Bulletin du cancer
-
Enzalutamide (MDV3100) is a non-steroidal antiandrogen of second generation that has shown efficacy in metastatic castration-resistant prostate cancer (mCRPC). The study AFFIRM demonstrated a statistically significant increase in overall survival among patients who have progressed following a docetaxel chemotherapy. ⋯ Other trials are underway to evaluate its earlier use in the management of mCRPC. A pivotal registration phase III study (PREVAIL) is ongoing to investigate the effectiveness of enzalutamide in patients who have not yet received chemotherapy.
-
Malignant pleural mesothelioma (MPM) is a bad-prognosis cancer raising difficult issues according to diagnosis. Reliable histological diagnosis indeed requires large-sized pathological samples obtained by thoracoscopy, and need diagnosis certification by the MESOPATH national expert pathological committee. MPM epidemiology shows a rising incidence among females, whereas an incidence plateau has been reached for males in France. ⋯ Surgery is more and more questioned, since radical surgery is currently abandoned, whereas debulking or cyto-reduction surgery has been proposed within a multimodality approach also including adjuvant chemotherapy and radiotherapy but still need prospective trials. Pemetrexed and cisplatin-based chemotherapy remains the reference treatment, which has proved in mesothelioma some efficacy on overall survival in randomized trials, with a 13-15 months median-overall survival. Final results of the large phase 3 clinical trial "MAPS" sponsored by French collaborative Intergroup (IFCT) evaluating the effect of bevacizumab addition to pemetrexed-cisplatin doublet will be released in early 2015, since 445 patients have been included by November 2013.
-
The orthopedic surgical treatment of metastases is very important in the treatment of osteophile cancers. The surgical option is always proposed after a multidisciplinary decision. ⋯ This risk has to be evaluated and a preventive treatment can often be performed. The surgical options are multiple: such as preventive osteosynthesis, pathological fracture treatment, reconstruction with prosthesis, carcinological excision… The choice of the treatment is support on the life expectancy and the functional risk of the metastatic bone lesion.
-
The administration of a radionuclide in unsealed source whose radiation will destroy cells that have selectively accumulated product is called radiometabolic therapy. The management of bone pain is a major problem, particularly in cases of breast or prostate where the presence of metastases can remain compatible with long-term survival of cancer patients. In this context, the radiometabolic therapy reduces the pain secondary to bone metastases, in association or not with analgesics. ⋯ In this setting, the currently used substances are Metastron® and Quadramet®. Recently, a new product, radium chloride (or Alpharadin®) has shown efficacy in bone metastases from prostate cancer, particularly in terms of bone pain palliation, but also of increased overall survival. In addition, this product has virtually no hematologic toxicity.
-
The announcement of the diagnosis of cancer is difficult for doctors and patients alike. The main objective is the study of announcement's techniques used by physicians to send their patients in cancer centers. The second objective is to analyze encountered difficulties and experience of the announcement of the diagnosis. ⋯ Some doctors have a positive experience and claim their role in this announcement. Their negative experience is linked to representations made about the disease and generated feeling. The results of this study show a need of training for physicians in order to acquire know-how and attitude at the time of cancer announcement.