[Endometrial cancer in the crossroads of modernity and immunotherapy]. / Cancer de l'endomètre : entre modernité et immunothérapie.

Frequent and with an increasing incidence in some territories, endometrial cancer is a complex disease leading to significant morbidity among affected patients. After years of research and the implementation of state-of-the-art molecular and gene assays significant breakthroughs were made. Through a better understanding of the underlying mechanisms of uterine carcinogenesis, a more precise and personalized risk stratification and the incorporation of immunotherapy, the treatment of endometrial cancer is experiencing significant improvements. This evolution, caries the genuine hope for an accurate selection of patients based on specific cancer-related characteristics, to tailor both treatment intensity and selection.

Le cancer du corps de l'utérus est une maladie fréquente, complexe et source de morbidité importante. L'implémentation de moyens de recherche de pointe, notamment l'immunothérapie, le séquençage génétique et les études moléculaires, ont abouti aux avancées discutées dans cet article. À travers une meilleure compréhension des mécanismes de la carcinogenèse endométriale, une stratification plus précise et personnalisée du risque de récidive et l'essor de l'immunothérapie, le traitement du cancer de l'utérus connaît actuellement un incontestable renouveau. Cette révolution, porteuse d'espoir, promet l'adéquation la plus exacte possible entre les traitements et l'agressivité de la maladie.

[2021 Oncology update]. / Oncologie.

Despite COVID-19 pandemic, which is still deeply affecting world economy and global health, medical oncology specialists keep pursuing their effort for the identification of new therapeutic options to improve patients' life expectancy and quality of life. 2021 confirms the immunotherapy efficacy, alone or in combination with other modalities, across several indications. This year, we are summarizing the new approaches in the following sectors: lung, breast, melanoma, gynecological, digestive, urological and ENT areas.

En dépit de la pandémie de Covid-19 qui continue à grandement impacter l'économie mondiale et la santé, l'oncologie médicale poursuit sa quête d'identification de nouvelles options thérapeutiques ayant pour buts la prolongation de l'espérance de vie et l'amélioration de la qualité de vie de ses patients, en nombre croissant. L'année 2021 confirme également l'efficacité de l'immunothérapie, seule ou en combinaison à d'autres modalités, dans de nombreuses indications. Cette année, nous vous résumons les nouvelles approches dans les domaines suivants: poumon, sein, mélanome, sphères gynécologique, digestive, urologique et ORL.

[Chemotherapy-induced febrile neutropenia: About 186 episodes. Clinical, microbiological and therapeutic characteristics]. / Les neutropénies fébriles chimio-induites: A propos de 186 épisodes Aspects épidémiologiques, diagnostiques et thérapeutiques.

BACKGROUND: One of the major side effects of anti-proliferative treatment is their medullar toxicity. This toxicity is particularly important in neutrophils and leads to a neutropenia. Fever during these episodes of neutropenia is a frequent complication but remains of indeterminate origin in 60% of cases. It's a medical emergency because of rapid evolution and a significant increase in mortality up to 10%. Thus, these episodes should be prevented and treated in priority with un empiric and large spectrum antibiotherapy, taking into account the bacterial ecology of each hospital. AIM: The aim of this study was to determinate the clinical, therapeutic and evolutive characteristics of febrile neutropenia (FN). METHODS: This retrospective study concerned 186 episodes of FN in 136 patients treated for solid tumors and lymphoma in the department of medical oncology of Sfax from january 2006 to December 2010. RESULTS: Mean age was 40 years (1 to 81) and sex ratio at 0.97. They were trated mainly solid tumors in 86.02%. Median time to onset of FN was 11 days and the mean duration of neutropenia was 5 days. 24.2% had a neutrophil count (ANC) <100 / mm3. Fever was clinically documented in 33.87%. Patients have mainly ORL clinical manifestations (38.46%) and specially mucositis (50%). Only 17.2% of cases were microbiologically documented and a bacteria was isolated in 76.46% of them in blood cultures, Gram-negative bacilli (GNB) accounted for the majority of organisms isolated in different samples in 66.66% of cases. Enterobacteriaceae were the most frequent dominated by Klebsiella spp, followed by Escherichia coli. Pseudomonas aeruginosa ranked second after the Enterobacteriaceae (21.21%). The Gram-positive cocci (GPC) were found in 24.24% mainly Staphylococcus aureus. The first line of empirical antibiotic therapy was associated in 88.7% of ceftazidime and amikacin or a fluoroquinolone that has to have an efficiency of 72.12%. The rate of death due to infection in our series was 9.14%. CONCLUSION: Our results are consistent with data in the literature concerning the short duration of neutropenia, causing fever and mortality, but our bacterial epidemiology is different from the current literature, where there is a predominance of CGP unlike our predominantly the BGN. And prescribing empiric antibiotic therapy must take into account the epidemiological and ecological particularities of each country, each hospital or each department.

Predictive Factors of Febrile Neutropenia Induced by Anticancer Chemotherapy in the South of Tunisia.

INTRODUCTION: Febrile Neutropenia (FN) secondary to chemotherapy is the most common and the earliest hematological complication. The aim of this work is to study the predictive factors of FN. Materiel and Methods: This is a retrospective study including 186 episodes of FN induced by chemotherapy treated in the department of oncology at Sfax in southern Tunisia during the period between 1 January 2006 and 31 December 2010. RESULT: The mean age of patients was 40 years. One hundred and seventeen patients had solid tumors (86.02%), 18 patients (13.23%) had hematological malignancies and one patient was treated for hypo pharyngeal cancer and aplastic Anemia. Chemotherapy was indicated for curative purpose in 94 cases and palliative purpose in 92 cases. One hundred and four patients (76.5%) had a single episode of FN and 32 (23.5%) had at least two episodes. The average time of febrile neutropenia was 11 days. CONCLUSION: Personal history of FN, poor performance status, chemotherapy regimen and the stage of the disease increased the risk of FN, with a statistically significant difference. Other factors such as hematological malignancies, the age over 65 years and concurrent chemo radiotherapy were not retained in our series.