Importance: Efficacy of second-line chemotherapy in advanced gastric or gastrooesphageal junction (GEJ) adenocarcinoma remains limited.
Ojectives: To determine the efficacy of 1 or 2 immune checkpoint inhibitors combined with FOLFIRI (leucovorin [folinic acid], fluorouracil, and irinotecan) in the treatment of advanced gastric/GEJ adenocarcinoma.
Design, Setting, And Participants: The PRODIGE 59-FFCD 1707-DURIGAST trial is a randomized, multicenter, noncomparative, phase 2 trial, conducted from August 27, 2020, and June 4, 2021, at 37 centers in France that included patients with advanced gastric/GEJ adenocarcinoma who had disease progression after platinum-based first-line chemotherapy.
Background: Chemotherapy is effective in metastatic pancreatic adenocarcinoma (mPA), but new approaches are still needed to improve patients' survival and quality of life. We have previously published good efficacy and tolerability results on a sequential treatment strategy of gemcitabine followed by an intensified FOLFIRI (5FU+irinotecan) regimen. In the present study, we evaluated the same sequence but replaced gemcitabine by the new gemcitabine + nab-paclitaxel standard first-line combination.
View Article and Find Full Text PDFBackground: Maintenance strategies beyond response or tumor stabilization with first-line chemotherapy in metastatic breast cancer (MBC) have not been extensively studied. Endocrine therapy combined with continued bevacizumab may be a helpful option for estrogen receptor (ER)-positive MBC.
Patients And Methods: In this prospective, open-label, phase III study, patients with histologically confirmed ER-positive, HER2-negative MBC and non-progressive disease after 16-24 weeks of taxane plus bevacizumab (T + BEV) were randomized to continuation of T + BEV or maintenance bevacizumab plus exemestane (E + BEV).
Advanced ovarian carcinoma in early progression (<6 months) (AOCEP) is considered resistant to most cytotoxic drugs. Gemcitabine (GE) and oxaliplatin (OXA) have shown single-agent activity in relapsed ovarian cancer. Their combination was tested in patients with AOCEP in phase II study.
View Article and Find Full Text PDFAims: Computed tomography (CT) is the reference technique for evaluating response to chemotherapy. The potential helpfulness of tumour markers is debated.
Materials And Methods: From March 1997 to January 1999, 91 consecutive patients receiving chemotherapy for metastatic colorectal carcinoma underwent whole-body spiral CT, estimates of anti-carcinoembryonic antigen (CEA) and CA19-9 every 8 weeks.
Evaluation of tumour size modifications in response to treatment is a critical issue in the management of advanced malignancies. In 1981, the World Health Organization (WHO) established guidelines for tumour response assessment. These WHO1981 criteria were recently simplified in a revised version, named RECIST (Response Evaluation Criteria in Solid Tumours), which uses unidimensional instead of bidimensional measurements, a reduced number of measured lesions, withdrawal of the progression criteria based on isolated increase of a single lesion, and different shrinkage threshold for definitions of tumour response and progression.
View Article and Find Full Text PDFAlthough the benefit of adjuvant therapy has largely been demonstrated for patients with local breast cancer, therapeutic indications remain controversial. The French regional cancer network Oncora investigated the decision-making process for this disease. Based on a thorough review of the literature, the risk of relapse and the potential benefit of adjuvant treatments for each group of patients were evaluated.
View Article and Find Full Text PDFTotal parenteral nutrition with "All in one" nutritive mixtures is used in France from 1970. These advances ensure a more simple treatment for intensive care units. Nutritive mixtures provide the caloric and nitrogen daily requirements added with micronutrients (electrolytes, trace elements and vitamins) and this technique allows home parenteral nutrition.
View Article and Find Full Text PDFBackground/aims: Long-term survival of patients with intestinal failure requiring home parenteral nutrition (HPN) has been only partly shown. Therefore, we described the survival of these patients and explored prognosis factors.
Methods: Two hundred seventeen noncancer non-acquired immunodeficiency syndrome adult patients presenting with chronic intestinal failure enrolled from January 1980 to December 1989 in approved HPN programs in Belgium and France; prognosis factors of survival were explored using multivariate analysis.
Our expérience in the treatment of 46 cases with radiation enteritis (RE) permitted to summarize 5 key points in the Surgical Strategy: laparotomy incision, enterolysis technique, small bowel and colon preservation, anastomosis technic and parenteral nutritional support. Surgery is imposed most of the time in digestive and nutritional Insufficiencies due to radiation enteritis. 46 patients aged to 33-81 years (mean age = 59) were included for possible surgery.
View Article and Find Full Text PDFDuring severe hepatic insufficiency, serum amino acid profile is modified with an increase of aromatic amino acids (AAA) (Tyrosine and Phenylalanine) and methionine concentrations and a decreased value of 3 branched chain amino acids (BCAA) (leucine, isoleucine and valine). These observations have been confirmed after hepatic surgery in experimental and clinical studies. In experimental models, after 10, 32, 68, 77 or 90% hepatectomy in Wistar rats, the BCAA/AAA ratio (R) is correlated with the extent of hepatectomy: r = 0.
View Article and Find Full Text PDFSince 1981, a consensus is appeared in order to define and to precise the natural evolution of short bowel with a maximal remaining small bowel of 150 cm. The phenomenon of intestinal adaptation which are better known in animals than in humans, are on the dependence of luminal, hormonal and humoral factors (epidermal growth factor, polyamines). The knowledge of prognostical factors and the anatomical and functional evaluation of remaining small bowel allow to "measure" the improvement of digestive absorption and to decide the duration of nutritional support.
View Article and Find Full Text PDFThe development of a fistula is a serious postoperative complication. Conservative medical treatment with total parenteral nutrition, skin care and intensive infection control usually succeeds in closing fistulas (60 to 75 percent), but the treatment is of long duration (two to three months), high cost and high morbidity related to prolonged hospitalization. We have used octreotide, a long half-life stomatostatin analog, in 40 patients from two European university centers with postoperative enterocutaneous fistulas.
View Article and Find Full Text PDFGlutamine is a nonessential neutral amino acid that is widely consumed by the intestinal tract in catabolic states. We have followed up the plasma amino acid profile after extensive small-bowel resection in dogs receiving total parenteral nutrition (TPN) with or without glutamine (GLN) or N-acetylglutamine (aGLN) supplementation. Animals were divided into four groups according to the type of surgery (enterectomy or transection) and nutrition (TPN, TPN with aGLN, or TPN with GLN).
View Article and Find Full Text PDFRecent studies have demonstrated that glutamine may be required for mucosal growth and that it is widely utilised by the intestinal tract after surgery. This study has evaluated the effect of massive small bowel resection on plasma and jejunal glutamine and related amino-acids level evolution after surgery. Transection was performed in 6 dogs (control group) and enterectomy in 10 dogs leaving 25cm of jejunum, associated with colectomy (group 1).
View Article and Find Full Text PDFMassive resections of the intestine including the ileocecal valve are associated with a high mortality. This model of short bowel in the dog consists of an extensive small-bowel resection (remaining jejunum 25 cm) associated with colectomy. Small-bowel adaptation is evidenced by increases of crypt depth (p = 0.
View Article and Find Full Text PDFFunctional adaptation of remaining intestine was evaluated in 30 patients with extensive small bowel resection. Calcium and xylose absorption tests were compared. Calcium absorption was measured by a double-radiotracer technique.
View Article and Find Full Text PDFInt J Rad Appl Instrum B
October 1989
To calculate hepatic volume in the dog by single photon emission computerized tomography (SPECT), we determined the limits of the organ by choosing an isocontour on each section. This choice entailed prior calculation of an overestimated pseudovolume. The accuracy of the measurement in the animal then approached that of measurements in vitro.
View Article and Find Full Text PDFHome parenteral nutrition (HPN) is a growing therapy in North America and Europe. This first multicenter retrospective study of HPN in France has collected data on 81 patients sent home before December 31st, 1985. Intestinal failure, secondary to short bowel syndrome, small bowel stenosis or fistula, was the main indication for HPN.
View Article and Find Full Text PDFAmbulatory total parenteral nutrition (TPN) at home was used in 85 patients within a 6-yr period. Indications include severe malabsorption, fistulas, anorexia nervosa, and malignancies. The median duration of home TPN (HPN) was 67 days (range: 30-4,155 days).
View Article and Find Full Text PDFThe treatment of epithelial carcinoma of the ovary (90% of malignant ovarian tumours) has largely benefited from chemotherapy, notably since the advent of cisplatinum. Radiotherapy may be an important adjuvant treatment to sterilize the pelvis. Both chemo- and radiotherapy are effective mainly on small residual diseases, hence the importance of initial surgery with maximal cell reduction, notably in carcinomas classified as stage III according to the International Gynaecology and Obstetrics Federation system.
View Article and Find Full Text PDFBetween 1979 and 1986, 100 patients underwent parenteral nutrition at home on account of malnutrition consecutive to digestive insufficiency or heavy anti-cancer chemotherapy. Parenteral feeding was performed through a buried catheter for a mean period of 74 days (range 30 to 430 days). The patients' nutritional status was improved, with a significant increase in weight, total plasma proteins and serum albumin (P less than 0.
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