Niraparib maintenance treatment improves time without symptoms or toxicity (TWiST) versus routine surveillance in recurrent ovarian cancer: a TWiST analysis of the ENGOT-OV16/NOVA trial

Purpose: this study estimated time without symptoms or toxicity (TWiST) with niraparib compared with routine surveillance (RS) in the maintenance treatment of patients with recurrent ovarian cancer. Patients and methods: mean progression-free survival (PFS) was estimated for niraparib and RS by fitting parametric survival distributions to Kaplan-Meier data for 553 patients with recurrent ovarian cancer who were enrolled in the phase III ENGOT-OV16/NOVA trial. Patients were categorized according to the presence or absence of a germline BRCA mutation-gBRCAmut and non-gBRCAmut cohorts. Mean time with toxicity was estimated based on the area under the Kaplan-Meier curve for symptomatic grade 2 or greater fatigue, nausea, and vomiting adverse events (AEs). Time with toxicity was the number of days a patient experienced an AE post-random assignment and before disease progression. TWiST was estimated as the difference between mean PFS and time with toxicity. Uncertainty was explored using alternative PFS estimates and considering all symptomatic grade 2 or greater AEs. Results: in the gBRCAmut and non-gBRCAmut cohorts, niraparib treatment resulted in a mean PFS benefit of 3.23 years and 1.44 years, respectively, and a mean time with toxicity of 0.28 years and 0.10 years, respectively, compared with RS. Hence, niraparib treatment resulted in a mean TWiST benefit of 2.95 years and 1.34 years, respectively, compared with RS, which is equivalent to more than four-fold and two-fold increases in mean TWiST between niraparib and RS in the gBRCAmut and non-gBRCAmut cohorts, respectively. This TWiST benefit was consistent across all sensitivity analyses, including modeling PFS over 5-, 10-, and 15-year time horizons. Conclusion: patients who were treated with niraparib compared with RS experienced increased mean TWiST. Thus, patients who were treated with niraparib in the ENGOT-OV16/NOVA trial experienced more time without symptoms or symptomatic toxicities compared with control

Efficacy of trabectedin in metastatic solitary fibrous tumor

Solitary fibrous tumor is a rare tumor type and has an unpredictable course. Local recurrence rate varies between 9 and 19%, and rate of metastatic involvement between 0 and 36 %. It is characterized by a typical architecture and immuno-histochemistry tests. The most important prognostic factor is the complete resection of primary tumor. Treatment of recurrences is not clearly established. If a solitary fibrous tumor is too advanced to allow surgical resection, radiotherapy and chemotherapy may be used. The most often used drugs are doxorubicine and\or ifosfamide. We report the case of man with metastatic solitary fibrous tumor treated with trabectedin, administered at a dose of 1.5 mg/m² every 3 weeks. After 3 cycles, metastases had significantly decreased. Recurrence of the disease was demonstrated 8 months after the start of trabectedin. This case shows that trabectedin is a possible treatment option

Evaluation du bénéfice de la troisième ligne de chimiothérapie dans la prise en charge du cancer épithélial de l'ovaire récurrent

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF

Efficacité, tolérance et analyse du coût de la Trabectédine chez des patients présentant un sarcome des tissus mous (Une étude rétrospective bicentrique)

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF

Intérêt de la pharmacocinétique du 5-fluorouracile ?

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF

Cancer de l’ovaire : la rechute précoce

National audienceLa rechute précoce est définie par une récidive qui survient moins de 6 mois après la dernière injection de chimiothérapie à base de platine. Elle peut être primaire ou secondaire, et après une ou plusieurs lignes de traitements avec un sel de platine. Il n’y a pas d’indication à une chirurgie carcinologique. Il est recommandé une monochimiothérapie sans platine (doxorubicine liposomale pégylée [DLP], paclitaxel hebdomadaire, topotécan ou gemcitabine) en association avec du bévacizumab si la patiente n’en a pas reçu antérieurement (niveau de preuve 1, grade A). Early relapse (primary or secondary) is defined by relapse of disease less than 6 months before the last infusion of chemotherapy (with a platinum compound). There is no carcinological surgical indication. Disease should be treated with a non-platinum single agent (pegylated liposomal doxorubicin, weekly paclitaxel, gemcitabine or topotecan). Bevacizumab can be added if patients have not already received it (level of proof 1, grade A)

Mesure des concentrations intracellulaires de phosphate inorganique et d’ATP par Spectroscopie par Résonance Magnétique pendant une séance d’hémodialyse chez l’insuffisant rénal chronique terminal (Etude CIPHEMO).

International audienc

Surveillance des patients atteints de tumeur germinale du testicule

International audienc