Publications by authors named "Kurtz Jean-Emmanuel"

Objective: Therapeutic interventions for epithelial ovarian cancer (EOC) have increased greatly over the last decade but improvements outside of biomarker selected therapies have been limited. There remains a pressing need for more effective treatment options that can prolong survival and enhance the quality of life of patients with EOC. In contrast to the significant benefits of immunotherapy with immune checkpoint inhibitors (CPI) seen in many solid tumors, initial experience in EOC suggests limited efficacy of CPIs monotherapy.

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  • The study focused on individualized dosing of niraparib for patients with platinum-sensitive recurrent ovarian cancer (PSROC), revealing that most patients required treatment modifications due to adverse events (AEs) during the first three months.
  • A significant proportion of patients (62%) experienced AEs, with common issues including fatigue, insomnia, and thrombocytopenia, highlighting the physical and emotional burden of the therapy.
  • The findings indicated that physicians often underestimated these symptoms, emphasizing the importance of patient self-reporting for a comprehensive understanding of treatment-related challenges.
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Objective: To evaluate the prognostic impact of circulating tumor DNA (ctDNA) detection at diagnosis (T0) and its early decrease after one cycle (T1) of neoadjuvant chemotherapy (NACT) in patients with advanced epithelial ovarian cancer (EOC) included in the CHIVA trial (NCT01583322).

Methods: Blood samples were collected at T0 and before each administration of NACT. Circulating tumor DNA detection was performed by next-generation sequencing.

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Purpose: The CDK4/6 inhibitor palbociclib inhibits cyclin A, which is overexpressed in endometrial cancer. Combining palbociclib with endocrine therapy improves efficacy in hormone receptor-positive breast cancer. We investigated palbociclib combined with endocrine therapy for estrogen receptor-positive advanced/recurrent endometrial cancer.

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Background: Early palliative care (EPC) leads to an improvement in quality of life and an unexpected survival benefit compared with oncological care for patients with metastatic lung cancer. The Early Palliative Integrated Care (EPIC) is aimed at examining whether EPC can improve overall survival in patients with metastatic upper gastrointestinal cancer.

Methods: We performed a multicentre, open-label, randomised phase-3 trial.

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Tebentafusp, a bispecific immune therapy, is the only drug that demonstrated an overall survival benefit in patients with metastatic uveal melanoma (MUM). Circulating tumor DNA (ctDNA) has emerged as a potential prognostic and predictive marker in the phase 3 IMCgp100-202 trial using multiplex PCR-based next-generation sequencing (NGS). In this study (NCT02866149), ctDNA dynamics were assessed using droplet digital PCR (ddPCR) in 69 MUM patients undergoing tebentafusp treatment.

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Background: Ovarian cancer (OC) remains one of the most challenging and deadly malignancies facing women today. While PARP inhibitors (PARPis) have transformed the treatment landscape for women with advanced OC, many patients will relapse and the PARPi-resistant setting is an area of unmet medical need. Traditional immunotherapies targeting PD-1/PD-L1 have failed to show any benefit in OC.

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Desmoid fibromatosis is a rare locally aggressive soft tissue tumor that is characterized as benign as it cannot metastasize. It was managed until recently like sarcomas, i.e with radical surgical resection combined or not with radiotherapy.

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  • Desmoid tumors (DT) are rare, aggressive growths that have historically been treated primarily with surgery, but recent trends suggest a shift towards less invasive treatment options.
  • A consensus meeting held in Milan in June 2023 aimed to update global guidelines for DT management, bringing together over 90 experts and patient advocates to discuss new strategies and treatments.
  • The updated guidelines emphasize the importance of local therapies and include information on the latest medical agents, particularly γ-secretase inhibitors, to ensure informed and effective management of DT in specialized referral centers.
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Background: Perivascular epithelioid cell neoplasms (PEComas) encompass a heterogeneous family of mesenchymal tumors. Previously described clinicopathologic features aimed at distinguishing benign from malignant variants but lacked prognostic value.

Methods: This retrospective analysis examined clinicopathologic data from patients who had localized PEComa across French Sarcoma Network centers.

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Introduction: Giant cell tumor of bone (GCTB) is a very rare tumor encountered in the jaws and its histology is quite similar to the more common giant cell granuloma of the jaws (GCGJ). These two entities can be easily confused in maxillofacial region. They are classically managed surgically, but in some localizations and in specific medical-surgical contexts, neoadjuvant therapy with denosumab may be indicated.

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Purpose: Platinum-based doublets with concurrent and maintenance bevacizumab are standard therapy for ovarian cancer (OC) relapsing after a platinum-free interval (PFI) >6 months. Immunotherapy may be synergistic with bevacizumab and chemotherapy.

Patients And Methods: ATALANTE/ENGOT-ov29 (ClinicalTrials.

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  • Recent advancements in treating advanced cervical cancer now include immunotherapy options like pembrolizumab for patients with PD-L1 positive tumors, as well as the availability of generic bevacizumab alongside traditional chemotherapy.
  • Cemiplimab can also be prescribed for patients who relapse after platinum-based treatments and haven't received immunotherapy, regardless of PD-L1 status.
  • A thorough pre-treatment evaluation using imaging and PD-L1 status is essential for determining treatment eligibility, and multidisciplinary discussions are encouraged for tailored locoregional care, while early supportive care and clinical trial participation are advised.
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  • This study explored the characteristics, management, and outcomes of patients with active cancer who were admitted for cardiogenic shock, finding that they made up about 6.6% of the 772 enrolled patients.
  • Although active cancer patients had similar initial in-hospital outcomes as non-cancer patients, they required more intensive drug management but received less mechanical support.
  • While both groups had similar 30-day mortality rates, the active cancer group had significantly higher long-term mortality rates at 1 year, indicating that active cancer dramatically impacts survival after initial treatment for cardiogenic shock.
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Renal medullary carcinoma (RMC) is an aggressive tumour driven by bi-allelic loss of SMARCB1 and tightly associated with sickle cell trait. However, the cell-of-origin and oncogenic mechanism remain poorly understood. Using single-cell sequencing of human RMC, we defined transformation of thick ascending limb (TAL) cells into an epithelial-mesenchymal gradient of RMC cells associated with loss of renal epithelial transcription factors TFCP2L1, HOXB9 and MITF and gain of MYC and NFE2L2-associated oncogenic and ferroptosis resistance programs.

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  • A case study is presented of a patient whose postchemotherapy thymic teratoma developed an MNT component and later experienced vertebral metastasis corresponding to anaplastic MNT, highlighting the complications that can arise from teratomas.
  • Genetic analysis revealed 19 shared somatic mutations among the tumor components, with several mutations found in known cancer-related genes, suggesting a potential pathway for the progression of MNT transformation and underscoring the need for
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  • The study focused on the prevalence and impact of pain in patients diagnosed with desmoid-type fibromatosis (DF), analyzing data from 382 participants.
  • Pain was found in 36% of patients, significantly linked to larger tumor sizes and specific locations like the neck and shoulders, affecting quality of life and mental health.
  • Furthermore, patients experiencing pain had poorer event-free survival rates, highlighting the need for better management strategies for those affected.
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  • The study investigates how the ability of ovarian cancer (OC) cells to form RAD51 foci after DNA damage can serve as a functional measure of homologous recombination deficiency (HRD) and its link to treatment response to platinum-based chemotherapy.
  • Tumor samples from the CHIVA trial were analyzed, revealing that 54% of tumors were RAD51-low, which correlated with better responses to neoadjuvant platinum therapy and longer progression-free survival.
  • Interestingly, within the BRCAmut tumors, those classified as RAD51-high demonstrated a poorer response to chemotherapy, challenging expectations about their treatment sensitivity.
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  • The study utilized the NETSARC database to analyze management and outcomes of adolescents and young adults (AYAs) with sarcoma in France from 2010 to 2017, focusing on surgical cases.
  • Findings showed significant discrepancies in adherence to treatment guidelines between patients treated at reference sarcoma centers (RSC) and non-reference centers (non-RSC), with RSC having better rates of crucial pre-treatment procedures.
  • Despite similar overall survival rates (OS) for AYAs in both settings, those treated in RSC had notably better locoregional recurrence-free survival (LRFS) and progression-free survival (PFS), underscoring the benefits of multidisciplinary care in specialized centers.
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Cancer genetics has to date focused on epithelial malignancies, identifying multiple histotype-specific pathways underlying cancer susceptibility. Sarcomas are rare malignancies predominantly derived from embryonic mesoderm. To identify pathways specific to mesenchymal cancers, we performed whole-genome germline sequencing on 1644 sporadic cases and 3205 matched healthy elderly controls.

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Background: According to guidelines, all patients with sarcoma must be managed from initial diagnosis at expert sarcoma centers. However, in everyday practice, the time interval to an expert center visit can be long, which delays presentation to an expert multidisciplinary tumor board and increases the risk of inappropriate management, negatively affecting local tumor control and prognosis. The advent of mobile health offers an easy way to facilitate communication and cooperation between general health care providers (eg, general practitioners and radiologists) and sarcomas experts.

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Purpose: To compare standard versus extended duration of bevacizumab treatment in combination with front-line chemotherapy in women with newly diagnosed stage IIB-IV ovarian cancer.

Methods: In this multicenter, open-label, randomized phase III trial (ClinicalTrials.gov identifier: NCT01462890), patients with newly diagnosed International Federation of Gynecology and Obstetrics stage IIB-IV epithelial ovarian, fallopian tube, or peritoneal cancer underwent primary cytoreductive surgery followed by six cycles of chemotherapy (paclitaxel 175 mg/m plus carboplatin area under the curve 5 once every 3 weeks) and bevacizumab (15 mg/kg once every 3 weeks).

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  • * A Delphi consensus method was used, where a committee of 17 experts drafted 52 statements on managing treatment initiation, adverse effects, special populations, patient communication, and adherence, with 49 statements reaching consensus through voting.
  • * The findings aim to improve side effect management of PARP inhibitors, enhance patient adherence, and maintain quality of life, marking the first Delphi consensus on this topic.
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