23 research outputs found
Tumeurs germinales seminomateuses du testicule de stade I à risque de rechute (évaluation rétrospective et comparative de deux modalités thérapeutiques sur une série de 142 patients traités au Centre Léon Bérard et à l'Institut Claudius Regaud)
TOULOUSE3-BU Santé-Centrale (315552105) / SudocTOULOUSE3-BU Santé-Allées (315552109) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Addressing heterogeneity in the design of phase II clinical trials in geriatric oncology
Immune checkpoint inhibitor-related acral vasculitis
Abstract Commentary on « Ipilimumab induced vasculitis » by Padda A. et al., J Immunother Cancer. 2018;6:12. The authors diagnosed a small vessel vasculitis following treatment with anti-CTLA-4 (ipilimumab) for a resected stage III B/C melanoma. We report a similar case of acral vasculitis occurring with a combination of anti-CTLA-4 (tremelimumab) and anti-PD-L1 (durvalumab) prescribed for the management of a metastatic urothelial bladder cancer. In contrast to Padda A. et al., we observed a significant improvement with oral corticosteroids
Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors in the Treatment of Advanced Renal Cancer
Seven tyrosine kinase inhibitor compounds with anti-angiogenic properties remain key drugs to treat advanced renal cell carcinoma. There is a strong rationale to develop therapeutic drug monitoring for these drugs. General considerations of such monitoring of the several groups of anticancer drugs are given, with a focus on oral therapy. Pharmacokinetics and the factors of inter- and intraindividual variabilities of these tyrosine kinase inhibitors are described together with an exhaustive presentation of their pharmacokinetic/pharmacodynamic relationships. The latter was observed in studies where every patient was treated with the same dose, and the results of several prospective studies based on dose individualization support the practice of increasing individual dosage in case of low observed plasma drug concentrations. Finally, the benefits and limits of therapeutic drug monitoring as a routine practice are discussed
Comment prendre en compte lâhĂ©tĂ©rogĂ©nĂ©itĂ© dans le schĂ©ma des essais cliniques de phase II en oncogĂ©riatrie ?
Taking care of older patients with cancer in the context of COVID-19 pandemic
International audienc
HFSâ14, a Specific Quality of Life Scale Developed for Patients Suffering from HandâFoot Syndrome
A Signal-Finding Study of Abemaciclib in Heavily Pretreated Patients with Metastatic Castration-Resistant Prostate Cancer : Results from CYCLONE 1
Purpose: Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors radically changed the treatment paradigm for breast cancer. Similar to estrogen receptor in breast cancer, androgen receptor signaling activates cyclin D-CDK4/6, driving proliferation and resistance to hormonal manipulation in prostate cancer. This study was designed to detect signals of clinical activity for abemaciclib in treatment-refractory metastatic castration-resistant prostate cancer (mCRPC). Patients and Methods: Eligible patients had progressive mCRPC, measurable disease, and previously received â„1 novel hormonal agent(s) and 2 lines of taxane chemotherapy. Abemaciclib 200 mg twice daily was administered on a continuous dosing schedule. Primary endpoint was objective response rate (ORR) without concurrent bone progression. This study was designed to detect a minimum ORR of 12.5%. Results: At trial entry, 40 (90.9%) of 44 patients had objective radiographic disease progression, 4 (9.1%) had prostate-specific antigen (PSA)-only progression, and 20 (46.5%) had visceral metastases (of these, 60% had liver metastases). Efficacy analyses are as follows: ORR without concurrent bone progression: 6.8%; disease control rate: 45.5%; median time to PSA progression: 6.5 months [95% confidence interval (CI), 3.2-NA]; median radiographic PFS; 2.7 months (95% CI, 1.9-3.7); and median OS, 8.4 months (95% CI, 5.6-12.7). Most frequent grade â„3 treatment-emergent adverse events (AE) were neutropenia (25.0%), anemia, and fatigue (11.4% each). No grade 4 or 5 AEs were related to abemaciclib. Conclusions: Abemaciclib monotherapy was well tolerated and showed clinical activity in this heavily pretreated population, nearly half with visceral metastases. This study is considered preliminary proof-of-concept and designates CDK4/6 as a valid therapeutic target in prostate cancer
Repenser la prise en charge des sujets ĂągĂ©s atteints dâun cancer : propositions du groupe PrioritĂ©s Ăge Cancer
International audienceThe growing incidence of cancer associated with an aging population implies important health challenges that require questioning on the care management of older adults with cancer. There is a need to rethink the care management of older cancer patients with patient-centered decisions and an adjustment of the care pathway for this population. The Priorities Age Cancer (PAC) French group, made up of physicians, pharmacists and researchers in geriatric oncology, set up proposals to answer this need. First, the heterogeneity and the specificities of older adults as well as their preferences regarding cancer treatment goals, care management decisions must be patient-centered. The frailty screening tools should be generalized in clinical practice to provide geriatric assessment-guided recommendations and help for treatment decisions, and patients' involvement and shared decision should be developed. Second, older adults with cancer confront a complex health care system that demands a high level of health literacy. The caregivers, playing an essential role, may not be prepared for all these challenges. Thus, there is a need to promote health literacy by patient education, and patient-experts should be involved in health pathway. Third, there is a need to deal with dedicated partners and adjust the care pathway. New pathway careers as case-management nurses and specialized pharmacists should be involved in patient care and may play a central role together with other careers. Community-Hospital coordination should also be reinforced.Plus de la moitiĂ© des cancers sont diagnostiquĂ©s chez des sujets ĂągĂ©s, et cette part va croĂźtre dans les prochaines annĂ©es. La prise en charge des patients ĂągĂ©s atteints dâun cancer constitue un dĂ©fi majeur, qui nĂ©cessite de placer le patient au cĆur des dĂ©cisions et de rĂ©organiser le parcours de soins, en repensant la collaboration entre les diffĂ©rents partenaires. Le groupe PrioritĂ©s Ăge Cancer, composĂ© de praticiens, de pharmaciens et de chercheurs en oncogĂ©riatrie, a Ă©mis plusieurs propositions afin de rĂ©pondre Ă ces besoins. ConsidĂ©rant lâhĂ©tĂ©rogĂ©nĂ©itĂ© et les spĂ©cificitĂ©s des sujets ĂągĂ©s, mais Ă©galement leurs prĂ©fĂ©rences, les dĂ©cisions thĂ©rapeutiques doivent ĂȘtre individualisĂ©es. Une gradation coordonnĂ©e des soins doit ĂȘtre rĂ©alisĂ©e en gĂ©nĂ©ralisant les outils de repĂ©rage de la fragilitĂ©. Lâimplication des patients doit ĂȘtre renforcĂ©e afin de dĂ©velopper une meilleure dĂ©cision partagĂ©e. Les patients ĂągĂ©s sont confrontĂ©s Ă un systĂšme de soins complexe qui exige un niveau Ă©levĂ© de littĂ©ratie pour comprendre les traitements et les diffĂ©rentes Ă©tapes du parcours de soins. Les aidants participent Ă la prise en charge de leurs proches, mais peuvent ne pas ĂȘtre prĂ©parĂ©s Ă relever les dĂ©fis, que ce rĂŽle essentiel implique. Il est nĂ©cessaire de renforcer lâinformation des patients, et promouvoir le rĂŽle des patients experts, mais Ă©galement de soutenir, former et intĂ©grer les aidants au parcours de soins. Il semble Ă©galement nĂ©cessaire dâimpliquer de nouveaux partenaires comme les pharmaciens ou les infirmiers formĂ©s Ă la gestion de cas. Le lien ville-hĂŽpital doit ĂȘtre renforcĂ©, notamment avec les acteurs du premier recours