Patterns of Disease Progression and Outcome of Patients With Testicular Seminoma Who Relapse After Adjuvant or Curative Radiation Therapy.

PURPOSE Radiation therapy is a possible treatment strategy for patients with testicular seminoma after orchiectomy in clinical stage I or II disease. Little is known about the outcome of patients who experience a relapse after radiation therapy. METHODS AND MATERIALS Data from 61 patients who relapsed after adjuvant or curative radiation therapy from 17 centers in 11 countries were collected and retrospectively analyzed. Primary outcomes were disease-free and overall survival. Secondary outcomes were time to relapse, stage at relapse, treatment for relapse, and rate of febrile neutropenia during chemotherapy for relapse. RESULTS With a median follow-up of 9.9 years (95% confidence interval [CI], 7.5-10.9), we found a 5-year disease-free survival of 90% (95% CI, 79-95) and a 5-year overall survival of 98% (95% CI, 89-100). Sixty-six percent of patients had stage III disease at time of relapse and 93% of patients fell into the good prognosis group per the International Germ Cell Cancer Collaborative Group classification. The median time to relapse after radiation therapy was 15.6 months (95% CI, 12-23). Twenty-two (36%) patients relapsed more than 2 years after radiation therapy and 7 (11.5%) patients relapsed more than 5 years after radiation therapy. One-third of relapses was detected owing to patients' symptoms, whereas two-thirds of relapses were detected during routine follow-up. The majority (93%) of cases were treated with cisplatin-based chemotherapy. The rate of febrile neutropenia during chemotherapy was 35%. Five patients experienced a second relapse. At last follow-up, 55 patients (90%) were alive without disease. Only 1 patient died owing to disease progression. CONCLUSIONS Cisplatin-based chemotherapy for patients with seminoma who have relapsed after treatment with radiation therapy alone leads to excellent outcomes. Patients and physicians should be aware of possible late relapses after radiation therapy

Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population

Réalisation de vidéos pédagogiques pour les travaux pratiques d odontologie conservatrice (thème abordé : les composites. Partie II, la pose de composite)

La transmission du savoir a de tout temps, et sous toutes ses formes, joué un rôle capital. L enseignement de l Odontologie Conservatrice lors de travaux pratiques a subi ces dernières années de profonds changements, dus notamment à l augmentation substantielle du nombre d étudiants, et à l apparition de nouvelles technologies en salle de simulation, comme le microscope opératoire par exemple. L objectif de ce travail est de développer de nouveaux supports pédagogiques pour les travaux pratiques d Odontologie Conservatrice en P.C.E.O.2 et D.C.E.O.1, concernant la pose de composites sur des cavités de site 2 stade 2, de site 2 stade 4 suite à carie, et de site 2 stade 4 suite à fracture sur incisive centrale maxillaire. Ce travail consiste premièrement en la réalisation de vidéos pédagogiques, par le biais d un microscope opératoire, décrivant les étapes successives de la réalisation des thèmes précédemment cités. En outre, il a donné lieu à la réalisation de diaporamas sur les trois thèmes abordés, qui seront utilisés en début de chaque séance de travaux pratiques, et permettront ainsi d uniformiser le discours transmis aux étudiants, l enseignant, quel qu il soit, disposant ainsi d une trame solide sur laquelle appuyer son discours. Cette thèse poursuit le travail commencé il y a de cela quelques années au sein de la sous-section d Odontologie Conservatrice-Endodontie de la Faculté d Odontologie de Lille, et dont le but est de couvrir l ensemble du programme pédagogique abordé durant les différentes années d études.LILLE2-UFR Odontologie (593502202) / SudocLILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Precision immunity: Immunoscore and neoadjuvant treatment in bladder cancer

International audienceThis review details the clinical utility of Immunoscore, measuring the immune response to cancer within the tumor microenvironment, in bladder cancer. Immunoscore was recently introduced into ESMO Clinical Practice Guidelines for gastrointestinal cancer and into the WHO classification of the Digestive System Tumors. In muscle-invasive bladder cancer (MIBC), the standard-of-care treatment is neo-adjuvant chemotherapy and cystectomy. However, only 50% of the patients are still alive at 5 years. The degree of histologic response positively correlated with Immunoscore and patients at lower risk of relapse or death were associated with a high-Immunoscore. Immunoscore is also predicting response to neoadjuvant chemotherapy-based treatment in several indications. This paves the way for the use of Immunoscore in clinical practice not only in gastrointestinal tumors but also in bladder cancer, and beyond

Innovation in Radionuclide Therapy for the Treatment of Prostate Cancers: Radiochemical Perspective and Recent Therapeutic Practices

Prostate cancer represents the second cause of death by cancer in males in western countries. While early-stage diseases are accessible to surgery and/or external radiotherapy, advanced metastatic prostate cancers are primarily treated with androgen deprivation therapy, to which new generation androgen receptor antagonists or taxane-based chemotherapies are added in the case of tumor relapse. Nevertheless, patients become invariably resistant to castration with a median survival that rarely exceeds 3 years. This fostered the search for alternative strategies, independent of the androgen receptor signaling pathway. In this line, radionuclide therapies may represent an interesting option as they could target either the microenvironment of sclerotic bone metastases with the use of radiopharmaceuticals containing samarium-153, strontium-89 or radium-223 or tumor cells expressing the prostate-specific membrane antigen (PSMA), a protein found at the surface of prostate cancer cells. This review gives highlights the chemical properties of radioligands targeting prostate cancer cells and recapitulates the clinical trials evaluating the efficacy of radionuclide therapies, alone or in combination with other approved treatments, in patients with castration-resistant prostate tumors. It discusses some of the encouraging results obtained, especially the benefit on overall survival that was reported with [177Lu]-PSMA-617. It also addresses the specific requirements for the use of this particular class of drugs, both in terms of medical staff coordination and adapted infrastructures for efficient radioprotection

In vitro virucidal activity of nebulized citrate-complexed silver nanoparticles against equine herpesvirus-1 and murine norovirus

peer reviewedViruses can be involved in respiratory disorders in horses, with limited therapeutic options. Citrate-complexed silver nanoparticles (C–AgNP) have shown bactericidal properties after in vitro nebulization. The aim of the present study was to assess the virucidal activity of C–AgNP after in vitro instillation or nebulization on equine herpesvirus-1 (EHV-1) and murine norovirus (MNV), the latter used as surrogate for small non-enveloped viruses. Both viruses were instilled or nebulized with C–AgNP of increasing concentrations, and titres were determined via TCID50 method. We demonstrated efficient inactivation of enveloped EHV-1 following instillation and nebulization of C–AgNP (infectivity losses of ≥ three orders of magnitude). While tenacious MNV was inactivated via 2000 ppm C–AgNP instillation, nebulized C–AgNP did not lead to reduction in MNV titres. Nebulization of C–AgNP may represent a novel virucidal therapeutic approach in horses. Further investigations are needed to assess its safety and effective concentrations for in vivo use

Pharmaceutical consultation to detect drug interactions in patients treated with oral chemotherapies: A descriptive cross‐sectional study

International audienc

Leg electrical resistance predicts venous blood viscosity and hematocrit

International audienc

Human Immunodeficiency Virus (HIV) Type 1 Reverse Transcriptase Resistance Mutations in Hepatitis B Virus (HBV)-HIV-Coinfected Patients Treated for HBV Chronic Infection Once Daily with 10 Milligrams of Adefovir Dipivoxil Combined with Lamivudine

Adefovir dipivoxil (ADV) at a suboptimal concentration for human immunodeficiency virus type 1 (HIV-1) (10 mg once daily) can be used to treat hepatitis B virus (HBV) infection in HIV-1-HBV-coinfected patients and does not, even in the case of uncontrolled HIV-1 replication, select for either ADV mutations at codons 65 and 70 or any other particular HIV-1 reverse transcriptase resistance profile

Added value of hepcidin quantification for the diagnosis and follow-up of anemia-related diseases.

International audienceIron homeostasis is based on a strict control of both intestinal iron absorption and iron recycling through reticulo-endothelial system. Hepcidin controls the iron fluxes in order to maintain sufficient iron levels for erythropoietic activities, hemoproteins synthesis or enzymes function, but also to limit its toxic accumulation throughout the body. Hepcidin expression is regulated by various stimuli: inflammation and iron stimulate the production of the peptide, while anemia, erythropoiesis and hypoxia repress its production. Regulation of hepcidin expression is not so simple in complex pathological situations such as hemolytic anemia, cancer or chronic inflammation. Serum hepcidin quantification in association with the diagnostic tests currently available is quite promising for the diagnosis or the follow-up of anemia in those conditions. This study is part of the working group « Clinical interests of hepcidin quantification » of the Société française de biologie clinique