Long-term disease-free survival in advanced melanomas treated with nitrosoureas: mechanisms and new perspectives

BACKGROUND: Median survival of metastatic malignant melanoma is 6.0 to 7.5 months, with a 5-year survival of ~6.0%. Although long-term complete remissions are rare, few reports describe cases after chemotherapy. Fifty-three patients with metastatic melanoma were treated with Cystemustine, a chloroethyl nitrosourea (CENU) (60 or 90 mg/m(2)). CASE PRESENTATION: We describe 5 cases, presenting with complete response with long-term disease-free survival of long-term remission of 14, 12, 9, 7 and 6 years after Cystemustine therapy alone. CONCLUSION: Long-term survival has already been described in literature, but in all cases they have been obtained after chemotherapy associated with or followed by surgery. But despite these noteworthy and encouraging but also rare results, it appears essential to increase cystemustine efficiency

Importance of metabolic changes induced by chemotherapy on prognosis of early-stage breast cancer patients: a review of potential mechanisms

International audienceWeight variation has been reported as a side effect of chemotherapy treatment in early breast cancer patients and has been identified as a factor of poor prognosis. Causes of weight variation during chemotherapy and mechanisms involved in the poor prognosis have been little studied. Here is reviewed the current knowledge about the main causes and mechanisms involved in body weight change. Special emphasis is placed on factors associated with weight variation which could potentially be involved in the risk of relapse in breast cancer survivors. In recent decades, some studies have investigated the causes of weight variation by studying energy balance of breast cancer patients during chemotherapy. Weight gain or loss may be the consequence of energy imbalance through different factors linked with chemotherapy, such as poor treatment tolerance, decreased muscle mass and function, or hormonal alterations. This results in body composition modifications in favour of fat gain and/or lean body mass loss. Increased adipose tissue, especially in the abdominal region, could induce metabolic disturbances such as insulin resistance, through various pathways involving adipokines. These molecules have growth properties and could therefore play a role in cancer relapse. Understanding such mechanisms is key to developing preventive strategies for improving the prognosis of early-stage breast cancer patients

Nanoparticules AGuIX1 et radiothérapie : du développement préclinique aux premiers essais chez l’homme

International audienceFor several years, the use of nanotechnology has been at the heart of research. The use of nanoparticles in oncology opens a vast field of clinical applications. Indeed, nanoparticles have the ability to act as radiosensitizers. They enhance the effectiveness of irradiation in tumor cells, and may represent a promising approach for the local treatment of tumors by external radiotherapy. In this context, the biotechnology company, NH TherAguix (Grenoble, France), has developed AGuIX (Activation and Guidance of Irradiation by X-ray) nanoparticles. These ultra-small nanoparticles, around 5 nm, are composed of a polysiloxane matrix and gadolinium chelates. The nanoparticles have very high radiosensitizing properties as well as contrast agent properties due to the presence of gadolinium. According to the various studies carried out, no signs of toxicity were observed in two animal species (rodents and monkeys) after intravenous administration. The biodistribution in different animal models has shown that the nanoparticles accumulate passively and selectively in tumours due to the EPR effect (Enhanced Permeability and Retention effect) and are cleared via renal elimination. A radiosensitizing effect has also been observed with different types of irradiation in vitro and in vivo on several types of cancers, including radio-resistant models. These promising nanoparticles are therefore currently undergoing clinical trials combined with radiotherapy in several centres in France and in the USA. This review summarizes the main preclinical results that have led to the first administration of AGuIX nanoparticles in humans.Depuis quelques années, l’utilisation des nanotechnologies est au cœur des recherches thérapeutiques. L’utilisation en cancérologie de nanoparticules ouvre un vaste champ d’applications cliniques. En effet, les nanoparticules ont la capacité d’agir comme des radiosensibilisants. Elles permettent d’améliorer l’efficacité de l’irradiation au niveau des cellules tumorales. Leur utilisation pourrait donc être une approche prometteuse pour le traitement local des tumeurs par radiothérapie externe. Dans ce contexte, la société de biotechnologies NH TherAguix (Grenoble, France) développe les nanoparticules AGuIX (Activation and Guidance of Irradiation by X-ray). Ce sont des nanoparticules de très petite taille, de l’ordre de 5 nm, constituées d’une matrice de polysiloxane et de chélates de gadolinium. Elles possèdent des propriétés radiosensibilisantes très importantes ainsi que des propriétés d’agent de contraste, grâce à la présence de gadolinium. D’après les différentes études réalisées, aucun signe de toxicité n’a été observé sur deux espèces animales (rongeurs et singes) après une administration intraveineuse. La biodistribution sur différents modèles animaux a prouvé une accumulation passive et sélective dans les tumeurs grâce à l’effet EPR (Enhanced Permeability and Retention effect) et une élimination rénale des nanoparticules après administration. Un effet radiosensibilisant a également été observé avec différents types d’irradiations in vitro et in vivo, sur plusieurs types de cancers, y compris des modèles radiorésistants. Ces nanoparticules prometteuses sont actuellement en cours d’évaluation dans des essais cliniques, en association avec la radiothérapie dans plusieurs centres en France et aux États-Unis. Cette revue résume ainsi les principaux résultats précliniques qui ont conduit à la première administration chez l’homme des nanoparticules AGuIX

Brown adipose tissue activity in relation to weight gain during chemotherapy in breast cancer patients: a pilot study

International audienceWeight gain has been reported in early stage breast cancer patients during chemotherapy, but the involved mechanisms remain unclear. A chemotherapy-induced decrease of brown adipose tissue (BAT) activity may partly contribute to weight gain in these patients. A positron emission tomography/computed tomography scan was performed at baseline and after 1 course of docetaxel + trastuzumab treatment in 26 breast cancer women. Variation of the maximal standardized uptake value of BAT in the cervical and supraclavicular regions between the 2 measures was assessed according to weight changes. Overall, (18)F-FDG uptakes in BAT decreased by 11.3% after 1 course of chemotherapy (p = 0.03). No correlation was found between the baseline values of (18)F-FDG uptake and body mass index or age of patients, but as expected (18)F-FDG uptake was dependent on season period. Among the patients, 35% gained weight, 25% lost weight, and 40% remained stable. Women who gained weight during chemotherapy experienced a significant decrease of (18)F-FDG uptake in BAT (p = 0.005). Decreased activity of BAT was associated with body weight gain during chemotherapy. These original data suggest for the first time that BAT modulation by chemotherapy would be a potential contributor to body weight gain through blunted thermogenesis in breast cancer patients

Attenuation of brown adipose tissue activity during chemotherapy treatment: a new mechanism of weight gain in breast cancer women?

International audienc

Impact d'une supplémentation orale en acide 13 cis rétinoique sur les fonctions leucocytaires : Etude chez des sujets sains jeunes et âgés

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