Bulletin Du Cancer最新文献

{"title":"Tislelizumab en deuxième ligne de traitement du carcinome épidermoïde avancé de l’œsophage après échec des sels de platine","authors":"Jeanne Duval , Aziz Zaanan","doi":"10.1016/j.bulcan.2024.03.006","DOIUrl":"10.1016/j.bulcan.2024.03.006","url":null,"abstract":"","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 629-631"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principaux troubles hydro-électrolytiques chez le patient de cancérologie","authors":"Arnaud Saillant , Mélanie Try , Ariane Laparra , Anne-Lise Lecoq , Mohamad Zaidan","doi":"10.1016/j.bulcan.2023.04.014","DOIUrl":"10.1016/j.bulcan.2023.04.014","url":null,"abstract":"<div><p>Les troubles hydro-électrolytiques sont fréquents chez les patients suivis en cancérologie et le plus souvent, les étiologies ne diffèrent pas de la population générale. Ces troubles hydro-électrolytiques peuvent également être liés au cancer ou à son traitement. Ils sont associés à une plus grande morbi-mortalité dans cette population et nécessitent une vigilance accrue de la part de l’oncologue ainsi qu’un travail pluridisciplinaire. L’hyponatrémie est le trouble hydro-électrolytique le plus fréquent, souvent multifactorielle, d’origine iatrogène ou secondaire à un syndrome de sécrétion inapproprié d’hormone antidiurétique, généralement dans le cadre d’un carcinome bronchique à petites cellules. Plus rarement, l’hyponatrémie peut révéler une insuffisance surrénalienne. L’hypokaliémie est généralement multifactorielle et associée à d’autres troubles hydro-électrolytiques. Le cisplatine et l’ifosfamide sont responsables de tubulopathies proximales avec notamment une hypokaliémie et/ou une hypophosphatémie. L’hypomagnésémie est souvent iatrogène, liée au cisplatine ou au cétuximab, mais peut être prévenue par supplémentation. L’hypercalcémie est également fréquente et peut être source d’altération de la qualité de vie, voire menacer le pronostic vital dans les cas les plus sévères. L’hypocalcémie, moins fréquente, est souvent d’origine iatrogène. Enfin, le syndrome de lyse est une urgence diagnostique et thérapeutique qui grève le pronostic des patients, souvent en début de prise en charge. Il est plus fréquent chez les patients suivis en hématologie, mais son incidence tend à augmenter en cancérologie solide en lien avec l’amélioration des thérapeutiques. La prévention et le diagnostic précoce des troubles hydro-électrolytiques sont primordiaux afin d’optimiser la prise en charge globale des patients suivis en oncologie. L’objectif de cette revue est de faire une synthèse des principaux troubles hydro-électrolytiques et de leur prise en charge.</p></div><div><p>Electrolyte disorders (ED) are common in patients with cancer and in most cases, the etiologies do not differ from the general population. They may also be induced by the cancer, its therapy or paraneoplastic syndromes. ED are associated with poor outcomes, increased morbidity and mortality in this population. Hyponatremia is the most common disorder, often multifactorial, iatrogenic or secondary to the syndrome of inappropriate antidiuretic hormone secretion, usually due to small cell lung cancer. More rarely, hyponatremia may reveal adrenal insufficiency. Hypokalemia is generally multifactorial and associated with other ED. Cisplatin and ifosfamide induce proximal tubulopathies with hypokalemia and/or hypophosphatemia. Hypomagnesemia is often iatrogenic, related to cisplatin or cetuximab, but can be prevented by supplementation. Hypercalcemia can impair life quality and be life-threatening in the most severe cases. Hypocalcemia is less common and often of iatrogenic origin. Final","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 687-700"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temps et espaces dans les parcours de soins de femmes souffrant d’un cancer du sein","authors":"Caroline Desprès , Audrey Bochaton , Benoît Conti , Hélène Charreire , Sandrine Baffert , Charlotte Ngo","doi":"10.1016/j.bulcan.2024.04.006","DOIUrl":"10.1016/j.bulcan.2024.04.006","url":null,"abstract":"<div><p>Face au cancer du sein, les femmes en situation de précarité ont plus de risque d’être dépistées à un stade avancé, et même à stade égal, elles meurent davantage et plus rapidement. Dans cet article, nous analysons un corpus de 40 entretiens semi-dirigés réalisés dans six services de cancérologie d’Île-de-France portant sur les parcours de soins de femmes souffrant d’un cancer du sein. L’analyse porte sur le début des parcours (jusqu’aux premiers soins) et se focalise sur la dimension spatiale et temporelle de ces derniers à l’aune de la précarité dans ses multiples dimensions. Selon les situations des femmes vis-à-vis de la précarité, la structuration spatiale des parcours et leur chronologie diffèrent. Il existe des temps de latence socialement différenciés qui retardent le diagnostic (en amont d’une rencontre avec un professionnel de santé) ou le début des soins (en lien avec les droits, la réactivité du système de soins, les interactions entre les femmes et le système). Sur le plan spatial, les parcours à géométrie variable reflètent des positionnements et des attentes différenciés selon les profils sociaux des femmes vis-à-vis des institutions sanitaires et du personnel médical. L’analyse fine des parcours permet néanmoins de nuancer ces différences au regard de la précarité. Ainsi, la capacité d’autonomie des femmes, l’accessibilité et la réactivité du système de soins, le réseau d’inter-connaissances des femmes ainsi que la dimension sensible et émotive de cet épisode éprouvant affectent les parcours aussi bien sur le plan du temps que de l’espace.</p></div><div><p>Facing breast cancer, women in precarious situations are more likely to be diagnosed at an advanced stage, and when detected at the same stage, they are more to die as well as faster. In this paper, we analyze a corpus of 40 semi-structured interviews conducted in six cancer services in hospitals of the Paris area on the care pathways of women with breast cancer. The analysis focuses on the beginning of the pathways (until the first treatments) and concentrates on their spatial and temporal dimension in the light of precariousness. Depending on the women's situations with regard to precariousness, the spatial and temporal organization of the pathways differs. There are socially differentiated latency periods that delay diagnosis (prior to meeting a medical professional) or the beginning of treatment (in relation to rights, the responsiveness of the health care system, and the interactions between women and the system). Spatially, the geometry of the pathways is variable and reflects different expectations of health institutions and medical staff according to the social profiles of the women. However, a detailed analysis of the pathways allows us to nuance these differences in terms of precariousness. The women's capacity to be autonomous, their network of contacts, the accessibility and responsiveness of the health care system, as well as the sensitive and emotional dime","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 646-660"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0007455124001802/pdfft?md5=2eb7392cf50c1d333982dae29f28a146&pid=1-s2.0-S0007455124001802-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthèse des profils de toxicité des anticorps drogue-conjugués dans le cancer du sein","authors":"Bérénice Collineau ,&nbsp;Anthony Gonçalves ,&nbsp;François Bertucci ,&nbsp;Alexandre de Nonneville","doi":"10.1016/j.bulcan.2024.04.004","DOIUrl":"10.1016/j.bulcan.2024.04.004","url":null,"abstract":"<div><p>L’arsenal thérapeutique du cancer du sein s’est enrichi de nouveaux anticorps drogues-conjugués dont l’utilisation est en large expansion dans l’ensemble des sous-types moléculaires connus. Ils représentent une classe thérapeutique innovante dont le principe repose sur la combinaison d’un agent cytotoxique à un anticorps monoclonal via une molécule de liaison, et dont l’objectif est de délivrer une chimiothérapie préférentiellement aux cellules exprimant l’antigène cible, et ainsi améliorer l’index thérapeutique. Le trastuzumab-emtansine a été le premier anticorps drogues-conjugués utilisé dans les cancers du sein HER2-surepxrimé. Plus récemment, le trastuzumab-deruxtecan et le sacituzumab-govitecan ont démontré une efficacité en survie sans progression et en survie globale dans les cancers du sein HER2-surexprimé et HER2-faibles pour le premier, et HER2-non surexprimé pour le second (incluant HER2-faible). De nombreux autres anticorps drogues-conjugués sont en cours de développement dans le cancer du sein. Bien qu’initialement développés avec l’intention d’élargir l’index thérapeutique et de limiter les toxicités, la gestion des effets indésirables liés aux anticorps drogues-conjugués reste un défi en clinique. L’objectif de cet article de synthèse est de rapporter les profils de toxicité de ces drogues déjà utilisées en pratique clinique courante ou en développement à travers les résultats observés dans les différentes études.</p></div><div><p>Therapeutic options for breast cancer have recently been enriched by new antibody-drug conjugates (ADC), which are now being utilized across all known molecular subtypes. ADCs represent a groundbreaking class of therapies that combine a cytotoxic agent with a monoclonal antibody via a combination molecule (linker). The primary objective is to selectively deliver chemotherapy to cells expressing the target antigen, thereby enhancing the therapeutic index. Trastuzumab-emtansine marked the pioneering use of this approach for HER2-overexpressed breast cancer. More recently, trastuzumab-deruxtecan and sacituzumab-govitecan have demonstrated efficacy in progression-free survival and overall survival in HER2-overexpressed and HER2-low breast cancer for the former, and HER2-non-overexpressed (including HER-low) for the latter. Numerous other ADCs are currently under development in breast cancer. While ADCs were initially designed to widen the therapeutic index and mitigate toxicities, managing ADC-related adverse events in the clinical setting remains a challenge. This review article aims to provide an overview of the toxicity profiles of these drugs already in current clinical practice or under development, drawing from results observed in various studies.</p></div>","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 765-781"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0007455124001553/pdfft?md5=864cb919da27cb0486c86848121925ef&pid=1-s2.0-S0007455124001553-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dernières nouveautés sur la glomérulopathie immunotactoïde et la glomérulonéphrite fibrillaire","authors":"Marie-Camille Lafargue ,&nbsp;Camille Cohen","doi":"10.1016/j.bulcan.2022.12.014","DOIUrl":"10.1016/j.bulcan.2022.12.014","url":null,"abstract":"<div><p>Diverses hémopathies malignes peuvent entraîner des complications rénales. La plus fréquente d’entre elles à atteindre le rein est le myélome multiple. Cependant un nombre croissant de maladies rénales sont associées avec d’autres gammapathies monoclonales. Il est reconnu que des clones en petite abondance peuvent être responsables de dommages d’organe sévère. C’est ainsi qu’est apparu le concept de gammapathie monoclonale de signification rénale (MGRS). Bien que l’hémopathie chez ces patients corresponde davantage à une gammapathie monoclonale de signification indéterminée (MGUS) qu’à un myélome multiple, le diagnostic d’une complication rénale change la prise en charge thérapeutique. La préservation et la restauration de la fonction rénale sont possibles avec un traitement ciblant le clone responsable. Dans cet article, nous prenons comme exemple la glomérulopathie immunotactoïde et fibrillaire, deux entités distinctes aux étiologies différentes et par conséquent ayant une prise en charge propre. La glomérulopathie immunotactoïde est le plus souvent associée à une gammapathie monoclonale ou une leucémie lymphoïde chronique. Les dépôts sur la biopsie rénale sont monotypiques, et le traitement repose donc sur le ciblage du clone. La glomérulonéphrite fibrillaire, quant à elle, est plutôt causée par des maladies auto-immunes ou des cancers solides. Les dépôts sur la biopsie rénale sont dans la majorité des cas polyclonaux. Il existe un marqueur spécifique en immunohistochimie, le DNAJB9, et le traitement est moins bien codifié.</p></div><div><p>Various hematologic malignancies can lead to renal complications. The most common of these hemopathies to affect the kidney is multiple myeloma, however an increasing number of kidney diseases are associated with other monoclonal gammopathies. It is recognized that clones in small abundance can be responsible for severe organ damage, thus the concept of monoclonal gammopathy of renal significance (MGRS) has emerged. Although the hemopathy in these patients is more consistent with monoclonal gammopathy of undetermined significance (MGUS) than with multiple myeloma, the diagnosis of a renal complication changes the therapeutic management. Preservation and restoration of renal function is possible with treatment targeting the responsible clone. In this article, we take as an example immunotactoid and fibrillary glomerulopathies, two distinct entities with different etiologies and consequently different management. Immunotactoid glomerulopathy is most often associated with monoclonal gammopathy or chronic lymphocytic leukemia, the deposits on renal biopsy are monotypic, and treatment is therefore based on clone targeting. Fibrillary glomerulonephritis, on the other hand, is caused by autoimmune diseases or solid cancers. Deposits on renal biopsy are in the vast majority polyclonal. There is a specific immunohistochemical marker, DNAJB9, and treatment is less well established.</p></div>","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 741-747"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury after CAR-T cell infusion","authors":"Adrien Rousseau ,&nbsp;Lara Zafrani","doi":"10.1016/j.bulcan.2022.08.014","DOIUrl":"10.1016/j.bulcan.2022.08.014","url":null,"abstract":"<div><p><span><span><span>Chimeric antigen receptor T (CAR-T)-cell, an adaptive immune therapy is approved for patients with </span>acute lymphoblastic leukemia and diffuse large B-cell lymphoma. Its use and subsequent toxicities are expected to rise in the coming years. The main toxicities are </span>cytokine release syndrome<span><span><span>, hemophagocytic lymphohistiocytosis<span> and immune effector cell associated </span></span>neurotoxicity syndrome. Cytokine release syndrome is observed in up to 40% of patients. Almost 20% of patient suffer from </span>acute kidney injury<span> after CAR-T cell infusion. Associated factors are high-grade cytokine release syndrome, a prior autologous or allogeneic stem cell transplantation andrequirement of </span></span></span>intensive care unit<span><span>. Several mechanisms may contribute to the occurrence of acute kidney injury after CAR-T infusion: hypoperfusion during cytokine release syndrome, cytokine injury, T cell infiltration, </span>tumor lysis syndrome and sepsis-induced injury. Kidney injury is associated with substantial increase in morbi-mortality.</span></p></div>","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 748-753"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33499206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Précarité : un marqueur de risque important en oncologie, même dans les pays riches","authors":"Emmanuelle Kempf ,&nbsp;Gilles Chatellier","doi":"10.1016/j.bulcan.2024.05.003","DOIUrl":"10.1016/j.bulcan.2024.05.003","url":null,"abstract":"","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 625-627"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’onco-néphrologie : origines, organisation et perspectives","authors":"Matthieu Delaye ,&nbsp;Jacques-Olivier Bay ,&nbsp;Antoine Thiery-Vuillemin ,&nbsp;Corinne Isnard-Bagnis","doi":"10.1016/j.bulcan.2022.06.008","DOIUrl":"10.1016/j.bulcan.2022.06.008","url":null,"abstract":"","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 661-662"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cancer treatments in hemodialysis patients","authors":"Paul Matte ,&nbsp;Kevin Bihan ,&nbsp;Corinne Isnard-Bagnis ,&nbsp;Noël Zahr ,&nbsp;Antoine Thiery-Vuillemin ,&nbsp;Paul Gougis ,&nbsp;Luca Campedel","doi":"10.1016/j.bulcan.2023.01.018","DOIUrl":"10.1016/j.bulcan.2023.01.018","url":null,"abstract":"<div><h3>Introduction</h3><p>The number of cancer patients receiving long-term hemodialysis (HD) is increasing, and HD could jeopardize treatments’ safety and efficacy. Therefore, managing anticancer drugs is critical in this frail population. In addition, evidence of HD safety or risk is regularly released both for cytotoxic chemotherapy (CT) or hormone therapy (HT) as well as new therapies with molecularly targeted therapies (MTT), immune checkpoint inhibitors (ICI), and a summary of current knowledge is needed.</p></div><div><h3>Methods</h3><p>We aimed to synthesize available data on cancer treatments in HD patients using PubMed database, FDA labels, summary of product characteristics (SmPC), FDA and EMA approval documents, guidelines and finally case reports for which relevant pharmacokinetic (PK) data is available.</p></div><div><h3>Results</h3><p>For CT, recently proposed guidelines were balanced by the publication of particular toxic reports following them. SmPC was helpful in some cases, but no data was found for most CTs. MTT, both oral and monoclonal antibodies, were rarely modified by HD. However, HD patients have particular frailty that could require dose adaptation despite no substantial PK modification. Similarly, exposure to ICIs is unlikely to be modified by HD since immunoglobulins are not dialyzable. For HT, PK characteristics and HD impact were more heterogeneous and were reviewed molecule by molecule.</p></div><div><h3>Conclusions</h3><p>We summarized current knowledge on HD and cancer treatments. Data remains scarce, and the latest guidelines rely on few clinical data. There is a need to collect both retrospective and prospective data to better characterize the safety and relevant dose and schedule adaptations whenever needed in this situation to reinforce future guidelines.</p></div>","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 7","pages":"Pages 701-719"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9484738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer : le besoin de croire","authors":"Sylvain Garciaz,&nbsp;Alexandre de Nonneville,&nbsp;Dominique Maraninchi","doi":"10.1016/j.bulcan.2024.04.001","DOIUrl":"10.1016/j.bulcan.2024.04.001","url":null,"abstract":"","PeriodicalId":9365,"journal":{"name":"Bulletin Du Cancer","volume":"111 6","pages":"Pages 550-551"},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}