Evaluation in usual practice of the bevacizumab-FOLFIRI combination for the first-line treatment of patients with unresectable metastatic colorectal cancer treated in 2006: focus on resected patients and oncogeriatrics: AVASTIN OUEST cohort of the Observatory of Cancer of the Brittany and Pays de la Loire Areas (Observatoire dédié au Cancer Bretagne / Pays de la Loire).

BACKGROUND: In 2006, bevacizumab, a targeted therapy agent was combined with FOLFIRI for the firstline treatment of patients with unresectable metastatic colorectal cancer. METHODS/RESULTS: A study on a homogenous series of 111 patients from the Brittany and Pays de la Loire areas who received bevacizumab-FOLFIRI as first-line treatment in 2006 showed the following results: 51 responses, 29 stabilisations, 21 progressions and 10 cases of toxicity prior to assessment. Median overall survival (OS) was 25.1 months and median progression-free survival was 10.2 months. Surgery secondary to treatment tripled median OS which reached 59.2 months in resected patients versus 18.8 months in unresected patients. Comparison of patients aged more or less than 70 years showed no differences in terms of benefits or risks. CONCLUSION: Bevacizumab-FOLFIRI could be administered as part of a routine care protocol to elderly patients previously evaluated by a geriatric assessment and validated by a multidisciplinary staff.

En 2006, bevacizumab-FOLFIRI représente la thérapie ciblée administrable dès la première ligne chez les patients porteurs d'un cancer colorectal métastatique non opérable. Une série homogène de 111 patients colligés en région Bretagne et Pays de la Loire ayant reçu du bevacizumab- FOLFIRI en première ligne en 2006 révèle les résultats suivants: 51 réponses, 29 stabilités, 21 progressions et 10 toxicités avant évaluation. La médiane de survie globale (OS) est de 25,1 mois et la médiane de survie sans progression (PFS) de 10,2 mois. Dans le cas d'une chirurgie secondaire, l'OS médian triple de 18,8 mois chez les patients non réséqués versus 59,2 mois ceux réséqués. En comparant les sujets âgés de plus et de moins de 70 ans, aucune différence n'a été mise en évidence en termes de bénéfice ou de risque. Bevacizumab-FOLFIRI pourrait être administré en pratique courante chez les personnes âgées sous couvert d'une évaluation gériatrique et d'une approche multidisciplinaire.

[Association of Takayasu's arteritis and inflammatory bowel disease (author's transl)]. / Association d'une maladie de Takayasu et d'une colite inflammatoire.

The association of an inflammatory colitis or enterocolitis with Takayasu's disease is very rare. The case presented here in a female patient treated for four years is compared to the eight previously described patients. These subjects are young women with digestive disease, ulcerative colitis, Crohn's disease or unclassified colitis which is usually discovered before the arterial disorder. Clinical symptoms and evolution of each disease are not modified by their association. Extra-intestinal involvement of eyes, joints, skin or pericardium may be found. These manifestations, the association of inflammatory bowel disease or Takayasu's disease with immunological disease as well as the pathological findings support the hypothesis of a common physiopathology.

[Tuberculosis or hepatic granulomatosis? (author's transl)]. / Tuberculose ou granulomatose hépatique?

The authors report 43 observations of pulmonary or extra-pulmonary tuberculosis, bacteriologically proved, in which liver biopsies revealed more or less complete granulomatous lesions. The culture of 29 liver fragments on Löwenstein and Colestos medium enabled the identification of the tuberculous bacillum in only one case. In the other cases the hepatic lesion has only been related to the tuberculosis because of the clinical and bacteriological context. Therefore, besides exceptional cases where Koch bacillum is revealed in the liver parenchyma, it seems that granulomatosis can be considered a control for the delayed hypersensitivity reaction to the tuberculous antigens, and not to the tuberculous infection localized to liver.

[Radio-immunoassay of antidiuretic hormone. Choice of a technic of extraction, Normal and pathological values (author's transl)]. / Dosage radio-immunologique de l'hormone antidiurétique. Valeurs usuelles et pathologiques. Choix d'une technique d'extraction.

The low serum concentration of ADH requires extraction prior to assay. Various methods are compared (direct extraction by acetone, adsorption on talcum powder. Florisil, silicilic acid, Fuller's earth, QUSO, carbon-dextran, adsormone, then elution with hydrochloric acetone). The technic finally used was extraction with Florisil. The antibody used was commercially accessible. The separation of bound from free hormone required a second antibody fixed on Sephadex (DASP). The usual values found in 31 normal subjects from 22 to 89 years were: 7,4 . 4,1 pmol/l (M 2 sigma) 1 pmol/l = 1,08 pg/ml. These assays were carried out on tissue extracts prepared by mashing tumour fragments or lymph nodes removed from a patient with the Schwartz Bartter syndrome. They showed the existence in these tissues of high concentrations of ADH immunologically identical with that present in the serum of normal subjects.

[The lung in monocional gammapatheis. Alternative hypotheses coming from a privileged observation (association of a diffuse interstitial fibrosis to a pulmonary tuberculosis then a disease of heavy gamma chains) (author's transl)]. / Le poumon dans les gammapathies monoclonales. Hypothèses alternatives à partir d'une observation privilègiée (association à une fibrose interstitielle diffuse d'une tuberculose pulmonaire puis d'une maladie des chaines lourdes gamma).

The observation of a 61 year old woman who had a diffuse interstitial fibrosis, a pulmonary tuberculosis and a disease of heavy gamma chains is reported here. The different tumoral and infectious pneumopathies during monoclonal gammapathies are analyzed. In the opposite, there are the various abnormalities observed in thoracic pathology: chronic infections, pulmonary tuberculosis and diffuse interstitial fibrosis.