146 research outputs found

    Oral Kaposi Sarcoma in two patients living with HIV despite sustained viral suppression : new clues

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    Kaposi sarcoma (KS) etiologically linked to Kaposi sarcoma-associated herpesvirus (KSHV) is the most common HIV associated cancer despite the generalization of antiretroviral therapy. Head, neck, and especially oral cavity are common and specific sites f

    A Solve-RD ClinVar-based reanalysis of 1522 index cases from ERN-ITHACA reveals common pitfalls and misinterpretations in exome sequencing

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    Purpose Within the Solve-RD project (https://solve-rd.eu/), the European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies aimed to investigate whether a reanalysis of exomes from unsolved cases based on ClinVar annotations could establish additional diagnoses. We present the results of the “ClinVar low-hanging fruit” reanalysis, reasons for the failure of previous analyses, and lessons learned. Methods Data from the first 3576 exomes (1522 probands and 2054 relatives) collected from European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies was reanalyzed by the Solve-RD consortium by evaluating for the presence of single-nucleotide variant, and small insertions and deletions already reported as (likely) pathogenic in ClinVar. Variants were filtered according to frequency, genotype, and mode of inheritance and reinterpreted. Results We identified causal variants in 59 cases (3.9%), 50 of them also raised by other approaches and 9 leading to new diagnoses, highlighting interpretation challenges: variants in genes not known to be involved in human disease at the time of the first analysis, misleading genotypes, or variants undetected by local pipelines (variants in off-target regions, low quality filters, low allelic balance, or high frequency). Conclusion The “ClinVar low-hanging fruit” analysis represents an effective, fast, and easy approach to recover causal variants from exome sequencing data, herewith contributing to the reduction of the diagnostic deadlock

    Marqueurs pronostiques dans une cohorte historico-prospective de Carcinomes de Merkel

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    Le carcinome de Merkel est un cancer cutanĂ© de diffĂ©renciation neuroendocrine rare, mais agressif, dont le facteur Ă©tiologique principal est le polyomavirus de Merkel (MCPyV). L’objectif de ce travail a Ă©tĂ© d’identifier des marqueurs virologiques et cellulaires pronostiques ou thĂ©ranostiques Ă  l’aide d’une cohorte historicoprospective de patients ayant un carcinome de Merkel. Les patients ayant des titres Ă©levĂ©s d’anticorps dirigĂ©s contre la protĂ©ine de capside VP1 du MCPyV ont un pronostic favorable, tandis les anticorps dirigĂ©s contre les oncoprotĂ©ines virales reflĂštent l’évolution tumorale. Par ailleurs, il existe une hĂ©tĂ©rogĂ©nĂ©itĂ© d’expression des rĂ©cepteurs Ă  la somatostatine dans les carcinomes de Merkel. Ce marqueur cellulaire peut constituer un outil thĂ©ranostique lors de thĂ©rapies ciblĂ©es utilisant les analogues de la somatostatine. Enfin, nos travaux actuels portent sur l’évaluation de l’immunitĂ© cellulaire chez ces patients, avec une Ă©tude ayant montrĂ© la valeur pronostique du ratio neutrophiles/lymphocytes sanguin

    Blood monitoring tests for Merkel Cell Carcinoma patients

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    La bouche, un monde inconnu ?

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    Palpez cette bouche que je ne saurais voir

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    Immune Checkpoint Inhibitors and Beyond: An Overview of Immune-Based Therapies in Merkel Cell Carcinoma

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    International audienceMerkel cell carcinoma (MCC) is an aggressive skin cancer. Until 2017, patients with advanced disease were typically treated with conventional chemotherapies, with a median response duration of 3 months. Increased evidence of the role of the immune system in controlling this cancer has paved the way for immune-based therapies, with programmed cell death protein 1 (PD-1)/programmed cell death protein ligand 1 (PD-L1) inhibitors at the frontline. Avelumab, an anti-PD-L1 antibody, was the first-ever drug approved in advanced MCC after showing meaningful efficacy in a second-line setting. Objective responses were observed in one-third of patients and, most importantly, were durable with half of patients and one-third of patients still alive at 1 and 2 years, respectively. When used in a first-line setting, PD-1/PD-L1 inhibitors (avelumab, pembrolizumab, nivolumab) are even more promising as objective responses are observed in approximately 50-70% of patients within the first 4-8 weeks of treatment. Safety profiles are acceptable with 10-20% of patients experiencing adverse events grade ≄ 3. PD-1/PD-L1 inhibitors are considered the standard of care in advanced MCC and are currently being investigated in the adjuvant and neoadjuvant settings. However, innovative treatments are still needed in the metastatic setting, as approximately 50% of these patients will not persistently respond to currently available immunotherapies, and no predictors of response are available yet. Therefore, other immunotherapeutic strategies are now being investigated-ideally in combinations-to enhance the various aspects of the immune response against tumoral cells
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