Sensitive detection methods are key to identify secondary EGFR c.2369C>T p.(Thr790Met) in non-small cell lung cancer tissue samples

Background: Correct identification of the EGFR c.2369C>T p.(Thr790Met) variant is key to decide on a targeted therapeutic strategy for patients with acquired EGFR TKI resistance in non-small cell lung cancer. The aim of this study was to evaluate the correct detection of this variant in 12 tumor tissue specimens tested by 324 laboratories participating in External Quality Assessment (EQA) schemes. Methods: Data from EQA schemes were evaluated between 2013 and 2018 from cell lines (6) and resections (6) containing the EGFR c.2369C>T p.(Thr790Met) mutation. Adequate performance was defined as the percentage of tests for w

Contribution à l'étude des altérations du cycle cellulaire au cours du cancer bronchique primitif et des lésions précancéreuses

Il est important de caractériser les altérations moléculaires des lésions précancéreuses et des cancers bronchiques primitifs, principale cause de mortalité dans les pays industrialisés. Dans une première partie de ce travail nous avons étudié la chronologie de l'hyperméthylation de CDKN2A et de hRARb2 dans un modèle de cultures primaires de lésions précancéreuses. L'hyperméthylation de CDKN2A a été trouvée dans 19 % des lésions testées : (1) sa fréquence augmente avec le grade histologique de la lésion (2) elle est corrélée aux antécédents de cancers bronchiques ou ORL du patient mais n'est pas influencée par le tabagisme et l'exposition professionnelle à l'amiante, (3) elle n'est pas prédictive de l'évolution de la lésion. L'hyperméthylation de hRARb2 ne semble pas être un événement précoce de la cancérisation bronchique dans notre étude. Dans une deuxième partie de ce travail nous avons documenté une altération de l'expression des cyclines B1 et B2 dans 15 % des CNAPC.It is important to characterize the molecular changes occurring in precancerous lesions and invasive lung cancer the leading cause of cancer's mortality in industrial nations. In the first part of this work we studied the timing of aberrant methylation of CDKN2A and hRARb2 in primary cultures of precancerous lesions. Aberrant methylation of the CDKN2A gene promoter was found in 19 % of preinvasive lesions: (1) its frequency increased with the histological grade of the lesions, (2) methylation was significantly more frequent in patients with a previous history of lung or ENT cancer but was not influenced by tobacco or asbestos exposure, (3) there was no relationship between CDKN2A hypermethylation and the evolutivity of the lesions. In contrast, aberrant methylation of hRARb2 was not an early event of lung carcinogenesis in our study. In a second part of this work we found an altered expression of Cyclins B1 and B2 in 15 % of non-small cell lung cancer.ROUEN-BU Sciences (764512102) / SudocSudocFranceF

Recherche de catalyseurs peu sensibles à la présence de monoxyde de carbone pour piles à combustible PEMFC alimentées en gaz de reformage

Le but de ce travail était de préparer des catalyseurs bimétalliques à base de platine destinés à la préparation d'anodes pour piles à combustible alimentées en hydrogène provenant de gaz de reformage et donc contenant quelques ppm de monoxyde de carbone. Le CO empoisonne le platine qui sert traditionnellement d'anode à ce type de pile ce qui provoque une chute de ces performances. L'addition d'étain permet de diminuer le potentiel d'oxydation du CO et de rendre le catalyseur moins sensible à ce poison. Un nouveau mode de préparation de catalyseurs Pt-Sn, présentant une bonne tolérance au monoxyde de carbone, a été mis au point au cours de cette thèse. Ce matériau est constitué de particules nanométriques (environ 2 nm) homogènes constituées uniquement de la phase Pt3Sn. Ce catalyseur a finalement été testé comme anode de pile à combustible. Il s'empoisonne moins que le catalyseur PtSn(3:1)/C E-TEK et possède une bonne stabilité.The aim of this work was to prepare and to characterize platinum-based bimetallic catalyst before testing their electrocatalytic activities, as fuel cell anode, in presence of some ppm of carbon monoxide. In order to avoid platinum poisoning, another metal such as tin is added. This process results in a material more tolerant to CO. A supported Pt-Sn catalyst was prepared by a chemical route, using a platinum carbonyl complex. This material was characterized by physical and chemical methods which indicate that it is constituted of nanostructured Pt3Sn particles. These particles have a narrow distribution size with a mean diameter of approximately 2 nm. Its activity towards CO, particularly in fuel cell conditions, was compared with an analogue commercial catalyst. This electrochemical study shows that the catalyst prepared from the carbonyl precursor is less sensitive to CO than the commercial one.POITIERS-BU Sciences (861942102) / SudocSudocFranceF

KRAS and BRAF Mutation Detection: Is Immunohistochemistry a Possible Alternative to Molecular Biology in Colorectal Cancer?

KRAS genotyping is mandatory in metastatic colorectal cancer treatment prior to undertaking antiepidermal growth factor receptor (EGFR) monoclonal antibody therapy. BRAF V600E mutation is often present in colorectal carcinoma with CpG island methylator phenotype and microsatellite instability. Currently, KRAS and BRAF evaluation is based on molecular biology techniques such as SNaPshot or Sanger sequencing. As molecular testing is performed on formalin-fixed paraffin-embedded (FFPE) samples, immunodetection would appear to be an attractive alternative for detecting mutations. Thus, our objective was to assess the validity of KRAS and BRAF immunodetection of mutations compared with the genotyping reference method in colorectal adenocarcinoma. KRAS and BRAF genotyping was assessed by SNaPshot. A rabbit anti-human KRAS polyclonal antibody was tested on 33 FFPE colorectal tumor samples with known KRAS status. Additionally, a mouse anti-human BRAF monoclonal antibody was tested on 30 FFPE tumor samples with known BRAF status. KRAS immunostaining demonstrated both poor sensitivity (27%) and specificity (64%) in detecting KRAS mutation. Conversely, BRAF immunohistochemistry showed perfect sensitivity (100%) and specificity (100%) in detecting V600E mutation. Although molecular biology remains the reference method for detecting KRAS mutation, immunohistochemistry could be an attractive method for detecting BRAF V600E mutation in colorectal cancer

Morphological and Molecular Characterization of KRAS G12C-Mutated Lung Adenocarcinomas

Lung adenocarcinoma (LUAD) is the major subtype of non-small cell lung cancer, accounting for approximately 60% of cases. Molecular analysis of LUADs showed that the KRAS gene is mutated in up to 30% of cases; such cases were previously considered “undruggable”. The KRAS G12C mutation has become a hot topic of research after initial, promising, phase I and II trials with targeted inhibitors. We analyzed the morphological and genomic landscape of 202 KRAS G12C mutated LUADs using next-generation sequencing, and identified a specific subtype of patients that could show an improved response to KRAS G12C inhibitors. The main histological subtype was acinar in 29.7% of cases. Tumor-infiltrating lymphocytes (TILs) were highly or moderately abundant in more than 60% of cases. The immunohistochemical profile showed TTF1 positivity in 78.7% of cases and PD-L1 positivity in 44.1% of cases. The molecular profile showed an association between KRAS G12C and STK11 mutations in 25.2% of cases. This subgroup was associated with a statistically significant lower TTF1 (p = 0.0092) and PD-L1 (p < 0.0001) positivity. This type of combined morphological and molecular analysis can improve our understanding of tumor biology, and help us to identify specific patient subgroups that can achieve the best treatment response

Molecular analysis of peripheral non-squamous non-small cell lung cancer sampled by radial EBUS

International audienceTreatment optimization of non-squamous non-small-cell lung cancers (nonSq-NSCLC) relies on the molecular analysis of the tumour. We aimed to assess the predictive factors of molecular analysis feasibility (MAF) from samples of peripheral nonSq-NSCLC obtained by radial endobronchial ultrasound bronchoscopy (r-EBUS) and 1.5 mm microbiopsy forceps

Patient-initiated consultations in community pharmacies

BACKGROUND: Mobilizing pharmacists practicing in community pharmacies as a new player in primary care has recently emerged as a cost-effective strategy for clinical consultations related to minor ailments. However, little is known about these consultations initiated by patients. The objectives of this study were to describe patient initiated consultations in community pharmacies, and to estimate the impact of these consultations on care-seeking behaviors of patients. METHODS: A cross sectional study was conducted in 11 retail pharmacies in Quebec, Canada, from October until December 2017, using two data sources: 1) an application and 2) structured interviews. Pharmacists had to compile all consultations in the app during a 4 week-period. Consenting patients were interviewed on the day of the consultation and one week after. Descriptive statistics on the number of consultations were calculated, as well as on the recommendation and the experience of the patient. RESULTS: A total number of 4994 consultations were entered in the app by 55 pharmacists, with an average of 18 consultations (SD = 7) per pharmacy per day. Of the 900 patients consented to participate to the study, 600 (67%) completed the two interviews. Pharmacists reported that they recommended another healthcare resource to patients (e.g. emergency department (ED), walk-in clinic) in only 15% of cases. In the week following the consultation, 105 (18%) patients reported that they avoided going to the ED as a result of the consultation. Patients in rural regions or consulting in a pharmacy far from a medical clinic were more likely to report avoiding an ED visit as a result of the consultation with the pharmacist. CONCLUSIONS: This study suggests that patients are seeking advice from pharmacists for a variety of health care concerns and that pharmacists are able to manage most of these consultations, with a high level of patient satisfaction

Worse prognosis of KRAS c.35 G > A mutant metastatic colorectal cancer (MCRC) patients treated with intensive triplet chemotherapy plus bevacizumab (FIr-B/FOx).

International audienceBACKGROUND: Prognosis of KRAS wild-type and mutant metastatic colorectal cancer (MCRC) patients (pts) treated with bevacizumab (BEV)-containing chemotherapy is not significantly different. Since specific KRAS mutations confer different aggressive behaviors, the prognostic role of prevalent KRAS mutations was retrospectively evaluated in MCRC pts treated with first line FIr-B/FOx, associating BEV to triplet chemotherapy. METHODS: Tumor samples were screened for KRAS codon 12, 13 and BRAF V600E mutations by SNaPshot and/or direct sequencing. MCRC pts A, 15 (25.4%); c.35 G > T, 7 (11.8%); c.38 G > A, 3 (5%); other, 3 (5%). KRAS wild-type, 31 pts (52.7%). The objective response rate (ORR), PFS and OS were, respectively: c.35 G > A mutant, 71%, 9 months, 14 months; other than c.35 G > A mutants, 61%, 12 months, 39 months. OS was significantly worse in c.35 G > A pts compared to KRAS wild-type (P = 0.002), KRAS/BRAF wild-type (P = 0.03), other MCRC patients (P = 0.002), other than c.35 G > A (P = 0.05), other codon 12 (P = 0.03) mutant pts. OS was not significantly different compared to c.35 G > T KRAS mutant (P = 0.142). CONCLUSIONS: KRAS c.35 G > A mutant status may be significantly associated with a worse prognosis of MCRC pts treated with first line FIr-B/FOx intensive regimen compared to KRAS/BRAF wild type and other than c.35 G > A mutant pts