Etude des toxicités chroniques des traitements anticancéreux chez les patientes porteuses cancer

CANTO is a prospective cohort dedicated to research questions focused on cancer survivorship. The aim of the study is to identify the medium- and long-term toxicities of cancer treatments, assess their impact on patients and society, and predict them using multimodal markers. The breast cohort included 12,012 patients between 2012 and 2018. For each patient, in addition to standard medical follow-up, the CANTO-specific follow-up includes 16 patient-reported questionnaires. It also includes the collection of 8 blood and 2 stool samples. CANTO allows for the collection of primary tumor samples, the digitization of HE/HES slides, and the collection of imaging data. Since Nov 2020, the resumption of inclusions has enabled us i) to enrich the cohort with women under 45 years of age at initial diagnosis, ii) to include patients treated with innovative therapies (in breast and lung cancer) in order to assess their impact on the patient and the healthcare system. The CANTO infrastructure relies on thematic research groups, as well as partnerships with structures of excellence for data analysis. CANTO has become a reference in the global survivorship landscape, having mapped the impact of cancer and the main associated needs. It has also generated predictive algorithms for long-term toxicity that clinicians can use to inform their clinical practice. CANTO has secured several competitive grants enabling the cohort to be exploited by academic teams. Three major challenges are being considered for the future: i) to increase recruitment of patients receiving innovative therapies by diversifying indications, ii) to ensure continuing effective matching with SNDS data, and iii) to promote the integration of new tools enabling both the collection of data reported by patients while ensuring long-term follow-up (control of attrition). Finally, the cohort infrastructure will be used for recruitment and data collection of several nested interventional clinical studies.