Safety and efficacy of immunotherapy using a double-dose regimen in advanced non-small cell lung cancer (NSCLC): results of IDEE study.

Background: Pembrolizumab 400 mg every six weeks (Q6W) and nivolumab 480 mg every four weeks (Q4W) are used since 2020 and the coronavirus disease 2019 (COVID-19) pandemic. This recommendation relied on pharmacokinetic and pharmacodynamic models. The objective of the IDEE (Immunothérapie Double dose Etendue: Experience bretonne) study is to determine the safety and efficacy of this treatment regimen in real life conditions. Methods: We conducted an observational, retrospective, multicentric study including 117 patients with advanced non-small cell lung cancer (NSCLC) who received pembrolizumab Q6W or nivolumab Q4W between March 2020 and March 2021. Results: The median age was 67 years, 68% were men with predominantly lung adenocarcinoma. The median time to double-dose regimen failure (TDDF) was 9.2 months. The survival rate at 12 months was 79%. TDDF was not influenced by sex, line of treatment, pathologic subtypes or anti-programmed cell death protein 1 (PD-1) antibody. There was no correlation between TDDF and duration of prior exposition to immunotherapy before switching. Sixty-eight patients experienced double-dose treatment failure, 28% because of toxicity including five definitive discontinuations. Five grade ≥3 immune-adverse events were reported included two cases of pneumonitis, all responding to corticosteroid therapy. Conclusions: Our multicentric cohort supports the feasibility of pembrolizumab Q6W and nivolumab Q4W for patients with advanced NSCLC. There is no warning signal regarding safety neither efficacy in our real-life data.

Sleep disturbances and impaired daytime functioning in outpatients with newly diagnosed lung cancer.

BACKGROUND: Clinical experience suggests that lung cancer (LC) is associated with sleep disturbances that may contribute to impaired daytime functioning and quality of life. Using questionnaires and home actigraphic recordings, we tried to determine whether sleep quality and daytime alertness are impaired in patients with newly diagnosed LC. PATIENTS AND METHODS: Twenty-nine outpatients with newly diagnosed LC and an Eastern Cooperative Oncology Group performance status

Personalised medicine in asthma: from curative to preventive medicine.

The concept of asthma has changed substantially in recent years. Asthma is now recognised as a heterogeneous entity that is complex to treat. The subdivision of asthma, provided by "cluster" analyses, has revealed various groups of asthma patients who share phenotypic features. These phenotypes underlie the need for personalised asthma therapy because, in contrast to the previous approach, treatment must be tailored to the individual patient. Determination of the patient's asthma phenotype is therefore essential but sometimes challenging, particularly in elderly patients with a multitude of comorbidities and a complex exposure history. This review first describes the various asthma phenotypes, some of which were defined empirically and others through cluster analysis, and then discusses personalisation of the patient's diagnosis and therapy, addressing in particular biological therapies and patient education. This personalised approach to curative medicine should make way in the coming years for personalised preventive and predictive medicine, focused on subjects at risk who are not yet ill, with the aim of preventing asthma before it occurs. The concept of personalised preventive medicine may seem a long way off, but is it really?

[Docetaxel and non-small cell lung cancer]. / Docetaxel et cancer bronchique non à petites cellules.

Docetaxel (Taxotere) is a taxoid used in various tumoral diseases. Its role in metastatic or locally advanced non small cell lung cancer treatment is undeniable. In pretreated patients with metastatic NSCLC, two recent phase III trials have shown an improvement of survival and quality of life for patients receiving docetaxel. In front line treatment, docetaxel administered alone every three weeks or in combination with a platine compound has became a gold standard treatment. Activity of the associations cisplatinium/docetaxel and carboplatin/docetaxel is similar to those reported with previous combinations containing a platine derivative. The weekly schedule of docetaxel and its combination with other well known active drugs in NSCLC such as gemcitabin or vinorelbin deserve further evaluations. Therapeutic options with docetaxel in adjuvant situation in resected NSCLC or in combination with radiation therapy in operable locally advanced NSCLC should be developed in the next future.

[Molecular therapy targets in lung cancer]. / Thérapeutiques moléculaires ciblées en cancérologie bronchique.

Molecular targeted therapies offer great hope in lung cancer because they are supposed to act upon biologic abnormalities specific to cancer cells. In the present review, we will describe the major pathways of tumor cell growth, apoptosis, angiogenesis and invasion as well as the targeted therapies interacting with these pathways. We will provide an overview of the trials involving targeted therapies in lung cancer, along with the specific problems related to the development of these new therapies.

[Management of stable COPD]. / Principes de la prise en charge de la bronchopneumopathie chronique obstructive.

The term chronic obstructive pulmonary disease (COPD) is mainly characterised by an irreversible obstructive airway obstruction, that in most cases, is secondary to tobacco exposure. Management of the disease includes an assessment of severity, and measures to decrease FEV decline, to treat bronchial obstruction, to improve exercise tolerance and to correct abnormal gas exchange. Treatment not only requires drug therapy, but also respiratory rehabilitation, surgery of emphysema, and psychosocial support. In this way, a global strategy, adapted to the severity of COPD, can be proposed.