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1.
Oncology ; 100(12): 633-644, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36283345

RESUMEN

INTRODUCTION: Soft tissue sarcomas (STSs) are a rare and heterogenous group of tumors, with poor prognostic, judging from their frequency to relapse. Few drugs are available after the conventional first-line regimen. Since 2007, trabectedin got approval after failure of anthracyclines and ifosfamide, for advanced or metastatic STS. This led to a FDA approval in 2015, but real-world evidence is still required, complementary to the pivotal phase II and III trials. METHODS: One hundred twenty-six patients with STS, treated by trabectedin between 2002 and 2019, were analyzed in this retrospective study, in two French centers. The effects of trabectedin on survival, response, and toxicity were described. All patients were tested for toxicities, and efficacy was assessed in patients exposed to at least 2 cycles of trabectedin. RESULTS: Three median cycles were administered per patient (1-79). Among the 113 patients analyzed for efficacy, the median progression-free survival was 3.0 months (95% CI: 2.3-4.8), with an overall survival of 12.3 months (95% CI: 10.2-16.9). The rate of disease control was 46% at the end of treatment. Myxoid liposarcoma (n = 11) was the histology subtype that benefited most from this chemotherapy with median progression-free survival and overall survival of 13.3 months (95% CI: 2.3-18.7) and 27.8 months (95% CI: 3.2-64.7), respectively. Adverse events were manageable. DISCUSSION AND CONCLUSION: Efficacy of trabectedin is confirmed in terms of clinical benefit and low toxicity, especially for myxoid liposarcoma. Combinatory regimens are under clinical trials to optimize the place of this chemotherapy.


Asunto(s)
Leiomiosarcoma , Liposarcoma Mixoide , Sarcoma , Neoplasias de los Tejidos Blandos , Tetrahidroisoquinolinas , Humanos , Adulto , Trabectedina/efectos adversos , Estudios Retrospectivos , Liposarcoma Mixoide/tratamiento farmacológico , Tetrahidroisoquinolinas/efectos adversos , Dioxoles/efectos adversos , Leiomiosarcoma/patología , Antineoplásicos Alquilantes/efectos adversos , Supervivencia sin Enfermedad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neoplasias de los Tejidos Blandos/tratamiento farmacológico
2.
J Pediatr Gastroenterol Nutr ; 75(5): 553-555, 2022 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-36070526

RESUMEN

Hepatitis-associated aplastic anemia (HAAA) accounts for 4% of autoimmune hepatitis in children. An episode of seronegative autoimmune hepatitis is followed a few days or months later by aplastic anemia or full aplasia. This autoimmune disease could be due to a regulation defect in the immune response to a viral trigger, in a genetically predisposed individual. Other causes of hepatitis or aplastic anemia have to be ruled out. Steroids and azathioprine usually control the liver damage but do not prevent the development of aplastic anemia. Aplastic anemia is treated with either hematopoietic stem cell transplantation in patients with a sibling donor or anti-thymocyte globulins and cyclosporine. We propose guidelines to explore and treat this rare disease. We emphasize on the necessary close collaboration between hepatologists and hematologists.


Asunto(s)
Anemia Aplásica , Trasplante de Células Madre Hematopoyéticas , Hepatitis Autoinmune , Niño , Humanos , Anemia Aplásica/complicaciones , Anemia Aplásica/terapia , Hepatitis Autoinmune/complicaciones , Hepatitis Autoinmune/terapia , Ciclosporina/uso terapéutico , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Hermanos
4.
Prev Med ; 90: 52-8, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27370167

RESUMEN

Human papillomaviruses (HPV) are involved in the development of anogenital and head and neck cancers. The purpose of this study was to assess the risk of developing a second primary cancer (SPC) after a first potentially-HPV-related cancer, and to analyze the sites where SPCs most frequently occurred in these patients. All patients with a first cancer diagnosed between 1989 and 2004, as recorded by 10 French cancer registries, were followed up until December 31, 2007. Only invasive potentially-HPV-related cancers (namely, cervical, vagina, vulva, anal canal, penile, oropharynx, tongue and tonsil) were included. Standardized Incidence Ratios (SIRs) were calculated to assess the risk of SPC. A multivariate Poisson regression model was used to model SIRs separately by gender, adjusted for the characteristics of the first cancer. 10,127 patients presented a first potentially-HPV-related cancer. The overall SIR was 2.48 (95% CI, 2.34-2.63). The SIR was 3.59 (95% CI, 3.33-3.86) and 1.61 (95% CI, 1.46-1.78) in men and women respectively. The relative risk of potentially-HPV-related SPC was high among these patients (SIR=13.74; 95% CI, 8.80-20.45 and 6.78; 95% CI, 4.61-9.63 for men and women, respectively). Women diagnosed in the most recent period (2000-2004) showed a 40% increase of their relative risk of SPC as compared with women diagnosed between 1989 and 1994 (ratio of SIRs=1.40; 95% CI, 1.06-1.85). HPV cancer survivors face an increased risk of SPC, especially second cancer. Clinicians may consider this increased risk of developing HPV-related SPC during follow-up to improve subsequent cancer prevention in these patients.


Asunto(s)
Neoplasias Primarias Secundarias/epidemiología , Infecciones por Papillomavirus/complicaciones , Vigilancia de la Población/métodos , Femenino , Francia , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Incidencia , Papillomaviridae/aislamiento & purificación , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Urogenitales/epidemiología
5.
Bull Cancer ; 109(11): 1125-1131, 2022 Nov.
Artículo en Francés | MEDLINE | ID: mdl-35987855

RESUMEN

Pegaspargase (Oncaspar®), a pegylated form of native Escherichia Coli-derived L-asparaginase is an essential component chemotherapy used in the treatment of acute lymphoblastic leukemia (ALL) in pediatric and adult patients. Its particular toxicity profile requires a specific management to improve safety and tolerability and optimize treatment outcome and therefore survival. Within the framework of workshops of practice harmonization of the French Society of Children and Adolescent Cancers, diagnostic and management of the most commonly occuring toxicities (excluding coagulation abnormalities) during Pegaspargase treatment were reviewed according to the analysis of published studies.


Asunto(s)
Antineoplásicos , Trastornos de la Coagulación Sanguínea , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adulto , Humanos , Adolescente , Niño , Asparaginasa/efectos adversos , Polietilenglicoles/efectos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Resultado del Tratamiento , Antineoplásicos/efectos adversos
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