ABSTRACT
Immunotherapy has revolutionized cancer management in recent years and is affecting more and more patients. Immunotherapy side effects are specific, immune-related, and their early recognition and management are essential. Here we describe the main adverse effects of immunotherapy and their general principles of management.
L'immunothérapie a révolutionné la prise en charge des cancers ces dernières années et concerne de plus en plus de patients. Les manifestations indésirables de l'immunothérapie sont spécifiques, de type dysimmunitaire, et leur reconnaissance et prise en charge précoces sont primordiales. Dans cet article, nous décrivons les principaux effets secondaires de l'immunothérapie et leurs principes généraux de prise en charge.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Neoplasms , Humans , Immunologic Factors , Immunotherapy/adverse effects , Neoplasms/therapyABSTRACT
Glioblastoma is the most common primary malignant brain tumor. Despite treatments combining excisional surgery, chemotherapy, and radiotherapy, overall survival remains low and the incidence of tumor recurrence remains high. Advances in the understanding of the disease, particularly its molecular biology and the mechanisms of action of systemic and radiotherapeutic treatments, as well as the development of image-guided surgical techniques, offer hope for the control of this hitherto incurable disease.
Le glioblastome est la tumeur cérébrale maligne primitive la plus fréquente. Malgré des traitements combinant la chirurgie d'exérèse, la chimiothérapie et la radiothérapie, la survie globale reste faible avec une incidence élevée de récidive tumorale. Les progrès dans la compréhension de la maladie, et en particulier de la biologie moléculaire et des mécanismes d'action des traitements systémiques et radiothérapeutiques, de même que le développement des techniques chirurgicales guidées par l'image, permettent d'entrevoir un espoir dans le contrôle de cette maladie jusqu'ici incurable.
Subject(s)
Brain Neoplasms , Glioblastoma , Biomarkers, Tumor , Brain Neoplasms/therapy , DNA Methylation , Glioblastoma/genetics , Glioblastoma/therapy , Humans , Mutation , Neoplasm Recurrence, Local/genetics , PrognosisABSTRACT
Lung cancer is the third most common cancer in Belgium in 2017 and remains the leading cause of cancer death worldwide. There is no longer any doubt that the main cause of lung cancer is smoking. However, the prevalence of lung cancer in never-smokers has been increasing overtime. Moreover, it is now recognized that the lung cancer of non-smoker patients has very distinct characteristics. In this retrospective cohort study (N = 520), we describe the characteristics of non-smoker patients and their non-small cell lung carcinoma and compare them to those of smokers. The patients included in this study were whose with a new diagnostic of lung cancer made at the Liège University Hospital of Liège over 2 years round. Non small cell lung cancer occurring in never-smokers patients is more often seen in young and very old patients, more frequent in female, essentially adenocarcinoma and often associated with mutations. This work confirms that lung cancer in never-smokers shows different features than lung cancer seen in patients with a smoking history.
Le cancer pulmonaire est le troisième cancer le plus fréquent en Belgique en 2017 et reste la première cause de décès par cancer dans le monde. Il ne fait plus aucun doute que la cause principale de cancer du poumon est le tabagisme. Il est toutefois apparu, ces dernières décennies, que le pourcentage de patients non fumeurs augmente parmi les patients présentant un cancer du poumon. Par ailleurs, il est dorénavant reconnu que le cancer pulmonaire du patient non fumeur présente des caractéristiques bien distinctes. Dans ce contexte, nous présentons une étude rétrospective reprenant les caractéristiques cliniques et néoplasiques de l'ensemble des patients ayant présenté un carcinome pulmonaire non à petites cellules dans notre institution sur une période de 2 ans (N = 520). Les cancers non à petites cellules observés chez les nonfumeurs sont plus fréquents chez les sujets jeunes ou très âgés, plus fréquents dans le sexe féminin, en très grande majorité des adénocarcinomes, et souvent associés à des mutations. Nous confirmons ainsi qu'il s'agit d'un cancer aux caractéristiques différentes des cancers pulmonaires des patients fumeurs.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Belgium/epidemiology , Carcinoma, Non-Small-Cell Lung/epidemiology , Female , Hospitals , Humans , Lung Neoplasms/epidemiology , Mutation , Retrospective Studies , SmokersABSTRACT
The incidence of cancer is raising and the treatments are increasingly aggressive. Consequently, physicians are regularly facing side effects of cytotoxic therapies. Cancer- therapy-induced cardiotoxicity is a serious complication because it can be fatal and causes a temporary or permanent cessation of the treatment. In this article, we summarize the mechanisms, the monitoring and the multidisciplinary management of patients with cancer-therapy induced cardiotoxicity.
Les cancers sont de plus en plus fréquents et leurs traitements de plus en plus agressifs. En conséquence, les médecins se trouvent régulièrement confrontés aux effets secondaires des traitements cytotoxiques. La cardiotoxicité induite par les traitements anti-cancéreux est une complication gravissime, car elle peut être mortelle et provoque un arrêt temporaire, voire définitif, des traitements. Dans cet article, nous décrivons les mécanismes, le dépistage et la prise en charge multidisciplinaire de la cardiotoxicité des agents anti-cancéreux.
Subject(s)
Antineoplastic Agents/adverse effects , Cardiotoxicity/epidemiology , Neoplasms/drug therapy , Neoplasms/epidemiology , Antineoplastic Agents/classification , Cardiotoxicity/etiology , HumansABSTRACT
The authors review the principles of systemic therapy in breast cancer. They analyze the degree of treatment individualization in our current approach. New technologies allow the detection of genomic alterations in cancer cells. Unfortunately, we do not know yet how to best use this knowledge for routine patient care. Most genomic alterations are rare events complicating further drug development. Temporal and spatial heterogeneity in tumors also has to be taken into account. An intense international collaboration is ongoing to try and demonstrate that precision medicine will really improve treatment outcome.
Subject(s)
Breast Neoplasms/therapy , Molecular Targeted Therapy , Precision Medicine/methods , Antineoplastic Agents, Hormonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/diagnosis , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Chemotherapy, Adjuvant , Female , Humans , Meta-Analysis as Topic , Molecular Targeted Therapy/statistics & numerical data , Molecular Targeted Therapy/trends , Neoplasm Staging , Precision Medicine/trends , Prognosis , Sequence Analysis, DNA , TranscriptomeABSTRACT
The incidence of cancer is raising and the treatments are increasingly aggressive. Consequently, general practitioners, emergency departments, hematologists and oncologists are regularly facing a severe side-effect of cytotoxic therapy, febrile neutropenia (FN). FN is a serious complication of chemotherapy because it can be quickly fatal and causes a temporary or definitive cessation of treatment. In this article, we summarize the latest recommendations for the management of patients with FN under anti-cancer treatments.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy-Induced Febrile Neutropenia/therapy , Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy-Induced Febrile Neutropenia/diagnosis , Drug Monitoring/methods , Granulocyte Colony-Stimulating Factor/therapeutic use , Humans , Practice Guidelines as Topic , Risk FactorsABSTRACT
In western countries, every woman out of eight will develop breast cancer. Over the last two decades, the incidence has considerably increased, but mortality has remained stable and begins to decrease in Europe and the United-States, probably because of new therapy, changes in the use of hormone replacement therapy in postmenopausal women and early diagnosis. Breast cancer is still the first cause of death by cancer in woman under 65. "Triple negative" a breast cancer, a subtype representing 10% of all breast cancers, is characterised by the absence of receptors to oestrogen, progesterone and no histochemical expression of HER-2 growth factor. This subtype carries a poor prognosis and a high incidence of early metastatic recurrence. Furthermore, no target therapy can be defined up to now in this subtype. Thus, identification of new target therapy and prediction of tumoral response to various treatments could help in the global understanding of patients affected by this particularly aggressive type of breast cancer.
