Ne sous-estimons pas le risque à long terme de second cancer pulmonaire après exérèse chirurgicale d'un cancer du poumon non à petites cellules

Etat de la question Plusieurs etudes ont montre que les survivants d’un cancer du poumon sont a haut risque de developper un second cancer broncho-pulmonaire (SCBP). L’evaluation du risque de SPBC au cours du temps a d’importante repercussion sur la strategie de surveillance post-chirurgicale des cancers du poumon non a petites cellules (CPNPC). L’objectif principal de cette etude etait de mesurer le risque de SCP sur le long terme en tenant compte du risque competitif de deces. Materiel et methodes Le risque cumule de SCBP a ete estime a l’aide de l’incidence cumulee chez des patients operes en resection complete d’un CPNPC de stade I a III diagnostiques entre 2002 et 2015 et recenses par …

Does large NGS panel analysed using exome tumour sequencing improve the management of advanced non-small-cell lung cancers?

Abstract Introduction Non-small-cell lung cancer (NSCLC) is one of the most common and deadly cancers. Several molecular drivers of oncogene addiction are now known to be strong predictive biomarkers for target therapies. Advances in large Next Generation Sequencing (LNGS) have improved the ability to detect potentially targetable mutations. However, the integration of LNGS into clinical management in an individualized manner remains challenging. Methods In this single-center observational study we included all patients with advanced NSCLC who underwent LNGS. Somatic and germline exome analysis was performed with a restriction on 323 cancer related genes. Variants were classified and Molecu…

Risk of scleroderma according to the type of immune checkpoint inhibitors

Abstract Introduction Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events (irAEs). Among them, ICIs-induced systemic sclerosis (SSc) is poorly known. Methods To better characterize this irAE, our comprehensive approach combined the description of ICIs-induced scleroderma cases, the systematic review of the literature and the analysis of VigiBase, the WHO pharmacovigilance database. Results We identified two cases with underlying limited cutaneous SSc who presented a dramatic increase in the skin thickening following pembrolizumab, associated with scleroderma renal crisis in one case. In the literature, four cases of scleroderma and four cases of morphea hav…

Outcomes of Patients With Advanced NSCLC From the Intergroupe Francophone de Cancérologie Thoracique Biomarkers France Study by KRAS Mutation Subtypes

Abstract Introduction KRAS mutations are detected in 20% to 30% of NSCLC. However, KRAS mutation subtypes may differently influence the outcome of patients with advanced NSCLC. Methods In the Biomarkers France study, 4894 KRAS mutations (26.2%) were detected in 4634 patients from the 17,664 enrolled patients with NSCLC. Survival and treatment data on noncurative stage III to IV NSCLC were available for 901 patients. First- and second-line treatment effects on progression-free survival and overall survival were analyzed according to the KRAS mutations subtype. Results Over 95% of patients with KRAS mutation were smokers or former smokers who were white (99.5%), presenting with adenocarcinoma…

Cutaneous Toxicity Induced by Hibiscus Tea in a Patient Treated with Erlotinib

Les traitements péri-opératoires des cancers bronchiques non à petites cellules (CNPC) : standards actuels et perspectives

Resume La chirurgie est le traitement de reference des CNPC de stades I, II et IIIA. Plusieurs essais randomises de phase III de chimiotherapie adjuvante ou neoadjuvante avec une chimiotherapie a base de platine ont ete menes dans les cancers de stades I, II et IIIA. Ces essais ont demontre un gain de survie significatif de la chimiotherapie adjuvante ou neoadjuvante evalue a 5 % a 5 ans dans les stades II et IIIA. Ce benefice a ete confirme par deux meta-analyses sur donnees individuelles. En revanche pour les stades I, le benefice de la chimiotherapie n’est que suggere dans les stades IB > 4 cm. La place de la radiotherapie adjuvante dans les tumeurs N2, sera precisee par l’essai Lung-ART…

Time to give a rest to cetuximab in the treatment of advanced non-small cell lung carcinoma?

Chemotherapy with a platinum-based doublet has long been the cornerstone of the treatment for advanced non-small cell lung carcinoma (NSCLC) (1). Since the early 2000s, several driver gene mutations and translocations have been discovered, giving rise to the possibilities of targeted therapies (2-4).

Prophylactic cranial irradiation in stage IV small cell lung cancer

Background: Due to conflicting results between major trials the role of prophylactic cranial irradiation (PCI) in stage IV small cell lung cancer (SCLC) is controversial.Methods: We obtained a list of 13 European experts from both the European Society for Therapeutic Radiation Oncology (ESTRO) and the International Association for the Study of Lung Cancer (IASLC). The strategies in decision making for PCI in stage IV SCLC were collected. Decision trees were created representing these strategies. Analysis of consensus was performed with the objective consensus methodology.Results: The factors associated with the recommendation for the use of PCI included the fitness of the patient, young age…