Safety assessment of anticancer drugs in association with radiotherapy in metastatic malignant melanoma: a real-life report : Radiation/systemic drug combo in metastatic melanoma.

PURPOSE: To assess the safety of the association of radiotherapy (RT) and systemic treatments for patients with metastatic malignant melanoma (mMM). METHODS: A retrospective analysis included consecutive patients treated with palliative RT, and at least one line of systemic therapy for mMM between 2001 and 2016. Treatments were defined as sequential or concomitant when RT and the systemic drug were administered, respectively, at more or less than five half-lives from each other. RESULTS: 92 patients were included. They had 110 palliative RT treatments. RT was delivered with a "conventional" chemotherapy (mainly fotemustine and/or dacarbazine) and a "modern" systemic therapy (BRAF inhibitors, association of BRAF and MEK inhibitors, immunotherapy), respectively, in 88 (80%) and 22 (20%) cases. Systemic treatments and RT were mainly concurrently performed (n = 61, 55.5%). Regarding acute grade ≥ 3 toxicity, no difference was reported between sequential and concomitant groups either in the whole cohort (p = 1) or in the subgroup of patients receiving "modern" systemic therapies (p = 1). Acute and late grade ≥ 3 toxicities only occurred with vemurafenib. BRAF inhibitors and RT produced more severe infield adverse events than other associations (p = 0.001) with two deaths. CONCLUSION: In our series, compared to sequential administration, concomitant association of systemic anticancer drugs and palliative RT did not increase toxicity in mMM patients. BRAF inhibitors and RT produced severe infield toxicities. Prospective studies are needed to better characterize the toxicity of each association.

[Metastatic nasopharynx cancer at diagnosis: clinical and prognostic (study of 51 cases)]. / Cancer du cavum d'emblee metastatique: étude clinique et pronostique (à propos de 51 cas).

This retrospective study aimed to highlight the different epidemiological, clinical, therapeutic and prognostic features of nasopharinx cancer with inaugural metastases in patients hospitalized in a Tunisian Hospital. We here report 51 cases of histologically diagnosed nasopharynx cancer (NPC) with inaugural metastases. Data were collected in the ENT departments and in the radiation therapy departments at the University Hospital Farhat Hached, Sousse, Tunisia as well as at the Centre Medical Ibn Khaldoun, Hammam Sousse, between January 1995 and December 2010. We collected data on 51 patients with metastatic nasopharynx cancer at diagnosis. The average age was 49 years. Sex ratio was 6,2. Bone metastases were the most common finding (94.1%), followed by liver metastases (34.6%). In the majority of our patients therapeutic approach was based on chemotherapy (41 patients); 31 of these patients underwent chemotherapy in combination with radiation therapy. Adriamycin+cisplatin protocol was the most frequently used (92.6%). Twenty patients underwent cervicofacial radiation therapy with curative purposes (doses ≤ 70 Gy), fourteen patients underwent radiation treatment to the nasopharynx with symptomatic purposes (doses of 30Gy in 10 sessions) associated with radiation treatment to the metastatic sites in 9 cases. Overall survival at 2 years and 5 years was 29% and 10%, respectively. Nasopharinx cancer with inaugural metastases is a serious disease, rapidly fatal despite therapeutic advances. In view of our data and of those from the literature cisplatin-based chemotherapy and cervicofacial radiation therapy with curative doses and that of metastases resulted in long-term survival and even in complete responses. Future trials should focus on new molecules for therapeutic intensification.

Correction to: From IB2 to IIIB locally advanced cervical cancers: report of a ten-year experience.

In the original publication [1] one author name was spelled incorrect.

From IB2 to IIIB locally advanced cervical cancers: report of a ten-year experience.

BACKGROUND: Despite screening campaigns, cervical cancers remain among the most prevalent malignancies and carry significant mortality, especially in developing countries. Most studies report outcomes of patients receiving the usual standard of care. It is possible that these selected patients may not correctly represent patients in a real-world setting, which may be a limitation in interpreting outcomes. This study was undertaken to identify prognostic factors, management strategies and outcomes of locally advanced cervical cancers (LACC) treated in daily clinical practice. METHODS: Medical files of all consecutive patients treated with curative intent for LACC in a French Cancer Care Center between 2004 and 2014 were reviewed retrospectively. RESULTS: Ninety-four patients were identified. Performance status was ≥ 2 in 10.6%. Median age at diagnosis was 63.0. Based on the International Federation of Gynecology and Obstetrics classification, tumours were classified as follows: 10.6% IB2, 22.3% IIA, 51.0% IIB, 4.3% IIIA and 11.7% IIIB. Pelvic lymph nodes were involved in 34.0% of cases. Radiotherapy was delivered for all patients. Radiotherapy technique was intensity modulated radiation therapy or volumetric modulated arc therapy in 39.4% of cases. A concurrent cisplatin chemotherapy was delivered in 68.1% of patients. Brachytherapy was performed in 77.7% of cases. The recommended standard care (concurrent chemoradiotherapy with at least five chemotherapy cycles during radiotherapy, followed by brachytherapy) was delivered in 43.6%. The median overall treatment time was 56 days. Complete tumour sterilisation was achieved in 55.2% of cases. Mean follow-up was 54.3 months. Local recurrence rate was 18.1%. Five-year overall survival was 61.9% (95% Confident Interval (CI) = 52.3-73.2) and five-year disease-specific survival was 68.5% (95% CI = 59.2-79.2). Poor performance status, lymph nodes metastasis and absence of concurrent chemotherapy were identified as poor prognostic factors in multivariate analysis. CONCLUSIONS: Less than 50% of patients received the standard care. Because LACC patients and disease are heterogeneous, treatment tailoring appears to be common in current clinical practice. However, guidelines for tailoring management are not currently available. More data about real-world settings are required in order to to optimise clinical trials' aims and designs, and make them translatable in daily clinical practice. TRIAL REGISTRATION: retrospectively registered.