133 research outputs found
Efficacy and Safety of Immune Checkpoint Blockade in Patients With Li-Fraumeni Syndrome
No full textA case series evaluating efficacy and safety of immune checkpoint blockade in Li-Fraumeni syndrom
Evaluation pré-thérapeutique du risque toxique des traitements anti-tumoraux systémiques ( enquête prospective en Ile-de-France et Grand-Oues)
No full textLe risque toxique est le risque de survenue d un effet secondaire grave d un traitement anti-tumoral prescrit à la dose recommandée. L évaluation pré-thérapeutique des patients doit permettre l appréciation de ce risque afin de le prévenir ou d en surveiller l apparition. Il n existe pas de recommandation concernant les moyens à mettre en œuvre pour la réaliser. Nous avons donc souhaité connaître comment ce risque est évalué en pratique courante. Pour cela, nous avons réalisé une enquête prospective auprès des médecins prescripteurs de ces traitements, exerçant en Ile-de-France et Grand-Ouest. Après échantillonnage aléatoire, 376 médecins ont été invités à participer par courrier électronique. La population de répondants (n=111) était composée à 61% d hommes, majoritairement des oncologues médicaux (51%) exerçant en CLCC (38%). Il existe une sous-évaluation nutritionnelle avec seulement 51% des médecins jugeant impératif de connaître la perte de poids au cours des derniers mois et 74% prescrivant un bilan biologique avec albuminémie. Les facteurs de vulnérabilité gériatriques sont assez bien reconnus, mais l attitude face aux sujets âgés fit n est pas uniforme. La place du pharmacien est restreinte. Les expertises paramédicales sont demandées le plus souvent si un besoin est détecté, mais peu en systématique. La dénutrition n est pas assez dépistée ni identifiée comme facteur de risque de toxicité. La pratique de l évaluation pré-thérapeutique en interdisciplinarité est peu répandue. Il semble nécessaire de standardiser ce temps d évaluation afin d étudier chez les patients non sélectionnés les facteurs clinico-biologiques prédisant la toxicité ; de permettre un meilleur accès aux soins de support, et une trajectoire de soins fluide et sécurisée.Toxic risk is the risk of serious adverse event of a cytotoxic treatment that have been prescribed at the recommended dosage. Patient pre-therapeutic assessment has to estimate this risk in order to anticipate it. But today, there is no recommendations about how to lead this pre-therapeutic assessment. We wanted to know how this toxic risk is assessed by oncologists. So, we conceived a prospective, descriptive, quantitative survey conducted nearby french oncologists from "Grand-Ouest" and "Ile-de-France". We received 111 complete questionnaires. Participants were 61% men, in majority medical oncologists (51%) working in "Centre de Lutte contre le Cancer" (38%). Our study shows : - good knowledge about denutrition but it seems that oncologists don't use it as a potential factor of toxicity - geriatric vulnerability markers are quite enough identified but evaluation methods are not uniform - pharmacist has a limited position nearby oncologists- and interdisciplinarity is very few prevalent. Denutrition is probably under-screened in pre-therapeutic assessment and not enough taken into account like a real factor of toxicity. As regard to the fastness of anticancer drugs processing, it seems necessary to standardize pre-therapeutic assessment, which will permit to study predicting factors of toxicity of each drug and will guarantee to patients a better access to supportive care.ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF
Toxicités aiguës et retardées du sorafenib (description et facteurs prédictifs)
No full textPARIS7-Xavier Bichat (751182101) / SudocSudocFranceF
Rouge, une réécriture pour une génération de filles puissantes
No full textThe Little Riding Hood is the tale most often rewritten. This article proposes to study the rewriting of Pascaline Nolot in Rouge, a novel intended for adolescents. The analysis will show the writing processes used by the author to divert the traditional tale. By using many intertextual references, Pascaline Nolot renews the meaning of the tale by addressing the issues of harassment, rape, consent.The Little Riding Hood is the tale most often rewritten. This article proposes to study the rewriting of Pascaline Nolot in Rouge, a novel intended for adolescents. The analysis will show the writing processes used by the author to divert the traditional tale. By using many intertextual references, Pascaline Nolot renews the meaning of the tale by addressing the issues of harassment, rape, consent
Author response
No full textTranscription regulation in metazoans often involves promoter-proximal pausing of RNA polymerase (Pol) II, which requires the 4-subunit negative elongation factor (NELF). Here we discern the functional architecture of human NELF through X-ray crystallography, protein crosslinking, biochemical assays, and RNA crosslinking in cells. We identify a NELF core subcomplex formed by conserved regions in subunits NELF-A and NELF-C, and resolve its crystal structure. The NELF-AC subcomplex binds single-stranded nucleic acids in vitro, and NELF-C associates with RNA in vivo. A positively charged face of NELF-AC is involved in RNA binding, whereas the opposite face of the NELF-AC subcomplex binds NELF-B. NELF-B is predicted to form a HEAT repeat fold, also binds RNA in vivo, and anchors the subunit NELF-E, which is confirmed to bind RNA in vivo. These results reveal the three-dimensional architecture and three RNA-binding faces of NELF
How to Optimize Cancer Treatment in Older Patients
No full textInternational audienceCancer is a disease of older people, but this age group has often been excluded from clinical trials of cancer, which leads to poor transportability of standardized treatments in older cancer patients. One of the main reasons for the exclusion is the heterogeneity of older people in several domains: social environment, comorbidities, dependency, functional status, nutritional status, cognition status and mood status. Comprehensive geriatric assessment (CGA) aims to assess this heterogeneity and has identified frequent health problems often unknown before therapeutic decisions, which allows for targeted geriatric interventions with or without followup and appropriate cancer treatment selection. Several tools and scores have been developed for a complementary approach. These tools screen for vulnerability to select patients who may benefit from a CGA; are predictive tools for survival, post-operative complications, or chemotherapy-related toxicity; are decisional algorithms for cancer treatment; or define a core set of geriatric data to be collected in clinical cancer trials. Here, we present an overview of the geriatric tools that were published in PubMed from 2000 to 2017, that could help in the therapeutic decision-making for older cancer patients
Performance of AI for preoperative CT assessment of lung metastases. Retrospective analysis of 167 patients
No full textObjectives: To evaluate the performance of artificial intelligence (AI) in the preoperative detection of lung metastases on CT. Materials and methods: Patients who underwent lung metastasectomy in our institution between 2016 and 2020 were enrolled, their preoperative CT reports having been performed before an AI solution (Veye Lung Nodules, version 3.9.2, Aidence) became available as a second reader in our department. All CT scans were retrospectively processed by AI. The sensitivities of unassisted radiologists (original CT radiology reports), AI reports alone and both combined were compared. Ground truth was established by a consensus reading of two radiologists, who analyzed whether the nodules mentioned in the pathology report were retrospectively visible on CT. Multivariate analysis was performed to identify nodule characteristics associated with detectability. Results: A total of 167 patients (men: 62.9 %; median age, 59 years [47-68]) with 475 resected nodules were included. AI detected an average of 4 nodules (0-17) per CT, of which 97% were true nodules. The combination of radiologist plus AI (92.4 %) had significantly higher sensitivity than unassisted radiologists (80.4 %) (p < 0.001). In 27/57 (47.4 %) patients who had multiple preoperative CT scans, AI detected lung nodules earlier than the radiologist. Vascular contact was associated with non-detection by radiologists (OR:0.32[0.19, 0.54], p < 0.001), whilst the presence of cavitation (OR:0.26[0.13, 0.54], p < 0.001) or pleural contact (OR:0.10[0.04, 0.22], p < 0.001) was associated with non-detection by AI. Conclusion: AI significantly increases the sensitivity of preoperative detection of lung metastases and enables earlier detection, with a significant potential benefit for patient management
Experimentation of ‘Link for Health’, a new Telehealth application in Cochin Hospital, France
No full textOrange and Cochin Hospital have experimented ‘Link for Health’, a new Telehealth application in the Department of Oncology of Cochin Hospital, France.This new application allows a complete Telehealth service combining mobile application, sensors and questionnaires to return by internet to healthcare team.The purpose of this paper is to analyse and experiment the effectiveness of the Telehealth service, in oral and intravenous anti-cancer therapy to improve clinical and process outcomes.Results were analysed in terms of benefits for the patients and the hospital team
Relation between hypermetabolism, cachexia, and survival in cancer patients: a prospective study in 390 cancer patients before initiation of anticancer therapy ,
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