Intrapericardial instillation of bleomycin prevents recurrence of malignant pericardial effusions: Series of 46 cases and comprehensive literature review.

INTRODUCTION: Malignant pericardial effusion is a severe complication of lung and breast cancer. The median survival is less than 4 months and recurrences occurs in about 40% of cases. Systemic chemotherapy and/or local treatments are necessary, even if there is no consensus. METHODS: We collected data from patients in our center from 1997 to 2016 who received at least one intrapericardial instillation of bleomycin (60mg). At the same time, we conducted a review of the relevant literature on the subject. RESULTS: We included 46 patients in the analysis. Median survival was 2.6 months [95% CI: 1.7; 4.7]. Overall survival was 49% [33%; 63%] at 3 months and 28% [15%; 42%] at 6 months. In the lung cancer subgroup, overall survival was 18% [3%; 44%] at 3 months. In the breast cancer subgroup, overall survival was 73% [44%; 89%] at 3 months and 46% [21%; 69%] at 6 months. DISCUSSION: The best response rates in the literature are obtained with local instillation of bleomycin or cisplatin. Malignant pericardial effusions in breast cancer patients had a better prognosis. This is certainly related to the prognosis of the underlying disease. We have not found an increase in overall survival with intrapericardial chemotherapy injections, but preventing recurrence of malignant pericardial effusions is a benefit in itself, thus avoiding a lethal complication.

[Expectations of patients with ovarian cancer. Results of the European investigation EXPRESSION III in French patients from GINECO group]. / Attentes des patientes atteintes d'un cancer de l'ovaire. Résultats de l'enquête européenne EXPRESSION III chez les patientes françaises du groupe GINECO (Groupe d'investigateurs nationaux pour l'étude des cancers ovariens et du sein).

EXPRESSION III was designed to evaluate the information, needs and expectations of patients with ovarian cancer in different European countries. This abstract focuses on specific results from French OC patients. Two hundred and fifty-seven patients filled a 27-item questionnaire during a medical visit. Median age range was 63 years (26-89). Nearly all the patients (94 %) had primary surgery and adjuvant chemotherapy (95 %), 50 % had recurrent disease. At the time of the survey, 85 % reported symptoms: fatigue: 88 %, neuropathy: 55 %, nausea/vomiting: 40 %, pain: 39 %. Patients wished for non-alopeciant treatment (52 %) and a better management of fatigue (42 %). Eighty percent of the patients knew their chemotherapy but 60 % ignored their initial disease stage and how to find more information for treatment choice (91 %). Most patients (92 %) preferred to get it directly from their physician. Sixty-six percent expressed the need for clear information about their life expectancy. Still 21 % patients did not want to get negative information. French patients need for more support and clearer information on their disease. Direct information from their physician remains the mainstay of communication.

The N- and C-terminal fragments of ubiquitin are important for the antimicrobial activities.

Secretory granules of chromaffin cells contain catecholamines and several antimicrobial peptides derived from chromogranins and proenkephalin-A. These peptides are secreted in the extracellular medium following exocytosis. Here, we show that ubiquitin is stored in secretory chromaffin granules and released into the circulation upon stimulation of chromaffin cells. We also show that the C-terminal fragment (residues 65-76) of ubiquitin displays, at the micromolar range, a lytic antifungal activity. Using confocal laser scan microscopy and rhodamine-labeled synthetic peptides, we could demonstrate that the C-terminal peptide (residues 65-76) is able to cross the cell wall and the plasma membrane of fungi and to accumulate in fungi, whereas the N-terminal peptide (residues 1-34) is stopped at the fungal wall level. Furthermore, these two peptides act synergistically to kill filamentous fungi. Because of the interaction of the C-terminal sequence of ubiquitin with calmodulin, the synthetic peptide (residues 65-76) was tested in vitro against calmodulin-dependent calcineurin, an enzyme crucial for fungal growth. This peptide was found to inhibit the phosphatase activity of calcineurin. Our data show a new property of ubiquitin C-terminal-derived peptide (65-76) that could be used with N-terminal peptide (1-34) as a new potent antifungal agent.