Publications by authors named "Jean-Baptiste Bachet"

Background: This article summarizes the French intergroup guidelines regarding rectal adenocarcinoma (RA) management published in September 2023, available on the French Society of Gastroenterology website.

Methods: This work was supervised by French medical and surgical societies involved in RA management. Recommendations were rated from A to C according to the literature until September 2023.

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Aim Of The Study: The management of synchronous metastatic rectal cancer (SMRC) is complex and multimodal, involving chemotherapy, surgery and/or radiotherapy. The aim of this study was firstly to confirm the efficacy of the induction FOLFIRINOX, and secondly to evaluate the different therapeutic strategies and outcomes of patients.

Patients And Methods: This French study combined data from a prospective FFCD trial and a multicenter cohort.

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Article Synopsis
  • The study investigates predictive markers for the benefits of LV5FU2 maintenance therapy after first-line FOLFIRINOX treatment in patients with metastatic pancreatic cancer.
  • It compares two patient groups from the PRODIGE-35 trial: one receiving 12 cycles of FOLFIRINOX, and another receiving 8 cycles followed by LV5FU2 maintenance.
  • Results indicate that certain factors, like age and metastatic sites, affect patient outcomes, suggesting that LV5FU2 maintenance is generally beneficial except for some specific cases.
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Purpose: The adjuvant treatment for stage III colon cancer (CC) is chemotherapy combining fluoropyrimidine (FP) and oxaliplatin (OX). FP regimen plus OX (FPOX) may benefit in high-risk stage II CC. We performed a pooled analysis of pivotal MOSAIC and C-07 studies evaluating FPOX for the treatment of high-risk stage II CC according to prognostic factors, number of high-risk factors, and current clinicopathologic risk classification on the basis of T stage, tumor perforation, and number of lymph nodes examined.

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Objective: To investigate in patients treated for a resectable pancreatic ductal adenocarcinoma [pancreatic adenocarcinoma (PA)], the prognostic value of baseline carbohydrate antigen 19.9 (CA19-9) and circulating tumor DNA (ctDNA) for overall survival (OS), to improve death risk stratification, based on a planned ancillary study from PANACHE01-PRODIGE 48 trial.

Background: Biological borderline situation that was first used by the MD Anderson, became a standard practice following the international consensus conference in 2016 to manage PA.

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Background & Aims: Significant progress has been made in the management of pancreatic ductal adenocarcinoma (PDAC) in recent years. In this population-based study, we aimed to compare incidence, therapeutic strategies, and survival outcomes of PDAC patients in France over a decade.

Methods: This study was performed using a nationwide French database.

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Background: Bacterial peritonitis (BP) in patients with gastrointestinal (GI) cancer has been poorly described, and its prevalence is unknown.

Objectives: This study aimed to evaluate in patients with both GI cancer and ascites the prevalence of BP, associated features, mechanisms, prognosis, and the diagnostic performance of neutrophil count in ascites.

Design: A retrospective, multicenter, observational study.

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Background & Aims: Accumulating data has shown the rising incidence and poor prognosis of early-onset gastrointestinal cancers, but few data exist on biliary tract cancers (BTC). We aimed to analyse the clinico-pathological, molecular, therapeutic characteristics and prognosis of patients with early onset BTC (EOBTC, age ≤50 years at diagnosis), versus olders.

Methods: We analysed patients diagnosed with intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder adenocarcinoma between 1 January 2003 and 30 June 2021.

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A major advance has been made in the management of rectal cancer, with the emergence in 2021 of total neoadjuvant treatment. The main publications from the RAPIDO and PRODIGE-23 trials reported a significant improvement in progression-free survival and the pathological complete response rate. The aim of this review is to synthesize recent data on neoadjuvant treatment of rectal cancer, to explain the long-term results of the RAPIDO and PRODIGE-23 trials, and to put them into perspective, considering current advances in de-escalation strategies.

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Article Synopsis
  • Optimal management of colorectal liver metastasis (CRLM) involves chemotherapy and surgical resection, with the tumor regression grade (TRG) score helping assess chemotherapy response.
  • In a study of 327 patients, 41% showed a good response to treatment (TRG 1-2-3), while 36.7% had a poor response (TRG 4-5) and 22.3% had heterogeneous responses.
  • The good response group had significantly better overall survival compared to the heterogeneous and poor response groups, indicating a need for tailored treatment approaches based on TRG scores.
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Adjuvant chemotherapy benefits patients with resected pancreatic ductal adenocarcinoma (PDAC), but the compromised physical state of post-operative patients can hinder compliance. Biomarkers that identify candidates for prompt adjuvant therapy are needed. In this prospective observational study, 1,171 patients with PDAC who underwent pancreatectomy were enrolled and extensively followed-up.

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Purpose: GEMPAX was an open-label, randomized phase III clinical trial designed to assess the efficacy and tolerability of gemcitabine plus paclitaxel versus gemcitabine alone as second-line treatment for patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) who previously received 5-fluorouracil, oxaliplatin, and irinotecan.

Methods: Patients with histologically or cytologically confirmed mPDAC were randomly assigned (2:1) to receive GEMPAX (paclitaxel 80 mg/m + gemcitabine 1,000 mg/m; IV; once at day (D) 1, D8, and D15/arm A) or gemcitabine (arm B) alone once at D1, D8, and D15 every 28 days until progression, toxicity, or patient's decision. The primary end point was overall survival (OS).

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Background: The prognostic value of splenic vessel involvement in distal pancreatic adenocarcinoma remains controversial. The aim of the study was to assess its prognostic relevance in a large multicenter cohort.

Methods: Patients who underwent pancreatosplenectomy for distal pancreatic adenocarcinoma were identified from 5 pancreatic surgical centers.

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Article Synopsis
  • GemPred is a predictive transcriptomic signature designed to assess the effectiveness of adjuvant gemcitabine in pancreatic cancer, validated through samples from 350 patients in a clinical trial comparing gemcitabine and mFOLFIRINOX treatments.* -
  • Out of the patients studied, 25.5% were found to be GemPred+, showing significantly longer disease-free and cancer-specific survival when treated with gemcitabine compared to those who were GemPred-, but GemPred did not predict outcomes for those receiving mFOLFIRINOX.* -
  • The study concludes that while GemPred+ patients experienced better survival rates with gemcitabine, they also suffered from more severe adverse events when treated with
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  • Early relapse in stage III colon cancer patients, particularly those with proficient mismatch repair (pMMR) and RAS or BRAF mutations, is linked to poorer survival rates after recurrence.
  • * Patients with deficient mismatch repair (dMMR) had fewer recurrences but a shorter median time to recurrence compared to pMMR patients, highlighting the role of molecular status in recurrence patterns.
  • * The study suggests that early relapse significantly impacts survival, especially for those with specific genetic mutations, underlining the importance of molecular profiling in treatment strategies for colon cancer patients.
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Objectives: To apply the estimand framework in time to deterioration (TTD) analysis of patient-reported outcomes (PROs), and identify the appropriate statistical methods to deal with intercurrent event (IEs) such as death.

Study Design And Setting: Data from phase II randomized trial were used. We estimated TTD using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 questionnaire with death as the IE, by applying Kaplan-Meier (K.

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Background: Approximately 10-20% of patients with gastroesophageal adenocarcinoma (GE-ADK) have HER2-positive tumors. The addition of trastuzumab to chemotherapy improves OS in patients with advanced disease. We investigated the effect of perioperative trastuzumab on survival outcomes.

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Purpose: Baseline circulating tumour DNA (ctDNA) is a potential prognostic marker in metastatic colorectal cancer (mCRC) patients. However, few studies have compared ctDNA with the usual prognostic factors, and no ctDNA cut-off has been proposed for daily use in clinical practice.

Patients And Methods: Chemotherapy-naive patients with mCRC were prospectively included.

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Management of oligometastatic disease (OMD) in esophagogastric junction cancer is complex due to anatomical location and adenocarcinoma pathway. Specific curative strategy is mandatory to increase survival. A multimodal approach combining surgery, systemic and peritoneal chemotherapy, radiotherapy, and radiofrequency could be envisaged.

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Article Synopsis
  • Researchers identified two main subtypes of Pancreatic adenocarcinoma (PDAC) based on tumor and stroma characteristics, which can influence patient prognosis and treatment strategies.
  • They developed a deep learning model called PACpAInt to quickly classify PDAC using more accessible methods, trained on a diverse set of biopsy data from 202 patients and validated on additional cohorts.
  • The model effectively predicts tumor subtypes and survival outcomes while revealing complex tumor-stroma interactions, including new categories like Hybrid and Intermediate tumors that suggest varied evolution in PDAC.
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Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer, and chemotherapy is a key treatment for advanced PDAC. Gemcitabine chemotherapy is still an important component of treatment; however, there is no routine biomarker to predict its efficacy. Predictive tests may help clinicians to decide on the best first-line chemotherapy.

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Background: Prognostic factors of metastatic rectal cancer are not well known.

Aim: The objective of this study was to identify prognostic factors of overall survival (OS) in a cohort of patients with non-resectable synchronous metastatic rectal cancer.

Methods: Patients were retrospectively enrolled from 18 French centres.

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Background: PRECONNECT was an international, phase IIIb trial evaluating the safety and efficacy of trifluridine/tipiracil (FTD/TPI) for metastatic colorectal cancer (mCRC).

Methods: Patients with mCRC received FTD/TPI 35 mg/m twice-daily on days 1-5 and 8-12 of each 28-day cycle for third- or later-line treatment.

Primary Endpoint: safety and time to deterioration of Eastern Cooperative Oncology Group performance status [ECOG PS] to ≥2).

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