Menée à partir de données portant sur 315 patients atteints d'un cancer de la prostate de stade pN1 traité entre 2000 et 2012 (durée médiane de suivi : 54 mois), cette étude met en évidence une association entre le nombre de ganglions pelviens réséqués durant l'intervention chirurgicale et la survie spécifique des patients

More Extensive Pelvic Lymph Node Dissection Improves Survival in Patients with Node-positive Prostate Cancer

Abdollah, Firas ; Gandaglia, Giorgio ; Suardi, Nazareno ; Capitanio, Umberto ; Salonia, Andrea ; Nini, Alessandro ; Moschini, Marco ; Sun, Maxine ; Karakiewicz, Pierre I. ; Shariat, Sharhokh F. ; Montorsi, Francesco ; Briganti, Alberto

Background : The role of extended pelvic lymph node dissection (ePLND) in treating prostate cancer (PCa) patients with lymph node invasion (LNI) remains controversial. Objective : The relationship between the number of removed lymph nodes (RLNs) and cancer-specific mortality (CSM) was tested in patients with LNI. Design, setting, and participants : We examined data of 315 pN1 PCa patients treated with radical prostatectomy (RP) and anatomically ePLND between 2000 and 2012 at one tertiary care [...]

Menée aux Etats-Unis et en Suède sur 227 patients présentant une masse rénale suspecte traitée entre 2006 et 2013 (âge médian : 60 ans ; durée médiane de suivi : 2,7 ans), cette étude rétrospective multicentrique évalue, du point de vue de données péri- et intra-opératoires, de la qualité des marges de résection et de la récidive, l'efficacité d'une néphrectomie partielle rétropéritonéoscopique assistée par robot

Technique and Outcomes of Robot-assisted Retroperitoneoscopic Partial Nephrectomy: A Multicenter Study

Hu, Jim C. ; Treat, Eric ; Filson, Christopher P. ; McLaren, Ian ; Xiong, Siwei ; Stepanian, Sevan ; Hafez, Khaled S. ; Weizer, Alon Z. ; Porter, James

Background : Robot-assisted retroperitoneoscopic partial nephrectomy (RARPN) may be used for posterior renal masses or with prior abdominal surgery; however, there is relatively less familiarity with RARPN. Objective : To demonstrate RARPN technique and outcomes. Design, setting, and participants : A retrospective multicenter study of 227 consecutive RARPNs was performed at the Swedish Medical Center, the University of Michigan, and the University of California, Los Angeles, from 2006 to 2013. [...]

Mené sur 98 patientes atteintes d'un cancer du sein de stade I traité entre 2003 et 2006, cet essai de phase I évalue les résultats esthétiques à long terme et la toxicité d'une protonthérapie par rapport à une irradiation partielle accélérée du sein par radiothérapie conformationnelle 3D à base de photons

Long-Term Cosmetic Outcomes and Toxicities of Proton Beam Therapy Compared With Photon-Based 3-Dimensional Conformal Accelerated Partial-Breast Irradiation: A Phase 1 Trial

Galland-Girodet, Sigolène ; Pashtan, Itai ; MacDonald, Shannon M. ; Ancukiewicz, Marek ; Hirsch, Ariel E. ; Kachnic, Lisa A. ; Specht, Michelle ; Gadd, Michele ; Smith, Barbara L. ; Powell, Simon N. ; Recht, Abram ; Taghian, Alphonse G.

Purpose : To present long-term outcomes of a prospective feasibility trial using either protons or 3-dimensional conformal photon-based (accelerated partial-breast irradiation [APBI]) techniques. Methods and Materials : From October 2003 to April 2006, 98 evaluable patients with stage I breast cancer were treated with APBI (32 Gy in 8 fractions given twice daily) on a prospective clinical trial: 19 with proton beam therapy (PBT) and 79 with photons or mixed photons/electrons. Median follow-up [...]

Menée à partir de données portant sur 438 mastectomies épargnant le mamelon réalisées sur la période 2007-2012, cette étude analyse la prise en charge thérapeutique des patientes dont les marges de résection impliquant le tissu sub-aréolaire ou les canaux du mamelon sont positives

Management of Positive Sub-areolar/Nipple Duct Margins in Nipple-Sparing Mastectomies

Camp, Melissa S. ; Coopey, Suzanne B. ; Tang, Rong ; Colwell, Amy ; Specht, Michelle ; Greenup, Rachel A. ; Gadd, Michele A. ; Brachtel, Elena ; Austen, William G. ; Smith, Barbara L.

We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies [...]

Menée in vitro et in vivo, cette étude analyse les mécanismes d'activité antitumorale et la toxicité du nivolumab, un anticorps monoclonal anti PD-1

In vitro Characterization of the Anti-PD-1 Antibody Nivolumab, BMS-936558, and in vivo Toxicology in Non-Human Primates

Wang, Changyu ; Thudium, Kent B ; Han, Minhua ; Wang, Xi-Tao ; Huang, Haichun ; Feingersh, Diane ; Garcia, Candy ; Wu, Yi ; Kuhne, Michelle ; Srinivasan, Mohan ; Singh, Sujata ; Wong, Susan ; Garner, Neysa ; Leblanc, Heidi ; Bunch, Todd ; Blanset, Diann ; Selby, Mark ; Korman, Alan J

The programmed death-1 (PD-1) receptor serves as an immunologic checkpoint, limiting bystander tissue damage and preventing the development of autoimmunity during inflammatory responses. PD-1 is expressed by activated T cells and down-modulates T-cell effector functions upon binding to its ligands, PD-L1 and PD-L2, on antigen-presenting cells. In patients with cancer, the expression of PD-1 on tumor-infiltrating lymphocytes and its interaction with the ligands on tumor and immune cells in the [...]

A partir d'échantillons sanguins prélevés sur des patients atteints d'un cancer métastatique de la prostate ou d'un mélanome métastatique traité par ipilimumab, cette étude met en évidence des mécanismes permettant de rendre compte de l'activité antitumorale des anticorps monoclonaux anti CTLA-4

Improved Survival with T Cell Clonotype Stability After Anti–CTLA-4 Treatment in Cancer Patients

Cha, Edward ; Klinger, Mark ; Hou, Yafei ; Cummings, Craig ; Ribas, Antoni ; Faham, Malek ; Fong, Lawrence

Cytotoxic T lymphocyte–associated antigen-4 (CTLA-4) blockade can promote antitumor T cell immunity and clinical responses. The mechanism by which anti–CTLA-4 antibodies induces antitumor responses is controversial. To determine the effects of CTLA-4 blockade on the T cell repertoire, we used next-generation deep sequencing to measure the frequency of individual rearranged T cell receptor β (TCRβ) genes, thereby characterizing the diversity of rearrangements, known as T cell clonotypes. CTLA-4 [...]

Menée in vitro et sur 15 patients atteints d'une leucémie myéloïde aiguë, cette étude met en évidence des mécanismes par lesquels la protéine GLI1 favorise l'apparition d'une résistance à un traitement à base de ribavirine et de cytarabine

The sonic hedgehog factor GLI1 imparts drug resistance through inducible glucuronidation

Zahreddine, Hiba Ahmad ; Culjkovic-Kraljacic, Biljana ; Assouline, Sarit ; Gendron, Patrick ; Romeo, Andrea A. ; Morris, Stephen J. ; Cormack, Gregory ; Jaquith, James B. ; Cerchietti, Leandro ; Cocolakis, Eftihia ; Amri, Abdellatif ; Bergeron, Julie ; Leber, Brian ; Becker, Michael W. ; Pei, Shanshan ; Jordan, Craig T. ; Miller, Wilson H. ; Borden, Katherine L. B.

Drug resistance is a major hurdle in oncology. Responses of acute myeloid leukaemia (AML) patients to cytarabine (Ara-C)-based therapies are often short lived with a median overall survival of months. Therapies are under development to improve outcomes and include targeting the eukaryotic translation initiation factor (eIF4E) with its inhibitor ribavirin. In a Phase II clinical trial in poor prognosis AML5, ribavirin monotherapy yielded promising responses including remissions; however, all [...]

Menée à l'aide d'un modèle murin, cette étude suggère l'intérêt d'une combinaison alisertib-vincristine-rituximab pour le traitement de patients atteints d'un lymphome diffus à grandes cellules B

Alisertib Added to Rituximab and Vincristine Is Synthetic Lethal and Potentially Curative in Mice with Aggressive DLBCL Co-Overexpressing MYC and BCL2

Mahadevan, Daruka ; Morales, Carla ; Cooke, Laurence S. ; Manziello, Ann ; Mount, David W. ; Persky, Daniel O. ; Fisher, Richard I. ; Miller, Thomas P. ; Qi, Wenqing

Pearson correlation coefficient for expression analysis of the Lymphoma/Leukemia Molecular Profiling Project (LLMPP) demonstrated Aurora A and B are highly correlated with MYC in DLBCL and mantle cell lymphoma (MCL), while both Auroras correlate with BCL2 only in DLBCL. Auroras are up-regulated by MYC dysregulation with associated aneuploidy and resistance to microtubule targeted agents such as vincristine. Myc and Bcl2 are differentially expressed in U-2932, TMD-8, OCI-Ly10 and Granta-519, but [...]

Menée in vitro, in vivo et sur des patients atteints d'une tumeur à cellules géantes de type diffus, cette étude évalue l'activité antitumorale d'un anticorps monoclonal ciblant les macrophages par l'inhibition du récepteur CSF-1R

Targeting Tumor-Associated Macrophages with Anti-CSF-1R Antibody Reveals a Strategy for Cancer Therapy

Ries, Carola H ; Cannarile, Michael A ; Hoves, Sabine ; Benz, Jörg ; Wartha, Katharina ; Runza, Valeria ; Rey-Giraud, Flora ; Pradel, Leon P ; Feuerhake, Friedrich ; Klaman, Irina ; Jones, Tobin ; Jucknischke, Ute ; Scheiblich, Stefan ; Kaluza, Klaus ; Gorr, Ingo H ; Walz, Antje ; Abiraj, Keelara ; Cassier, Philippe A ; Sica, Antonio ; Gomez-Roca, Carlos ; de Visser, Karin E ; Italiano, Antoine ; Le Tourneau, Christophe ; Delord, Jean-Pierre ; Levitsky, Hyam ; Blay, Jean-Yves ; Rüttinger, Dominik

Macrophage infiltration has been identified as an independent poor prognostic factor in several cancer types. The major survival factor for these macrophages is macrophage colony-stimulating factor 1 (CSF-1). We generated a monoclonal antibody (RG7155) that inhibits CSF-1 receptor (CSF-1R) activation. In vitro RG7155 treatment results in cell death of CSF-1-differentiated macrophages. In animal models, CSF-1R inhibition strongly reduces F4/80+ tumor-associated macrophages accompanied by an [...]

Cet article passe en revue les perspectives offertes par le ciblage des voies de signalisation KRAS pour le traitement d'un cancer du poumon non à petites cellules

A RAS Renaissance: Emerging Targeted Therapies for KRAS-Mutated Non-Small Cell Lung Cancer

Vasan, Neil ; Boyer, Julie ; Herbst, Roy S.

Of the numerous oncogenes implicated in human cancer, the most common and perhaps the most elusive to target pharmacologically is RAS. Since the discovery of RAS in the 1960s, numerous studies have elucidated the mechanism of activity, regulation, and intracellular trafficking of the RAS gene products, and of its regulatory pathways. These pathways yielded druggable targets, such as farnesyltransferase during the 1980s-1990s. Unfortunately, early clinical trials investigating [...]

Menée in vitro, in vivo et sur deux patients atteints d'un cancer avancé du poumon non à petites cellules présentant la mutation T790M du gène EGFR, cette étude évalue l'activité antitumorale d'un nouveau composé appelé AZD9291, un inhibiteur de troisième génération de l'activité tyrosine kinase d'EGFR

AZD9291, an irreversible EGFR TKI, overcomes T790M-mediated resistance to EGFR inhibitors in lung cancer

Cross, Darren A. E. ; Ashton, Susan E ; Ghiorghiu, Serban ; Eberlein, Cath ; Nebhan, Caroline A ; Spitzler, Paula J ; Orme, Jonathon P ; Finlay, M. Raymond V. ; Ward, Richard A ; Mellor, Martine J ; Hughes, Gareth ; Rahi, Amar ; Jacobs, Vivien N ; Red Brewer, Monica ; Ichihara, Eiki ; Sun, Jing ; Jin, Hailing ; Ballard, Peter ; Al-Kadhimi, Katherine ; Rowlinson, Rachel ; Klinowska, Teresa ; Richmond, Graham H.P. ; Cantarini, Mireille ; Kim, Dong-Wan ; Ranson, Malcolm R ; Pao, William

First generation EGF receptor tyrosine kinase inhibitors (EGFR TKIs) provide significant clinical benefit in patients with advanced EGFR mutant (EGFRm+) non-small cell lung cancer (NSCLC). Patients ultimately develop disease progression, often driven by acquisition of a second T790M EGFR TKI resistance mutation. AZD9291 is a novel oral, potent and selective third generation irreversible inhibitor of both EGFRm+ sensitizing and T790M resistance mutants that spares wild-type EGFR. This [...]

Menée sur six patients atteints d'une leucémie lymphocytaire chronique, cette étude met en évidence des mécanismes associés à l'apparition d'une résistance à l'ibrutinib

Resistance Mechanisms for the Bruton's Tyrosine Kinase Inhibitor Ibrutinib

Woyach, Jennifer A. ; Furman, Richard R. ; Liu, Ta-Ming ; Ozer, Hatice Gulcin ; Zapatka, Marc ; Ruppert, Amy S. ; Xue, Ling ; Li, Daniel Hsieh-Hsin ; Steggerda, Susanne M. ; Versele, Matthias ; Dave, Sandeep S. ; Zhang, Jenny ; Yilmaz, Ayse Selen ; Jaglowski, Samantha M. ; Blum, Kristie A. ; Lozanski, Arletta ; Lozanski, Gerard ; James, Danelle F. ; Barrientos, Jacqueline C. ; Lichter, Peter ; Stilgenbauer, Stephan ; Buggy, Joseph J. ; Chang, Betty Y. ; Johnson, Amy J. ; Byrd, John C.

Background : Ibrutinib is an irreversible inhibitor of Bruton's tyrosine kinase (BTK) and is effective in chronic lymphocytic leukemia (CLL). Resistance to irreversible kinase inhibitors and resistance associated with BTK inhibition have not been characterized. Although only a small proportion of patients have had a relapse during ibrutinib therapy, an understanding of resistance mechanisms is important. We evaluated patients with relapsed disease to identify mutations that may mediate [...]

Mené sur 391 patients atteints d'une leucémie lymphoïde chronique ou d'un lymphome à petits lymphocytes, cet essai de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'ibrutinib et de l'ofatumumab

Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia

Byrd, John C. ; Brown, Jennifer R. ; O'Brien, Susan ; Barrientos, Jacqueline C. ; Kay, Neil E. ; Reddy, Nishitha M. ; Coutre, Steven ; Tam, Constantine S. ; Mulligan, Stephen P. ; Jaeger, Ulrich ; Devereux, Steve ; Barr, Paul M. ; Furman, Richard R. ; Kipps, Thomas J. ; Cymbalista, Florence ; Pocock, Christopher ; Thornton, Patrick ; Caligaris-Cappio, Federico ; Robak, Tadeusz ; Delgado, Julio ; Schuster, Stephen J. ; Montillo, Marco ; Schuh, Anna ; de Vos, Sven ; Gill, Devinder ; Bloor, Adrian ; Dearden, Claire ; Moreno, Carol ; Jones, Jeffrey J. ; Chu, Alvina D. ; Fardis, Maria ; McGreivy, Jesse ; Clow, Fong ; James, Danelle F. ; Hillmen, Peter

Background : In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. Methods : In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib [...]

Mené sur 671 patients atteints d'un cancer du poumon non à petites cellules de stade avancé, cet essai de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité de l'ajout du figitumumab à une chimiothérapie en traitement de première ligne

Randomized, Phase III Trial of First-Line Figitumumab in Combination With Paclitaxel and Carboplatin Versus Paclitaxel and Carboplatin Alone in Patients With Advanced Non–Small-Cell Lung Cancer

Langer, Corey J. ; Novello, Silvia ; Park, Keunchil ; Krzakowski, Maciej ; Karp, Daniel D. ; Mok, Tony ; Benner, Rebecca J. ; Scranton, Judith R. ; Olszanski, Anthony J. ; Jassem, Jacek

Purpose : Figitumumab (CP-751,871), a fully human immunoglobulin G2 monoclonal antibody, inhibits the insulin-like growth factor 1 receptor (IGF-1R). Our multicenter, randomized, phase III study compared figitumumab plus chemotherapy with chemotherapy alone as first-line treatment in patients with advanced non–small-cell lung cancer (NSCLC). Patients and Methods : Patients with stage IIIB/IV or recurrent NSCLC disease with nonadenocarcinoma histology received open-label figitumumab (20 mg/kg) [...]

Mené sur 1 717 patients atteints d'un cancer métastatique de la prostate résistant à la castration, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité de l'enzalutamide, un inhibiteur du récepteur des androgènes par voie orale

Enzalutamide in Metastatic Prostate Cancer before Chemotherapy

Beer, Tomasz M. ; Armstrong, Andrew J. ; Rathkopf, Dana E. ; Loriot, Yohann ; Sternberg, Cora N. ; Higano, Celestia S. ; Iversen, Peter ; Bhattacharya, Suman ; Carles, Joan ; Chowdhury, Simon ; Davis, Ian D. ; de Bono, Johann S. ; Evans, Christopher P. ; Fizazi, Karim ; Joshua, Anthony M. ; Kim, Choung-Soo ; Kimura, Go ; Mainwaring, Paul ; Mansbach, Harry ; Miller, Kurt ; Noonberg, Sarah B. ; Perabo, Frank ; Phung, De ; Saad, Fred ; Scher, Howard I. ; Taplin, Mary-Ellen ; Venner, Peter M. ; Tombal, Bertrand

Background : Enzalutamide is an oral androgen-receptor inhibitor that prolongs survival in men with metastatic castration-resistant prostate cancer in whom the disease has progressed after chemotherapy. New treatment options are needed for patients with metastatic prostate cancer who have not received chemotherapy, in whom the disease has progressed despite androgen-deprivation therapy. Methods : In this double-blind, phase 3 study, we randomly assigned 1717 patients to receive either [...]

A partir de deux essais de phase III ayant inclus un total de 4 690 patientes atteintes d'un cancer du sein HR+ avant la ménopause, cette étude évalue l'efficacité, du point de vue de la survie sans maladie (durée médiane de suivi : 68 mois), et la toxicité d'un traitement adjuvant à base d'exémestane ou de tamoxifène en complément d'une suppression ovarienne

Adjuvant Exemestane with Ovarian Suppression in Premenopausal Breast Cancer

Pagani, Olivia ; Regan, Meredith M. ; Walley, Barbara A. ; Fleming, Gini F. ; Colleoni, Marco ; Lang, István ; Gomez, Henry L. ; Tondini, Carlo ; Burstein, Harold J. ; Perez, Edith A. ; Ciruelos, Eva ; Stearns, Vered ; Bonnefoi, Hervé R. ; Martino, Silvana ; Geyer, Charles E. ; Pinotti, Graziella ; Puglisi, Fabio ; Crivellari, Diana ; Ruhstaller, Thomas ; Winer, Eric P. ; Rabaglio-Poretti, Manuela ; Maibach, Rudolf ; Ruepp, Barbara ; Giobbie-Hurder, Anita ; Price, Karen N. ; Bernhard, Jürg ; Luo, Weixiu ; Ribi, Karin ; Viale, Giuseppe ; Coates, Alan S. ; Gelber, Richard D. ; Goldhirsch, Aron ; Francis, Prudence A.

Background : Adjuvant therapy with an aromatase inhibitor improves outcomes, as compared with tamoxifen, in postmenopausal women with hormone-receptor–positive breast cancer. Methods : In two phase 3 trials, we randomly assigned premenopausal women with hormone-receptor–positive early breast cancer to the aromatase inhibitor exemestane plus ovarian suppression or tamoxifen plus ovarian suppression for a period of 5 years. Suppression of ovarian estrogen production was achieved with the use of [...]

Cet article présente les données ayant servi de base à l'autorisation de mise sur le marché récemment délivrée par la Food and Drug Administation pour l'ado-trastuzumab emtansine dans le traitement des patientes atteintes d'un cancer métastatique du sein HER2+

FDA Approval: Ado-trastuzumab Emtansine for the Treatment of Patients with HER2-Positive Metastatic Breast Cancer

Amiri-Kordestani, Laleh ; Blumenthal, Gideon M. ; Xu, Qiang Casey ; Zhang, Lijun ; Tang, Shenghui W. ; Ha, Linan ; Weinberg, Wendy C ; Chi, Bo ; Candau-Chacon, Reyes ; Hughes, Patricia ; Russell, Anne Marie ; Pope Miksinski, Sarah ; Chen, Xiao Hong ; McGuinn, W. David ; Palmby, Todd ; Schrieber, Sarah J. ; Liu, Qi ; Wang, Jian ; Song, Pengfei ; Mehrotra, Nitin ; Skarupa, Lisa ; Clouse, Kathleen ; Al-Hakim, Ali ; Sridhara, Rajeshwari ; Ibrahim, Amna ; Justice, Robert ; Pazdur, Richard ; Cortazar, Patricia

On February 22, 2013, the FDA licensed ado-trastuzumab emtansine (Kadcyla, Genentech, Inc.) for use as a single agent for the treatment of patients with HER2-positive, metastatic breast cancer (MBC) who previously received trastuzumab and a taxane, separately or in combination. The clinical basis for licensure was a phase 3 trial in 991 patients with HER2-positive MBC which randomly allocated patients to receive ado-trastuzumab emtansine (N=495) or lapatinib in combination with capecitabine [...]

Mené sur 26 patients pédiatriques atteints d'un gliome diffus du tronc cérébral ou d'un autre gliome de haut grade, cet essai évalue la toxicité et l'activité antitumorale d'un vaccin peptidique

Antigen-Specific Immune Responses and Clinical Outcome After Vaccination With Glioma-Associated Antigen Peptides and Polyinosinic-Polycytidylic Acid Stabilized by Lysine and Carboxymethylcellulose in Children With Newly Diagnosed Malignant Brainstem and NonBrainstem Gliomas

Pollack, Ian F. ; Jakacki, Regina I. ; Butterfield, Lisa H. ; Hamilton, Ronald L. ; Panigrahy, Ashok ; Potter, Douglas M. ; Connelly, Angela K. ; Dibridge, Sharon A. ; Whiteside, Theresa L. ; Okada, Hideho

Purpose : Diffuse brainstem gliomas (BSGs) and other high-grade gliomas (HGGs) of childhood carry a dismal prognosis despite current treatments, and new therapies are needed. Having identified a series of glioma-associated antigens (GAAs) commonly overexpressed in pediatric gliomas, we initiated a pilot study of subcutaneous vaccinations with GAA epitope peptides in HLA-A2–positive children with newly diagnosed BSG and HGG. Patients and Methods : GAAs were EphA2, interleukin-13 receptor alpha 2 [...]

Menée in vitro et in vivo, cette étude évalue l'efficacité d'une stratégie thérapeutique, basée sur la formation d'un agrégat intracellulaire composé de nanoparticules d'or et de nanocapsules transportant une substance active, pour amplifier localement l'effet des rayons X ou de la chimiothérapie et favoriser la destruction des cellules tumorales via l'éclatement de nanobulles plasmoniques induites par un laser pulsé

On-demand intracellular amplification of chemoradiation with cancer-specific plasmonic nanobubbles

Lukianova-Hleb, Ekaterina Y. ; Ren, Xiaoyang ; Sawant, Rupa R. ; Wu, Xiangwei ; Torchilin, Vladimir P. ; Lapotko, Dmitri O.

Chemoradiation-resistant cancers limit treatment efficacy and safety. We show here the cancer cell-specific, on-demand intracellular amplification of chemotherapy and chemoradiation therapy via gold nanoparticle- and laser pulse-induced mechanical intracellular impact. Cancer aggressiveness promotes the clustering of drug nanocarriers and gold nanoparticles in cancer cells. This cluster, upon exposure to a laser pulse, generates a plasmonic nanobubble, the mechanical explosion that destroys the [...]

Cet article fait le point sur la prise en charge thérapeutique d'un cancer colorectal avec métastases hépatiques synchrones

Management of colorectal cancer presenting with synchronous liver metastases

Siriwardena, Ajith K. ; Mason, James M. ; Mullamitha, Saifee ; Hancock, Helen C. ; Jegatheeswaran, Santhalingam

Up to a fifth of patients with colorectal cancer (CRC) present with synchronous hepatic metastases. In patients with CRC who present without intestinal obstruction or perforation and in whom comprehensive whole-body imaging confirms the absence of extrahepatic disease, evidence indicates a state of equipoise between several different management pathways, none of which has demonstrated superiority. Neoadjuvant systemic chemotherapy is advocated by current guidelines, but must be integrated with [...]

Menée à partir de données portant sur 284 patientes atteintes d'un cancer localement avancé du sein et traitées entre 2002 et 2007 (durée médiane de suivi : 6,3 ans), cette étude française compare, du point de vue des taux de récidive loco-régionale et de survie globale, l'efficacité d'un traitement conservateur et d'une mastectomie après une chimiothérapie néoadjuvante et une radiothérapie

Loco-regional Control After Neo-adjuvant Chemotherapy and Conservative Treatment for Locally Advanced Breast Cancer Patients

Levy, Antonin ; Borget, Isabelle ; Bahri, Manel ; Arnedos, Monica ; Rivin, Eleonor ; Vielh, Philippe ; Balleyguier, Corinne ; Rimareix, Françoise ; Bourgier, Céline

Breast-conserving treatment (BCT) has been validated for breast cancer patients receiving adjuvant chemotherapy. Our objective was to evaluate the difference in loco-regional recurrence (LRR) rates between BCT and mastectomy in patients receiving radiation therapy after neo-adjuvant chemotherapy (NCT). A retrospective data base was used to identify all patients with breast cancer undergoing NCT from 2002 to 2007. Patients with initial metastatic disease were excluded from this analysis. LRR was [...]

A l'occasion du cinquantième anniversaire de l'American Society of Clinical Oncology, cet article passe en revue l'évolution récente des traitements du cancer du sein et analyse les défis à relever pour les développements futurs

Past, Present, and Future Challenges in Breast Cancer Treatment

Sledge, George W. ; Mamounas, Eleftherios P. ; Hortobagyi, Gabriel N. ; Burstein, Harold J. ; Goodwin, Pamela J. ; Wolff, Antonio C.

The past half century—the lifetime of the American Society of Clinical Oncology—represents a historical watershed in the management of breast cancer, a period in which old dogmas were overthrown, to be replaced by biology-driven therapeutic approaches. These approaches transformed the disease from one where mutilating local therapy was followed by distant recurrence and death, to one where patients regularly choose local (and often minimal) therapy, then receive systemic therapies that are [...]

Menée par questionnaires auprès de femmes incluses dans l'essai International Breast Cancer Intervention Study-II, cette étude évalue l'intérêt d'un document d'aide à la décision pour dissiper leurs doutes sur l'intérêt de participer à l'essai

Improving decision making about clinical trial participation - a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial

Juraskova, I. ; Butow, P. ; Bonner, C. ; Bell, M. L. ; Smith, A. B. ; Seccombe, M. ; Boyle, F. ; Reaby, L. ; Cuzick, J. ; Forbes, J. F.

Background: Decision aids may improve informed consent in clinical trial recruitment, but have not been evaluated in this context. This study investigated whether decision aids (DAs) can reduce decisional difficulties among women considering participation in the International Breast Cancer Intervention Study-II (IBIS-II) trial. Methods: The IBIS-II trial investigated breast cancer prevention with anastrazole in two cohorts: women with increased risk (Prevention), and women treated for ductal [...]