References of "Jerusalem, Guy"
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See detailPhase 2 Results of XL184 in a Cohort of Patients with Advanced Melanoma
Nechushtan, Hovav; Edelman, Gerald; JERUSALEM, Guy ULg et al

in EJC Supplements (2010, November), 8(7), 126-127

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See detailLe cancer du sein "triple négatif"
Freres, Pierre; Collignon, Joëlle ULg; Gennigens, Christine ULg et al

in Revue Médicale de Liège (2010), 65(3), 120-126

Le cancer du sein touche une femme sur huit dans les pays occidentaux. Son incidence a considérablement augmenté au cours de ces deux dernières décennies mais, en même temps, le niveau de mortalité ... [more ▼]

Le cancer du sein touche une femme sur huit dans les pays occidentaux. Son incidence a considérablement augmenté au cours de ces deux dernières décennies mais, en même temps, le niveau de mortalité spécifique est resté stable et a même diminué en Europe et aux Etats-Unis, notamment, grâce à l’apport de nouvelles armes thérapeutiques, aux changements dans l’utilisation du traitement hormonal substitutif à la ménopause et à un diagnostic plus précoce. Malgré cela, le cancer du sein reste la première cause de décès par cancer chez la femme de moins de 65 ans. Le cancer du sein «triple négatif», un sous-type représentant environ 10 % des cancers du sein, est caractérisé par l’absence de récepteurs hormonaux aux oestrogènes et à la progestérone et l’absence d’expression du facteur de croissance HER-2 en étude d’immunohistochimie. Ce type de cancer du sein est associé à un profil clinique défavorable avec un haut risque de rechute métastatique précoce. De plus, le cancer du sein «triple négatif» ne présente aucune cible thérapeutique propre et son pronostic est donc particulièrement mauvais. La définition de facteurs prédictifs de la réponse tumorale aux différents traitements et l’apport des thérapies ciblées sont deux pistes susceptibles d’améliorer la prise en charge et la survie des patients atteints par ce type de cancer extrêmement agressif. [less ▲]

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See detailHet belang van de tumormarge na conservatieve chirurgie bij borstkanker in een vroeg stadium
Coucke, Philippe ULg; Vavassis, Peter; Vanderick, JEAN ULg et al

in Nederlandsch Tijdschrift voor Verloskunde en Gynaecologie (2010), 6

Conclusie Zo conservatief mogelijk opereren is een prijzenswaardige benadering, zeker, maar niet alleen, bij jonge borstkankerpatiënten. Deze betrachting mag echter geen prioriteit worden ten opzichte van ... [more ▼]

Conclusie Zo conservatief mogelijk opereren is een prijzenswaardige benadering, zeker, maar niet alleen, bij jonge borstkankerpatiënten. Deze betrachting mag echter geen prioriteit worden ten opzichte van het risico op lokale recidieven met duidelijk nadelige gevolgen voor de overleving. Men dient zich ervan bewust te zijn dat, met name bij jonge patiënten en in het geval van een EIC, met radiotherapie het risico op lokale recidieven niet altijd voldoende verlaagd kan worden. Het verhogen van de dosis lijkt echter niet te helpen dit probleem op te lossen. Verhoging van de intensiteit van de chemotherapie verbetert de lokale controle wel, maar kan leiden tot een vertraging van de bestraling, vooral bij patiënten met een verhoogd risico op een lokaal recidief. Extra voorzichtigheid is daarom geboden bij patiënten met een krappe marge. Daarnaast dient de mogelijkheid van een chirurgische re-interventie overwogen te worden, en eventueel een mastectomie en reconstructie, vooral bij jonge patiënten en patiënten met een EIC. Dit artikel is eerder gepubliceerd in Belgian Journal of Medical Oncology (Belg J Med Oncol 2009;3:93-100). [less ▲]

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See detailPourquoi les traitements de radiothérapie adjuvante pour cancer du sein ne comptent-ils plus autant de séances ?
Coucke, Philippe ULg; Jansen, Nicolas ULg; Collignon, Joëlle ULg et al

in Revue Médicale de Liège (2010), 65(1), 10-14

La radiothérapie adjuvante postopératoire pour cancer du sein compte habituellement vingt-cinq séances de radiothérapie auxquelles on ajoute une surimpression centrée sur le lit tumoral. Dans le contexte ... [more ▼]

La radiothérapie adjuvante postopératoire pour cancer du sein compte habituellement vingt-cinq séances de radiothérapie auxquelles on ajoute une surimpression centrée sur le lit tumoral. Dans le contexte d’une augmentation progressive et continue de la charge de travail et afin de réduire les contraintes humaines et techniques, une radiothérapie plus courte est aujourd’hui utilisée. Ces schémas hypo-fractionnés sont validés par des essais randomisés et publiés. Sur la base de ces publications, un nouvel arbre décisionnel a été établi qui permet d’obtenir des résultats équivalents en contrôle local tout en gardant un taux de complications comparable, voire même inférieur au schéma classique [less ▲]

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See detailL'observance au traitement de longue durée : le cas particulier de l'hormonothérapie adjuvante du cancer du sein
Bleret, Valerie ULg; Collignon, Joëlle ULg; Coucke, Philippe ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 405-408

L'objectif de l'hormonothérapie adjuvante dans le cancer du sein est d'atteindre en pratique quotidiennee, une efficacité comparable à celle obtenue au cours des études cliniques. Malgré l'efficacité ... [more ▼]

L'objectif de l'hormonothérapie adjuvante dans le cancer du sein est d'atteindre en pratique quotidiennee, une efficacité comparable à celle obtenue au cours des études cliniques. Malgré l'efficacité démontrée de l'hormonothérapie, la compliance constitue un défi majeur et un problème multidimensionnel. Une meilleure compréhension des raisons de cette non-compliance aiderait à mieux identifier les patientes à risque et à développer des interventions capables d'améliorer l'adhésion à l'hormonothérapie adjuvante.C'est dans ce but que nous avons entrepris une revue de la littérature des six dernières années (Pub Med 2003-2006). [less ▲]

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See detailAn open-label expanded access study of lapatinib and capecitabine in patients with HER2-overexpressing locally advanced or metastatic breast cancer.
Capri, G.; Chang, J.; Chen, S. C. et al

in Annals of Oncology (2010), 21(3), 474-80

BACKGROUND: The Lapatinib Expanded Access Program (LEAP) was designed to provide access to lapatinib plus capecitabine for HER2-positive metastatic breast cancer patients who previously received an ... [more ▼]

BACKGROUND: The Lapatinib Expanded Access Program (LEAP) was designed to provide access to lapatinib plus capecitabine for HER2-positive metastatic breast cancer patients who previously received an anthracycline, a taxane, and a trastuzumab and had no other treatment options. PATIENTS AND METHODS: LEAP opened globally and enrollment continued until lapatinib received regulatory approval in each participating country. Patients were assessed for progression-free survival (PFS) and overall survival (OS) and monitored for serious adverse events (SAEs). RESULTS: As of 30 September 2008, 4283 patients from 45 countries enrolled in LEAP. The median treatment duration was 24.7 weeks. The most common drug-related SAEs were diarrhea (9.7%), vomiting (4.3%), and nausea (2.4%) and were mainly grade 3 or higher. The incidences of special interest SAEs were decreased left ventricle ejection fraction (0.5%), interstitial lung disease/pneumonitis (0.2%), and serious hepatobiliary events (0.4%). This safety profile is consistent with the overall lapatinib program. The median PFS and OS were 21.1 [95% confidence interval (CI) = 20.1-22.3] and 39.6 (95% CI = 37.7-40.7) weeks, respectively (n = 4006). Subgroup analysis showed longer PFS and OS in patients who had not received prior capecitabine. CONCLUSIONS: These results demonstrate the safety and efficacy of lapatinib in a broader patient population compared with a clinical trial. [less ▲]

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See detailLe medicament du mois. Everolimus (RAD001/Afinitor) dans le traitement du cancer du rein métastatique.
Gennigens, Christine ULg; Sautois, Brieuc ULg; Jerusalem, Guy ULg

in Revue Médicale de Liège (2010), 65(4), 212-6

Renal cell carcinoma accounts for 3% of all malignant tumours. Until a few years ago, immunotherapy (interferon and/or interleukin-2) was the only approved option in the metastatic setting. Better ... [more ▼]

Renal cell carcinoma accounts for 3% of all malignant tumours. Until a few years ago, immunotherapy (interferon and/or interleukin-2) was the only approved option in the metastatic setting. Better knowledge of renal cell cancer biology drew attention on the fundamental role of angiogenesis. Several strategies targeting angiogenesis have been developed including VEGF ("Vascular Endothelial Growth Factor") and VEGFR inhibitors. They are now the usual treatment in first line. Until recently, no standard treatment was available after failure under or after these inhibitors. Everolimus (Afinitor), a mTOR ("mammalian Target Of Rapamycin") inhibitor, has just been validated and reimbursed in this setting. In this paper, we will review the mechanism of action and the clinical results of everolimus. [less ▲]

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See detailResults of the CONFIRM phase III trial comparing fulvestrant 250 mg with fulvestrant 500 mg in postmenopausal women with estrogen receptor-positive advanced breast cancer.
Di Leo, Angelo; Jerusalem, Guy ULg; Petruzelka, Lubos et al

in Journal of Clinical Oncology (2010), 28(30), 4594-600

PURPOSE: We compared fulvestrant 500 mg regimen with the approved dose of fulvestrant 250 mg per month for treatment of postmenopausal women with estrogen receptor-positive advanced breast cancer who ... [more ▼]

PURPOSE: We compared fulvestrant 500 mg regimen with the approved dose of fulvestrant 250 mg per month for treatment of postmenopausal women with estrogen receptor-positive advanced breast cancer who experienced progression after prior endocrine therapy. PATIENTS AND METHODS: Comparison of Faslodex in Recurrent or Metastatic Breast Cancer (CONFIRM) is a double-blind, parallel-group, multicenter, phase III study. Patients were randomly assigned to fulvestrant 500 mg (500 mg intramuscularly [IM] on day 0, then 500 mg IM on days 14 and 28 and every 28 days thereafter) or 250 mg every 28 days. Primary end point was progression-free survival (PFS). Secondary end points included objective response rate, clinical benefit rate (CBR), duration of clinical benefit (DoCB), overall survival (OS), and quality of life (QOL). RESULTS: PFS was significantly longer for fulvestrant 500 mg (n = 362) than 250 mg (n = 374) (hazard ratio [HR] = 0.80; 95% CI, 0.68 to 0.94; P = .006), corresponding to a 20% reduction in risk of progression. Objective response rate was similar for fulvestrant 500 mg and 250 mg (9.1% v 10.2%, respectively). CBR was 45.6% for fulvestrant 500 mg and 39.6% for fulvestrant 250 mg. DoCB and OS were 16.6 and 25.1 months, respectively, for the 500-mg group, whereas DoCB and OS were 13.9 and 22.8 months, respectively, in the 250-mg group. Fulvestrant 500 mg was well tolerated with no dose-dependent adverse events. QOL was similar for both arms. CONCLUSION: Fulvestrant 500 mg was associated with a statistically significant increase in PFS and not associated with increased toxicity, corresponding to a clinically meaningful improvement in benefit versus risk compared with fulvestrant 250 mg. [less ▲]

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See detailANTICORPS MONOCLONAUX ET CANCER DU SEIN: Actualités thérapeutiques
Collignon, Joëlle ULg; Gennigens, Christine ULg; Rorive, Andrée ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 279-83

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of ... [more ▼]

About 9,500 new breast cancers are diagnosed in Belgium every year. Improvement of our knowledge of altered molecular events leading to the proliferation of tumor cells has resulted in the development of targeted therapies in subgroups of cancers. One of the first validation of targeted therapy is the anti-HER-2 monoclonal antibody trastuzumab (Herceptin) in patients with overexpression of human epidermal growth factor receptor type 2 (HER2) occurring in 20 to 25% of invasive breast carcinoma. Trastuzumab binds the extracellular juxtamembrane domain and is only active in tumor with HER2 gene amplification detected by fluorescence in situ hybridization (FISH). The results from randomized trials have rapidly lead to the approvement of the drug in the metastatic and then in the adjuvant setting. Another targeted therapy, also approved in the treatment of breast cancer, is the monoclonal antibody bevacizumab with an anti-VEGF (Vascular Endothelial Growth Factor) activity. We will review the benefit of these targeted therapies in breast cancer and their role in the treatment of breast cancer. [less ▲]

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See detailTumor Margin after conservative breast cancer surgery for early disease: an issue or not ?
Coucke, Philippe ULg; Vavassis, Peter; Vanderick, JEAN ULg et al

in Belgian Journal of Medical Oncology [=BJMO] (2009), 3(3), 93-100

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical ... [more ▼]

Summary is standard of care. However, the question is Conservative breast surgery (CBS), i.e. tumorec- whether this approach is able to consolidate local tomy (TUM), has replaced more radical surgical control irrespective of the extent of the surgical approaches such as mastectomy (MAST) and margin. No consensus exists in the literature con-quadrantectomy (QUAD). The aim of surgeons is cerning what should be considered as a minimal to avoid recurrence and still obtain a good cos-and hence a safe margin. This review will summetic result. After CBS for early disease, adjuvant marize the published data in order to try to define radiation consisting of whole breast irradiation a pragmatic treatment approach. followed by a boost dose on the surgical bed is standard of care. However, the question is whether this approach is able to consolidate local control irrespective of the extent of the surgical margin. No consensus exists in the literature concerning what should be considered as a minimal and hence a safe margin. This review will summarize the published data in order to try to define a pragmatic treatment approach. [less ▲]

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See detailTrastuzumab treatment of early stage breast cancer is cost-effective from the perspective of the Belgian health care authorities.
Van Vlaenderen, I.; Canon, J. L.; Cocquyt, V. et al

in Acta Clinica Belgica (2009), 64(2), 100-12

Trastuzumab (Herceptin, Roche) is a recombinant, humanized monoclonal antibody directed against the neu-HER2 protein, since May 2002 reimbursed in Belgium for the treatment of metastatic HER2+ breast ... [more ▼]

Trastuzumab (Herceptin, Roche) is a recombinant, humanized monoclonal antibody directed against the neu-HER2 protein, since May 2002 reimbursed in Belgium for the treatment of metastatic HER2+ breast cancer and since June 2007 also in adjuvant therapy of HER2+ early stage breast cancer. The purpose of this study was to estimate the cost-effectiveness from the Belgian health care payer perspective of reimbursing trastuzumab in the Latter indication. A Markov state transition model was designed to adequately capture the natural history and course of disease for early stage breast cancer patients, and to simulate cost and disease progression over a life time perspective. The model estimates differences in outcomes for patients treated with adjuvant trastuzumab during 1 year compared to current therapy, and captures cost consequences and health benefits of trastuzumab treatment. Health benefits were expressed in terms of quality-adjusted life years gained, and future benefits were discounted at 1.5%. Costs were calculated from the perspective of the Belgian authorities' health care budget, and future costs were discounted at 3%. Where relevant, the costs per Markov state were obtained from the IMS Hospital Disease database. Additionally, an expert opinion analysis on resource use during the follow-up of treated early breast cancer patients provided the cost estimates for states with minor or without hospital costs. The incremental cost-effectiveness ratio based on a life time simulation was estimated at Euro 10,315 per quality-adjusted life year gained. It can be concluded that trastuzumab treatment of HER2+ early stage breast cancer patients is cost-effective from the perspective of the Belgian health care authorities. [less ▲]

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See detailAngiosarcome sur lymphoedeme chronique: un cas de syndrome de Stewart-Treves.
Gonne, E.; Collignon, Joëlle ULg; Kurth, William ULg et al

in Revue Médicale de Liège (2009), 64(7-8), 409-13

The Stewart-Treves Syndrome is defined as an angiosarcoma (very aggressive malignant tumor originating from endothelial cells) appearing in a specific clinical setting. This tumor develops in patients ... [more ▼]

The Stewart-Treves Syndrome is defined as an angiosarcoma (very aggressive malignant tumor originating from endothelial cells) appearing in a specific clinical setting. This tumor develops in patients suffering from chronic lymphedema of the upper limb following mastectomy and axillary lymph node dissection for breast cancer. The diagnosis relies on medical history, clinical examination and a histological assesment (biopsy or resection). This syndrome represents a rare clinical entity. Unfortunately, the prognosis is poor. A large surgical resection is the treatment of choice if the patient is a candidate for a surgical resection with a curative intent Radiotherapy is sometimes used as a palliative local treatment. Chemotherapy is only used in more advanced cases, not curable by surgery alone. [less ▲]

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See detailAnticorps monoclonaux a usage therapeutique en hemato-oncologie. Generalites.
Gennigens, Christine ULg; Collignon, Joëlle ULg; Jerusalem, Guy ULg et al

in Revue Médicale de Liège (2009), 64(5-6), 264-7

For many years, chemotherapy, hormonotherapy and immunotherapy were the mainstay of cancer treatment. Recent advances in our knowledge of cell biology and particularly of cancer cell transformation ... [more ▼]

For many years, chemotherapy, hormonotherapy and immunotherapy were the mainstay of cancer treatment. Recent advances in our knowledge of cell biology and particularly of cancer cell transformation, growth and metastasis have led to the identification of specific pathways playing a role in the pathophysiology of cancer. New drugs specifically developed to control these targets are collectively named "targeted therapies". Two types of targeted therapies are available: kinase (mainly tyrosine kinase) inhibitors (suffix -nib) are small molecules binding directly to the intracellular kinase domain and acting as competitive inhibitor of ATP binding and monoclonal antibodies (suffix -mab) directed towards specific cell surface receptors or their ligands to prevent receptor activation. This paper will only review monoclonal antibodies (mabs). Thirty years after their discovery mAbs have become efficient therapeutic tools. Progress in molecular engineering as well as improved knowledge of cell signalling pathways together with a better selection of the targets turned them into valuable treatments. Several mAbs are currently licensed for the treatment of hematological or solid malignancies and many others are expected in the near future. [less ▲]

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See detailLe cas clinique du mois. Reaction de rappel d'irradiation induite par l'administration de cyclophosphamide.
Mievis, Carole ULg; Jansen, Nicolas ULg; Schleich, FLorence ULg et al

in Revue Médicale de Liège (2009), 64(4), 179-81

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic ... [more ▼]

Radiation recall dermatitis is an inflammatory skin reaction occurring in a previously irradiated field following the delivery of a promoting agent. It has been described after a number of antineoplastic agents such as gemcitabine, taxanes, anthracyclines. We report the case of a 50-year-old man with metastatic prostate cancer who developed two consecutive radiation recall dermatitis episodes triggered by oral cyclophosphamide. They occurred 4 to 5 weeks after palliative radiotherapy on bone metastasis. Spontaneous resolution was observed within 6 weeks after discontinuation of cyclophosphamide and with local supportive care. To our knowledge this is the first reported case of radiation recall dermatitis after oral cyclophosphamide. [less ▲]

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See detailNuclear medicine imaging
Jerusalem, Guy ULg; Withofs, Nadia ULg

in Schmoll, Hans-Joachim; Van't Veer, Laura; Vermorken, Jan (Eds.) et al ESMO Handbook of Cancer Diagnosis and Treatment Evaluation (2009)

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See detailCarninome intracanalaire (in situ) du sein : pouvons-nous raisonnablement éviter la radiothérapie pour certaines patientes opérées ?
Coucke, Philippe ULg; Barthelemy, Nicole ULg; Jansen, Nicolas ULg et al

in Revue Médicale de Liège (2008), 63(2), 75-81

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de ... [more ▼]

Dans le cadre de la prise en charge multidisciplinaire du carcinome intracanalaire du sein (carcinome intra-canalaire in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de renoncer à la radiothérapie complémentaire après un geste de chirurgie conservatrice. S’il est vrai que la radiothérapie, dans ce contexte, n’apporte pas de bénéfice en survie, il n’en reste pas moins qu’on observe à long terme un effet bénéfique en contrôle local. Il existe un effet significativement marqué sur le taux de rechute de type DCIS et de type invasif dans les différentes études randomisées destinées à éclaircir la problématique du rôle de la radiothérapie. La question est de savoir si on peut distinguer un sous-groupe de patientes pour qui le contrôle local n’est pas modifié par l’adjonction d’une radiothérapie adjuvante. Pour l’instant, nous ne sommes pas à même de définir ce sous-groupe, car les critères de sélection n’ont pas été mis à l’épreuve dans le cadre d’un essai randomisé. Faute de ces données, il nous semble plus adéquat de proposer jusqu’à preuve du contraire, une radiothérapie aux patientes opérées, même si l’intervention est a priori radicale, mais conservatrice, et même si les facteurs pronostiques semblent plutôt favorables. Cependant, la radiothérapie n’est pas indiquée après une mastectomie. [less ▲]

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See detailPET/CT for assessing bone involvement in prostate and breast cancer.
WITHOFS, Nadia ULg; GRAYET, Benjamin ULg; TANCREDI, T. et al

in Journal of Nuclear Medicine (The) (2008), 49(SUPPL), 21

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See detailTomographie à émission de positons et lymphomes
Hustinx, Roland ULg; Jerusalem, Guy ULg; De Prijck, Bernard ULg

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2008), 32

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