[Antiangiogenic pathways in the future]. / Les voies anti-angiogéniques du futur.

The metastatic process comprises several steps all dependent on different factors: cell proliferation and the Raf-MEK-ERK pathway, initiation, migration and angiogenesis via VEGF and collagenases (which digest the extracellular matrix), metastatic progression in bloodstream and implantation in a target tissues via CXCR4 according to the gradient of SDF1 chemokine. At present, inhibition of VEGF by antiangiogenic the treatment results in the activation of alternative pathways and recovery of metastasis process. The future of targeted therapies will integrate alternative paths, including CXCR4/SDF1 ones.

[Specificities of chemotherapy in elderly cancer patients]. / Spécificités de la prise en charge par chimiothérapie chez le sujet âgé.

The management of cancer in the elderly patients is becoming a major problem of public health. The population is becoming older, the risk of cancer is increasing with age and therapeutic tools are improving. The numerous pharmacological changes of age might influence the pharmacokinetic and pharmacodynamic variables of many drugs, in particular the agents of chemotherapy. The development of news drugs, with less toxicity, administrated weekly or orally, and of supportive care (hematological growth factors, nutritional support) allows proposing specific treatment to elderly patients with cancer. However, evidence-based medicine data are lacking to define optimal schedules in this population due to low inclusion rates in clinical trials. This paper explores the specificities of chemotherapy in elderly patients with cancer.