Experimental studies have shown that the IL6/GP130/STAT3 pathway is involved in pancreatic cancer tumorigenesis and progression as well as in the development of other tumors. Bazedoxifene, a selective estrogene receptor modulator clinically available for the treatment of osteoporosis, has been shown to be an effective GP130/STAT3 signaling inhibitor through in vitro and small animal studies. Our aim was to investigate the effect of bazedoxifene on tumor progression in patients with advanced pancreatic and gastric tumors. We analyzed the data of 7 patients (5 suffering from pancreatic and 2 from gastric adenocarcinoma), with locally advanced and/or metastatic disease, median age 73 years old (range 48 - 86 years). Bazedoxifene was given orally at a dose of 20 mg per day for a median duration of 9 months (range 5 - 14 months). Two patients received bazedoxifene as monotherapy, 5 patients were under concomitant chemotherapy. Results showed tumor marker reduction in 5 patients, stable disease on CT in 5 patients and metabolic regression on PET-CT in 3 patients. Weight was gained in 4 patients. Two patients developed deep vein thrombosis and one pulmonary embolism, the treatment was otherwise well tolerated. An immunhistochemical study of pSTAT3 was performed in 6 patients, out of which 3 were positive. Our preliminary data indicate that bazedoxifene is a potential new therapeutic option for pancreatic and gastric cancer therapy, safe to use and at low cost. It might be administrated at an early stage with current strategies. Based on these preliminary results, we will initiate a prospective clinical study.
Pancreatic cancer is the 10th leading cause of death worldwide. It is a very lethal and aggressive tumor, with a 5-year overall survival rate under 5 % for confirmed ductal adenocarcinoma. Even though many genes have been identified as possible treatment targets, surgery remains the only curative treatment. Imaging is essential to the initial workup and is mostly based on CT-scan and MRI studies. Resectability is based on the absence of distant metastases and arterial vasculature infiltration. 3D imaging reconstruction could add precision to the surgical evaluation. Many phase II non randomized studies have shown that neo-adjuvant chemotherapy had a positive effect on pancreatic cancer. Nevertheless this approach is only reserved for cases with locally advanced tumors.
Le cancer du pancréas est la 10e cause de décès au monde. C'est une tumeur très agressive avec un taux de survie global à cinq ans en dessous de 5 % pour les adénocarcinomes canalaires confirmés. Bien que plusieurs gènes aient pu être identifiés comme d'éventuels cibles de traitements, la chirurgie reste l'unique traitement curatif pour cette maladie. Dans le bilan initial, l'imagerie tient une place prépondérante et est surtout basée sur le CT-scan et l'IRM. Les critères de résécabilité chirurgicale sont basés sur l'absence de métastases à distance et d'infiltration des vaisseaux artériels. La reconstruction 3D des images semble apporter plus de précision afin de déterminer la stratégie chirurgicale. Plusieurs études prospectives de phase II non randomisées ont déjà montré que les traitements néoadjuvants de chimiothérapie auraient un effet bénéfique sur les cancers du pancréas. Toutefois, cette approche est pour l'instant réservée uniquement aux cas localement avancés.
CERN-MEDICIS is a facility dedicated to research and development in life science and medical applications. The research platform was inaugurated in October 2014 and will produce an increasing range of innovative isotopes using the proton beam of ISOLDE for fundamental studies in cancer research, for new imaging and therapy protocols in cell and animal models and for preclinical trials, possibly extended to specific early phase clinical studies (phase 0) up to phase I trials. CERN, the University Hospital of Geneva (HUG), the University Hospital of Lausanne (CHUV), the Swiss Institute for Experimental Cancer (ISREC) at Swiss Federal Institutes of Technology (EPFL) that currently support the project will benefit of the initial production that will then be extended to other centers.
Laboratories , Radioisotopes , Humans , Nuclear Medicine , Switzerland
Breast cancer is the most common cancer in women. Daily suffering of patients and their relatives is often ignored or underestimated. Scientific advances focus on medical treatments and survival and very little on the psychosocial impact of the disease. The shared expertise between breast cancer patients and health care providers is an innovative and promising approach aiming to provide better quality of life and care. The participation of patients permits to bring together professionals around common goals and to promote multidisciplinary disease management, networking and global care. Focusing on very concrete problems highlighted from patients' expertise also improves research, medical training, and health policy standards.
Breast Neoplasms/therapy , Health Personnel , Patient Compliance , Female , Humans
