Bulletin du cancer
-
This article offers a retrospective overview of 25 years of implementation of psycho-oncology at the Memorial Sloan Kettering Memorial Cancer Center. It shows the ways and means used to obtain a progressive development of this sub-specialty for the purpose of improving patients' quality of life and helping professional teams wishing to offer integrated care to patients and families. ⋯ This has enabled the determination of the prevalence psycho-pathologies in the field of cancer, and demonstrated the need for early screening, and the instatement and evaluation of various specific interventions. Today, psycho-oncology is considered as a natural component of supportive care, but it should continue to develop alongside other specialities in order to help patients and families to cope with cancer better, both during and after treatment.
-
Malignant gliomas of which glioblastomas represent the ultimate grade of malignancy are characterized by dismal prognoses because malignant glioma cells present both important proliferation and neoangiogenesis processes and can actively migrate through the narrow extra-cellular spaces in the brain, often travelling relatively long distances, making them elusive targets for effective surgical management. Invasive malignant glioma cells show a decrease in their proliferation rates and a relative resistance to apoptosis (type I programmed cell death) as compared to the highly cellular centre of the tumour, and this may contribute to their resistance to conventional proapoptotic chemotherapy and radiotherapy. The multidisciplinary up to date treatment for glioblastoma patients combined maximal surgical removal of the tumor with postoperative radiotherapy and concomitant chemotherapy with temozolomide. ⋯ It is a ligand of the alpha1 subunit of the pump which impairs the proliferation and migration of glioblastoma cells by disorganizing the actin cytoskeleton and inducing severe autophagic process in glioblastoma cells. Collectively, these data suggests that the novel cardenolide is an attractive candidate for preclinical and clinical development, at least in the area of glioblastoma. This compound should reach phase I clinical trials in the summer of 2008.
-
The microarray technology has enabled scientists to simultaneously investigate the expression of thousands of genes. Regarding breast cancer, this technology has provided a molecular classification into clinically relevant subtypes, new tools to predict disease outcome and response to treatment and new insights into carcinogenesis and metastatic progression pathways. Here we describe the state of the art of gene expression profiling for breast cancer, and we discuss the potential impact on breast cancer patient management considering its limits and promises.
-
In this brief review we describe the general principles of the antigenicity of human tumor cells, which can be recognized by T lymphocytes and particularly by cytolytic T lymphocytes. This antigenicity of tumor cells lead to the development of therapeutic anticancer vaccines that should induce tumor regressions or prevent the development of metastases in the vaccinated patients. ⋯ Detailed immunological analyses with some of these vaccinated patients showed strong anti-tumor T cell responses and suggested that the main limiting factor for clinical efficacy is a phenomenon of resistance of the tumor to T lymphocyte attack. Current research projects aim at elucidating the mechanisms of this resistance and to develop new vaccination strategies that circumvent this roadblock.
-
The epothilones are a new class of non-taxane tubulin polymerization agents obtained by natural fermentation of the myxobacteria Sorangium cellulosum. The cytotoxic activities of the epothilones, like those of the taxanes, have been linked to stabilization of microtubules, but they also have important differences. ⋯ Ixabepilone was evaluated in vivo in a panel of human and rodent tumour models, the majority of which were chosen because of their known, well-characterized resistance to paclitaxel, and seems able to overcome the over-expression of multidrug resistance and to be unaffected by mutations in the beta tubulin gene. The interest of ixabepilone was clinically confirmed in clinical studies of phase II which demonstrated a strong activity at the patients with metastatic breast cancer resistant to taxanes and in patients suffering of other types of chemoresistant tumors.