Bulletin du cancer最新文献

International organizations FACT and the Joint Accreditation Committee ISCT-Europe & EBMT (JACIE) have developed a reference framework that provides a safe structure for the management of cellular therapies. This framework (FACT-JACIE v8.2) is organized according to a quality management approach. During the annual workshops of the Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC), we aimed to enable medical directors to build an effective human resource management system that complies with JACIE standards. To this end, we designed a competency validation system, including an annual cycle for physicians and a three-year cycle for paramedical staff, structured around three key domains. By clearly distinguishing the training pathway and integrating digital tools, this model ensures real-time updating of competencies and can be extended to other specialties or healthcare professions, as well as reproduced at the national level with international perspectives. This article lays the foundations of a collaboratively developed skills enhancement program. It describes the necessary steps to fully involve each professional category in its design, details the mechanisms that foster their engagement, and identifies the essential elements to define and implement in order to achieve an operational competency matrix. The entire approach is carried out in compliance with FACT-JACIE requirements, ensuring its robustness and international alignment.

Objectives: To evaluate patient and pharmacist satisfaction with two information systems using QR codes to access information about oral cancer treatments.

Methods: THERANOVA-LIM (NCT04931329) was a prospective, descriptive, single-centre study of cancer patients receiving oral treatment. Patients were divided into two groups: one group using the information card and the other using the standard prescription with QR code. Patient satisfaction was assessed at 3 months using questionnaires.

Results: In all, 128 patients were included: 55 received a 'drug information card' and 73 a 'prescription with QR code'. The median age was 69 (37-90). The three most common cancers were breast (37.5%), prostate (14.1%) and brain (10.9%). The vast majority of patients had metastatic cancer (90%). The three most prescribed drugs were capecitabine (21.1%), ribociclib (11.7%) and temozolomide (11.7%). Patients presented the QR codes during medical consultations (25.0%), pharmacy visits (100%) and during home visits by nurses (25.0%). Both patients and professionals were satisfied with these new systems. Pharmacists felt that the prescription with a QR code was more useful for their daily practice in the pharmacy (P=0.02).

Conclusions: QR code systems proved effective in providing information to patients and healthcare professionals. The QR code prescription appeared to be the most practical for pharmacy activities.

Trial registration number and the date of registration: ClinicalTrials.gov, NCT04931329. 2021-05-10.

Introduction: Squamous cell carcinomas of the external auditory canal are rare, with limited data available in the literature on patient survival in Europe. The low incidence of this condition complicates the development of a standard surgical management procedure, particularly given the lack of consensus regarding the value of neck dissection. The aim of this study was to evaluate the benefit of parotidectomy and neck dissection combined with tumor resection, and to assess the survival outcomes of patients treated for squamous cell carcinoma of the external auditory canal.

Methods: Data on patients surgically treated for this condition were collected from five university hospitals between 2010 and 2022.

Results: Twenty-seven patients were included. Across all stages, the 5-year overall survival rate was 35.4%. Thirteen cN0 patients (48.1%) underwent parotidectomy and neck dissection, with metastatic lymphadenopathy found in one patient. Two patients (7.4%), preoperatively stage III and IV, were found to be pN+ on pathological examination of the parotidectomy and neck dissection, involving cervical areas II, III, and the parotid. No metastatic lymphadenopathy was found in the parotidectomy and neck dissection of stage I-II patients.

Conclusion: Parotidectomy and neck dissection did not identify any metastatic lymph nodes in patients with early-stage disease (I-II). These results provide additional data to the assessment of lymph node dissection as a potential strategy in early-stage patients (I-II). This study also suggests reconsidering the use of prophylactic radiotherapy to the cervical areas for stage I-II patients after complete surgical resection.

Trophoblastic diseases include benign pre-tumor entities (hydatidiform moles) and malignancies called gestational trophoblastic tumors. Most of the latter arise after a hydatidiform mole and are referred to as post-molar trophoblastic tumors. Their diagnosis relies on elevated human chorionic gonadotrophin (hCG) levels following a mole, without the need for histological confirmation. Other forms, including choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT), require histology; notably, PSTT and ETT are relatively resistant to chemotherapy and usually necessitate surgery. The management of post-molar tumors and choriocarcinomas is guided by the International Federation of Gynecology and Obstetrics prognostic score: low-risk cases are treated with monochemotherapy, whereas high-risk forms by polychemotherapy. In refractory disease, immune checkpoint inhibitors represent an emerging option. Gestational choriocarcinoma is characterized by its marked malignancy, aggressiveness, and ability to spread to the mother and fetus. Diagnosis is based on histology combined with abnormally elevated circulating or urinary levels of hCG. Neonatal choriocarcinoma, resulting from transplacental transmission, is exceptionally rare yet life-threatening. It typically manifests early in life, with hemorrhagic visceral metastases. Management, although non-standardized, generally involves platinum-based chemotherapy followed by possible surgical removal of residual lesions. Therapeutic intervention must be prompt and adapted to neonatal pharmacokinetics, while addressing the significant risk of hemorrhagic complications. This review summarizes current knowledges on the diagnosis and treatment of gestational trophoblastic diseases, with particular emphasis on gestational choriocarcinoma and its neonatal counterpart.

Low-grade serous ovarian carcinoma is a rare subtype of epithelial ovarian cancer, accounting for less than 10% of serous malignancies. Compared to high-grade serous ovarian carcinoma, it follows an indolent course, often affects younger women, and demonstrates resistance to conventional cytotoxic chemotherapy. Low-grade serous ovarian is characterized by recurrent MAPK pathway alterations (KRAS, BRAF, NRAS) and frequent expression of functional hormone receptors, supporting the rationale for targeted and endocrine strategies. Optimal management relies on complete surgical cytoreduction. Endocrine therapy has shown promise, particularly in maintenance settings, and is being investigated in frontline strategies. MEK inhibitors, especially trametinib and avutometinib in combination with defactinib, have recently demonstrated improved outcomes in recurrent disease, while new combination strategies are under active evaluation to overcome resistance mechanisms. Immunotherapy remains of limited efficacy, though biomarker-driven combinations are explored. Ongoing biomarker-guided trials are expected to refine treatment paradigms.

Background: While the gut microbiome is known to modulate systemic immunity and response to immune checkpoint inhibitors, the role of tumor-resident microbiota remains underexplored. Recent evidence suggests that these local microbial communities may influence intratumoral immunity and therapeutic outcomes.

Methods: A systematic review compliant with PRISMA guidelines was conducted to evaluate the impact of tumor-associated bacteria on anti-tumor immune responses. Four databases (PubMed, Scopus, Web of Science and EMBASE) were searched for studies published between January 2010 and April 2025. Eligible studies characterized non-intestinal microbiota within tumor tissue and assessed immune endpoints such as T cell infiltration, cytokine profiles, PD-L1 expression, or immune checkpoint inhibitors responsiveness. Due to endpoint heterogeneity, no meta-analysis was performed. Seventeen studies met inclusion criteria.

Results: In tumors including melanoma, pancreatic, esophageal, gastric, breast, lung, and colorectal cancers, intratumoral bacteria modulated immune responses and immune checkpoint inhibitors efficacy. Three recurring mechanisms emerged: immune activation via antigen presentation and Th1 polarization; immune suppression through regulatory T cell recruitment and stromal remodeling; and checkpoint modulation and T cell exhaustion via microbial signaling. These effects were spatially structured and tumor-context dependent.

Conclusion: Tumor-local microbiota represents a distinct and actionable component of the tumor-immune microenvironment. Incorporating microbial profiling into immuno-oncology strategies may enhance biomarker discovery, patient stratification, and development of microbiome-based therapies. Further research is warranted to map spatial microbial heterogeneity, validate functional mechanisms, and translate findings into clinical applications in precision immunotherapy.

Background: PRRT showed promising potential in the management of patients with pNETs. However, there is still a lack of evidence on its relative efficacy and safety compared with other treatment options. This review aims to synthesize the existing evidence on the efficacy and safety of PRRT (without SSA in key comparisons) for pNETs compared to different treatments.

Method: An electronic search was conducted from inception to December 2024. Comparative studies including RCTs, cohorts and case-control studies focused on using PRRT in the treatment of pNETs were included. Efficacy outcomes included DCR, CR, PR, SD, PFS, and OS. Safety outcomes were grade 3-4 hematological and renal toxicity and overall AEs.

Results: Nine studies met the inclusive criteria. Among them, only one (11.1%) study is an RCT. Meta-analysis between full and reduced dosages of 177Lu-DOTATATE for G1-G2 pNETs revealed no significant differences in DCR, CR, PR, SD, and PFS between the groups. However, the full dosage group suggested potential for improved OS in some studies, though not statistically significant. When PRRT was compared to other treatments such as surgery, chemotherapy, and targeted agents, it was associated with longer PFS and potentially OS. Additionally, PRRT combined with capecitabine and salvage PRRT also showed efficacy in advanced cases. Safety analysis indicated that PRRT is well-tolerated, with minimal severe toxicity reported.

Conclusion: PRRT is a promising therapeutic option for patients with advanced pNETs, offering a balance of efficacy and safety compared to other available treatments. Full dosage PRRT may provide better outcomes than reduced dosages, and salvage PRRT remains effective for progressive disease. However, further high-quality RCTs are needed to confirm these findings and optimize PRRT usage in pNETs.