Bulletin du cancer最新文献

Although the indications and the efficacy of the enteral nutrition are no longer questionable anymore, it is still underused. The French Société de nutrition clinique et métabolique, in collaboration with the NACRe activity issued recommendations in 2012, as far as the nutritional care is concerned for all the adult patients in the oncology field "Nutrition for the adult patients with cancer". This guide tends to recommend the setting of nutritional supports, especially some artificial nutrition as enteral and parenteral nutrition. The ADHENUTE research's first goal is to give a description of the respect of those recommendations within a Cancer Center, in the medical oncology department and is also willing to understand the reasons of the reluctance towards this type of nutritional support. Nutritional management was compared to the taking of the cares given to twenty hospitalized patients in the medical oncology department in our Cancer Center. One hundred and eighty-nine of the records had all the necessary informations for this type of cares and their setting. Among them, seventy-two patients required the setting of an enteral nutrition. The fact that only twenty-two patients actually got this form of nutrition does confirm the hypothesis of a clear underuse of this nutritional care.

Introduction: Aggressiveness of end-of-life care refers to intensive medical interventions at an advanced disease stage, including the late initiation of chemotherapy. This study assesses its incidence among patients hospitalized at the Léon-Bérard Center.

Methods: This retrospective study was based on a relevance review, according to the criteria defined by the French National Health Authority (HAS) and included 80 patients who died between November 2023 and May 2024. Aggressiveness of care was defined using a composite criterion: (1) chemotherapy within the last 14 days of life; (2) initiation of a new line of therapy within the last month of life; (3) transfer to intensive or critical care within the last month of life; (4) first contact with palliative care less than three days before death.

Results: Among the 75 records analyzed, 36 patients (48%) presented at least one criterion of aggressiveness in end-of-life care. The prevalence was 25.3% for chemotherapy within the last 14 days, 28% for the initiation of a new therapeutic line in the last month, 16% for transfer to intensive or critical care in the last month.

Discussion: Compared to the existing literature, these results indicate high rates of aggressive end-of-life care. They highlight the importance of early palliative care integration to improve care planning and reduce aggressiveness.

Conclusion: The use of prognostic tools and improved coordination between oncology and palliative care appear to be essential to optimize end-of-life management.

PD-L1 immunohistochemical assessment has become an essential biomarker in the management of squamous cell carcinomas of the upper aerodigestive tract (UADT). The Combined Positive Score (CPS) is currently the gold standard method for quantifying PD-L1 expression. This article provides an update on the technical and interpretative aspects of the CPS, practical recommendations for pathologists, and associated therapeutic implications. Particular attention is paid to challenges such as reproducibility of scoring, antibody selection, and the integration of PD-L1 expression data in therapeutic decisions, especially in the context of immunotherapy. The objective is to provide pathologists with an up-to-date synthesis of best practices and to give clinicians a better understanding of the role of PD-L1 in the personalized management strategy for patients with UADT squamous cell carcinoma.

Stage IV non-small cell lung cancer (NSCLC) without actionable mutations remains a major therapeutic challenge, especially following immunotherapy failure. The introduction of immune checkpoint inhibitors (anti-PD-1/PD-L1) has revolutionized first-line treatment, but second-line options remain largely dependent on older chemotherapies such as docetaxel or pemetrexed. A significant number of patients experience disease progression despite immunotherapy, highlighting tumor resistance mechanisms, whether primary (rapid failure) or acquired (after initial response). Resistance mechanisms include low CD8+ T-cell infiltration, genetic mutations (PTEN, JAK), loss of neoantigens, and tumor-induced immunosuppression. Innovative strategies are under investigation: antibody-drug conjugates (anti-TROP-2, anti-CEACAM-5), cancer vaccines (TEDOPI), external electric fields (TTFields), oncolytic viruses, and PROTACs. While some of these show promise in progression-free survival, global survival benefit remains modest. The identification of robust predictive biomarkers is essential for tailoring future therapies.

Introduction: Since 2020, the "marketing authorization updates" section of Bulletin du Cancer has provided a monthly educational summary of new marketing authorizations (MAs) granted by the European Medicines Agency (EMA) in the fields of oncology and hematology. A survey was conducted five years after its creation to assess the functioning of the format, its informative and educational value, and potential areas for improvement.

Methods: An online questionnaire comprising 16 items was distributed in May 2025 to the 245 authors who had contributed to at least one article in the AMM section.

Results: A total of 78 responses were collected, including 52 residents and 26 senior physicians. The results were positive regarding the organization and the quality of interactions within the author pairs, with writing guidelines rated as "clear" or "perfectly clear" in over 80% of responses. The perceived educational value was high for both trainees and seniors (median self-reported educational benefit of 9/10 for residents and 7.5/10 for senior physicians). Overall satisfaction with the format was also high, with a median rating of 9/10 in both groups.

Conclusion: This survey highlights the value of the "marketing authorization updates" section, which successfully fulfils a dual mission of education and information, while fostering intergenerational collaboration.