Bulletin du cancer最新文献

Purpose: This study aims to evaluate the efficacy and safety of combining androgen deprivation therapy (ADT) with stereotactic body radiation therapy (SBRT) in the treatment of localized prostate cancer.

Methods: A retrospective analysis was conducted on 30 patients treated with SBRT for localized prostate cancer at Cheikh Khalifa Hospital between 2017 and 2022. All patients presented with intermediate prognostic risk prostate cancer, as classified by the D'Amico criteria. Each patient received a total dose of 36.25Gy in five fractions using the TrueBeam STX system, along with six months of ADT. Patient outcomes were assessed based on relapse-free survival, biochemical recurrence, overall survival, and adverse effects, including gastrointestinal (GI) and genitourinary (GU) toxicities. Quality of life was evaluated using the EPIC-26 questionnaire.

Results: Over a median follow-up period of 33months, the relapse-free survival rate was 96.7%, with a biochemical recurrence rate of 3.3%. The overall survival rate at four years was 100%. Acute GI toxicities were minimal and transient, while GU toxicities were primarily grades 1 and 2, with no grade 3 or higher events reported. Erectile dysfunction was noted in 87% of patients. Quality of life assessments indicated low levels of urinary and bowel side effects but moderate impact on sexual function.

Conclusion: These findings suggest that the combination of ADT with SBRT approach offers favorable relapse-free and overall survival rates with manageable toxicity profiles. Further long-term studies are needed to confirm these results and better understand the impact on patient quality of life.

Therapies targeting HER2 and immune checkpoint inhibitors have improved survival in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma, but the prognosis associated with these cancers remains poor. Claudin 18.2 is a tight junction protein expressed in the oeso-gastric mucosa. Some gastric and gastro-oesophageal junction adenocarcinoma overexpress this protein, as well as some pancreatic, ovarian and pulmonary cancers. In pathological context, its epitope may be exposed at the surface of cells and therefore makes it an interesting therapeutic target. Zolbetuximab, a monoclonal antibody targeting claudin 18.2, showed a survival benefit in first line metastatic treatment in patients with claudin 18.2 positive gastric and gastro-oesophageal junction adénocarcinoma, in two phase III studies. CAR T-cells specifically targeting this protein have also shown promising efficacy from the second line of treatment. Considering the probable impact of the expression status of claudin 18.2 in future treatment algorithms, this review aims to present the pathophysiology underlying the targeting of claudin 18.2, summarize state of the art results of anti-claudin 18.2 therapies and discuss future challenges for the management of patients with claudin 18.2 positive gastric and gastro-oesophageal junction adenocarcinoma.

The covalent Bruton tyrosine kinase inhibitors (iBTKs) have profoundly transformed the management of B-cell lymphoid malignancies, particularly chronic lymphocytic leukemia (CLL). These targeted therapies, with ibrutinib as the pioneer, have paved the way for significant improvement in the prognosis of many patients. With second-generation iBTKs such as acalabrutinib and zanubrutinib, the therapeutic landscape has expanded, offering potential new options for patients with CLL. This review focuses on the cardiovascular adverse effects associated with these treatments. It delves into the underlying pathophysiological mechanisms of these effects, highlighting the complex interactions between these molecules and the cardiovascular system. Additionally, it examines the frequency of adverse effects according to the type of iBTK, drawing on data from clinical trials and real-world clinical practice. Finally, the importance of close cardio-oncological monitoring is emphasized, with essential collaboration between hematologists and cardiologists. Strategies for screening and managing cardiovascular adverse effects are also discussed, emphasizing the need for a proactive approach in managing these complications. Experts propose a pragmatic follow-up of these patients, through a central illustration and a figure adapted from European cardio-oncology guidelines, to simplify hematologists' practice.

Introduction: The care of cancer patients involves a large number of healthcare professionals. Communication at the transition points between healthcare establishments and primary care providers needs to be improved. The aim of this study is to evaluate the satisfaction of community pharmacists regarding the transmission of the discharge letter when their patient is discharged from an oncology ward.

Methods: The patients included were those discharged from hospital with one or more changes in treatment during their hospitalization in the Multidisciplinary Medial Oncology Unit of the University Hospital Center of Nantes and who returned home. From April 1, 2023 to December 1, 2023, a seventeen-question questionnaire was e-mailed to the community pharmacists of the patients included in the study.

Results: Forty-eight patients benefited from medication reconciliation at discharge. Thirty-eight pharmacists (79%) responded to the questionnaire. Of the 35 pharmacists that indicated they had received the discharge letter, 32 found it useful (42.9%) or very useful (48.6%), and were in favor of receiving it via e-mail (97.2%). For 94.3% of pharmacists, the document provided sufficient information.

Discussion: Transmitting the discharge letter to dispensing pharmacists would seem to be an interesting option for fostering the city-hospital link. Its presentation and content seemed to meet the expectations of community pharmacists. The pharmacists felt that the continuity of care was important for ensuring their patient's care, but that it required improvement.