Jouinot A, Vazeille C, Durand JP, Huillard O, Boudou-Rouquette P, Coriat R, Chapron J, Neveux N, De Bandt JP, Alexandre J, Cynober L, Goldwasser F.Resting energy expenditure in the risk assessment of anticancer treatments. Clin Nutr. 2018 Apr;37(2):558-565
7. Thomas-Schoemann A, Blanchet B, Bardin C, Noé G, Boudou-Rouquette P, Vidal M, Goldwasser F. Drug interactions with solid tumour-targeted therapies. Crit Rev Oncol Hematol. 2014 Jan;89(1):179-96.
8. Coriat R, Boudou-Rouquette P, Durand JP, Forgeot d'Arc P, Martin I, Mir O, Ropert S, Alexandre J, Goldwasser F. Cost effectiveness of integrated medicine in patients with cancer receiving anticancer chemotherapy. J Oncol Pract. 2012 Jul;8(4