Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006

Neoadjuvant (primary systemic) treatment has become a standard option for primary operable disease for patients who are candidates for adjuvant systemic chemotherapy, irrespective of the size of the tumor. Because of new treatments and new understandings of breast cancer, however, recommendations published in 2006 regarding neoadjuvant treatment for operable disease required updating. Therefore, a third international panel of representatives of a number of breast cancer clinical research groups was convened in September 2006 to update these recommendations. As part of this effort, data published to date were critically reviewed and indications for neoadjuvant treatment were newly define

Oligometastasis in breast cancer-current status and treatment options from a radiation oncology perspective

Evidence from a few small randomized trials and retrospective cohorts mostly including various tumor entities indicates a prolongation of disease free survival (DFS) and overall survival (OS) from local ablative therapies in oligometastatic disease (OMD). However, it is still unclear which patients benefit most from this approach. We give an overview of the several aspects of stereotactic body radiotherapy (SBRT) in extracranial OMD in breast cancer from a radiation oncology perspective. A PubMed search referring to this was conducted. An attempt was made to relate the therapeutic efficacy of SBRT to various prognostic factors. Data from approximately 500 breast cancer patients treated with SBRT for OMD in mostly in small cohort studies have been published, consistently indicating high local tumor control rates and favorable progression-free (PFS) and overall survival (OS). Predictors for a good prognosis after SBRT are favorable biological subtype (hormone receptor positive, HER2 negative), solitary metastasis, bone-only metastasis, and long metastasis-free interval. However, definitive proof that SBRT in OMD breast cancer prolongs DFS or OS is lacking, since, with the exception of one small randomized trial (n = 22 in the SBRT arm), none of the cohort studies had an adequate control group. Further studies are needed to prove the benefit of SBRT in OMD breast cancer and to define adequate selection criteria. Currently, the use of local ablative SBRT should always be discussed in a multidisciplinary tumor board

Lessons from prospective longitudinal follow-up of a French APECED cohort

Background Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome is a rare disease caused by biallelic mutations of the AIRE gene, usually presenting with the triad hypoparathyroidism-adrenal failure-chronic mucocutaneous candidiasis (CMC) and nonendocrine manifestations. The aim of this study was to determine the molecular profile of the AIRE gene, the prevalence of rare manifestations, and to characterize immunological disturbances in a French cohort. Patients and Methods A national, multicenter prospective observational study to collect genetic, clinical, biological, and immunological data (NCT03751683). Results Twenty-five patients (23 families) were enrolled. Eleven distinct AIRE variants were identified, 2 of which were not previously reported: an intronic variant, c.653-70G > A, and a c.1066del (p.Arg356GlyfsX22) variant (exon 9). The most common was the Finnish variant c.769C > T (16 alleles), followed by the variant c.967_979del13 (15 alleles), which seemed associated with a less severe phenotype. Seventeen out of 25 patients were homozygote. The median number of clinical manifestations was 7; 19/25 patients presented with the hypoparathyroidism-adrenal failure-CMC triad, 8/13 showed pulmonary involvement, 20/25 had ectodermal dystrophy, 8/25 had malabsorption, and 6/23 had asplenia. Fifteen out of 19 patients had natural killer cell lymphopenia with an increase in CD4+ and CD8+ T lymphocytes and an age-dependent alteration of B lymphocyte homeostasis compared with matched controls (P < .001), related to the severity of the disease. All tested sera (n = 18) were positive for anti-interferon-α, 15/18 for anti-IL-22 antibodies, and 13/18 for anti-IL-17F antibodies, without clear phenotypic correlation other than with CMC. Conclusion This first prospective cohort showed a high AIRE genotype variability, with 2 new gene variants. The prevalence of potentially life-threatening nonendocrine manifestations was higher with systematic screening. These manifestations could, along with age-dependent B-cell lymphopenia, contribute to disease severity. Systematic screening for all the manifestations of the syndrome would allow earlier diagnosis, supporting vaccination and targeted therapeutic approaches

Impact de l'élévation artificielle de température induite par le fonctionnement du Centre Nucléaire de Production Electrique du Bugey (fleuve Rhône) sur les communautés de poissons

Nous présentons l'effet du réchauffement du Centre Nucléaire de Production Electrique (CNPE) du Bugey (Rhône, France) sur les communautés rivulaires de poissons. Les données ont été obtenues par pêche électrique en continu des rives de 9 stations, 4 fois par an, de 1979 à 1994, soit 519 pêches et 46 356 poissons. Les poissons quittent progressivement les bordures dès que la température dépasse 15 degrés. Un seuil est atteint à 25 °C où les animaux les plus gros désertent la zone. La chute des effectifs est alors de plus en plus rapide et un deuxième seuil apparaît à 29 °C avec l'effondrement du nombre d'espèces. La composition des pêches dépend de la température uniquement pour les adultes, avec trois grands groupes, moins de 6 °C, 7 à 24 °C, et plus de 25 °C. Ces trois groupes restent dans l'ordre biotypologique O-IV de Verneaux (1977) typique du haut Rhône. Des modifications importantes de structures liées au débit et à la saison sont observées, et contribuent à masquer l'effet thermique dans le groupe central. Ces trois facteurs expliquent 30% de la variabilité des données. L'attrait hivernal pour les veines réchauffées apparaît quantitativement nul, et ne concerne structurellement que la perche que ce contraste semble attirer. Les captures de juvéniles sont extrêmement variables et leur composition ne peut pas être reliée à la température. Le site du Bugey paraît bien supporter la charge thermique du CNPE, peut-être en partie du fait du mauvais mélange des masses d'eau à la sortie de la centrale

Chapter 27 RECOVERING ALTERNATIVE PRESENTATION MODELS OF A WEB PAGE WITH VAQUITA

Abstract VAQUITA allows developers to reverse engineer a presentation model of a web page according to multiple reverse engineering options. The alternative models offered by these options not only widen the spectrum of possible presentation models but also encourage developers in exploring multiple reverse engineering strategies. The options provide filtering capabilities in a static analysis of HTML code that are targeted either at multiple widgets simultaneously or at single widgets at a time, for their attributes and other manipulations. This flexibility is particularly important when the presentation model is itself used to migrate the presentation of the web page to other types of user interfaces, possibly written in different languages, in different computing platforms

On line liquid valve coupled to GCxGC technique

International audienc