References of "Jerusalem, Guy"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailPatterns of resource utilization and cost for postmenopausal women with hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer in Europe.
Jerusalem, Guy ULg; Neven, Patrick; Marinsek, Nina et al

in BMC cancer (2015), 15

BACKGROUND: Healthcare resource utilization in breast cancer varies by disease characteristics and treatment choices. However, lack of clarity in guidelines can result in varied interpretation and ... [more ▼]

BACKGROUND: Healthcare resource utilization in breast cancer varies by disease characteristics and treatment choices. However, lack of clarity in guidelines can result in varied interpretation and heterogeneous treatment management and costs. In Europe, the extent of this variability is unclear. Therefore, evaluation of chemotherapy use and costs versus hormone therapy across Europe is needed. METHODS: This retrospective chart review (N = 355) examined primarily direct costs for chemotherapy versus hormone therapy in postmenopausal women with hormone-receptor-positive (HR+), human epidermal growth factor receptor-2-negative (HER2-) advanced breast cancer across 5 European countries (France, Germany, The Netherlands, Belgium, and Sweden). RESULTS: Total direct costs across the first 3 treatment lines were approximately euro10 000 to euro14 000 lower for an additional line of hormone therapy-based treatment versus switching to chemotherapy-based treatment. Direct cost difference between chemotherapy-based and hormone therapy-based regimens was approximately euro1900 to euro2500 per month. Chemotherapy-based regimens were associated with increased resource utilization (managing side effects; concomitant targeted therapy use; and increased frequencies of hospitalizations, provider visits, and monitoring tests). The proportion of patients taking sick leave doubled after switching from hormone therapy to chemotherapy. CONCLUSIONS: These results suggest chemotherapy is associated with increased direct costs and potentially with increased indirect costs (lower productivity of working patients) versus hormone therapy in HR+, HER2- advanced breast cancer. [less ▲]

Detailed reference viewed: 73 (3 ULg)
Full Text
Peer Reviewed
See detailAsporin Is a Fibroblast-Derived TGF-beta1 Inhibitor and a Tumor Suppressor Associated with Good Prognosis in Breast Cancer.
Maris, Pamela; Blomme, Arnaud; Palacios, Ana Perez et al

in PLoS medicine (2015), 12(9), 1001871

BACKGROUND: Breast cancer is a leading malignancy affecting the female population worldwide. Most morbidity is caused by metastases that remain incurable to date. TGF-beta1 has been identified as a key ... [more ▼]

BACKGROUND: Breast cancer is a leading malignancy affecting the female population worldwide. Most morbidity is caused by metastases that remain incurable to date. TGF-beta1 has been identified as a key driving force behind metastatic breast cancer, with promising therapeutic implications. METHODS AND FINDINGS: Employing immunohistochemistry (IHC) analysis, we report, to our knowledge for the first time, that asporin is overexpressed in the stroma of most human breast cancers and is not expressed in normal breast tissue. In vitro, asporin is secreted by breast fibroblasts upon exposure to conditioned medium from some but not all human breast cancer cells. While hormone receptor (HR) positive cells cause strong asporin expression, triple-negative breast cancer (TNBC) cells suppress it. Further, our findings show that soluble IL-1beta, secreted by TNBC cells, is responsible for inhibiting asporin in normal and cancer-associated fibroblasts. Using recombinant protein, as well as a synthetic peptide fragment, we demonstrate the ability of asporin to inhibit TGF-beta1-mediated SMAD2 phosphorylation, epithelial to mesenchymal transition, and stemness in breast cancer cells. In two in vivo murine models of TNBC, we observed that tumors expressing asporin exhibit significantly reduced growth (2-fold; p = 0.01) and metastatic properties (3-fold; p = 0.045). A retrospective IHC study performed on human breast carcinoma (n = 180) demonstrates that asporin expression is lowest in TNBC and HER2+ tumors, while HR+ tumors have significantly higher asporin expression (4-fold; p = 0.001). Assessment of asporin expression and patient outcome (n = 60; 10-y follow-up) shows that low protein levels in the primary breast lesion significantly delineate patients with bad outcome regardless of the tumor HR status (area under the curve = 0.87; 95% CI 0.78-0.96; p = 0.0001). Survival analysis, based on gene expression (n = 375; 25-y follow-up), confirmed that low asporin levels are associated with a reduced likelihood of survival (hazard ratio = 0.58; 95% CI 0.37-0.91; p = 0.017). Although these data highlight the potential of asporin to serve as a prognostic marker, confirmation of the clinical value would require a prospective study on a much larger patient cohort. CONCLUSIONS: Our data show that asporin is a stroma-derived inhibitor of TGF-beta1 and a tumor suppressor in breast cancer. High asporin expression is significantly associated with less aggressive tumors, stratifying patients according to the clinical outcome. Future pre-clinical studies should consider options for increasing asporin expression in TNBC as a promising strategy for targeted therapy. [less ▲]

Detailed reference viewed: 74 (11 ULg)
Full Text
Peer Reviewed
See detailImplementation of geriatric assessment-based recommendations in older patients with cancer: A multicentre prospective study
Baitar, Abdelbari; Kenis, Cindy; Moor, Ramona et al

in Journal of geriatric oncology (2015), 6(5), 401-10

PURPOSE: The main objective of this study was to describe geriatric recommendations based on a geriatric assessment (GA) and to evaluate the implementation of these recommendations. PATIENTS AND METHODS ... [more ▼]

PURPOSE: The main objective of this study was to describe geriatric recommendations based on a geriatric assessment (GA) and to evaluate the implementation of these recommendations. PATIENTS AND METHODS: A two-step approach of screening followed by a GA was implemented in nine hospitals in Belgium. Patients >/=70years were included at diagnosis or at disease progression/relapse. Concrete geriatric recommendations were systematically documented and reported to the treating physicians and consisted of referrals to professional health care workers. Patient charts were reviewed after one month to verify which geriatric recommendations have been performed. RESULTS: From August 2011 to July 2012, 1550 patients were included for analysis. The median age was 77 (range: 70-97) and 57.0% were female. A solid tumour was diagnosed in 91.4% and a haematological malignancy in 8.6%. Geriatric screening with the G8 identified 63.6% of the patients for GA (n=986). A median of two geriatric recommendations (range: 1-6) were given for 76.2% (95%CI: 73.4-78.8) of the evaluable patients (n=710). A median of one geriatric recommendation (range: 1-5) was performed in 52.1% (95%CI: 48.4-55.8) of the evaluable patients (n=689). In general, 460 or 35.3% (95%CI: 32.8-38.0) of all the geriatric recommendations were performed. Geriatric recommendations most frequently consisted of referrals to the dietician (60.4%), social worker (40.3%), and psychologist (28.9%). CONCLUSION: This implementation study provides insight into GA-based recommendations/interventions in daily oncology practice. Geriatric recommendations were given in about three-fourths of patients. About one-third of all geriatric recommendations were performed in approximately half of these patients. [less ▲]

Detailed reference viewed: 23 (9 ULg)
Full Text
Peer Reviewed
See detailOlaparib tablet formulation : effect of food on the pharmacokinetics after oral dosing in patients with advanced solid tumours
Plummer, Ruth; Swaisland, Helen; Leunen, Karin et al

in Cancer Chemotherapy & Pharmacology (2015), 76

Detailed reference viewed: 46 (3 ULg)
Full Text
Peer Reviewed
See detailGenetic study of triple negative breast cancers
Boukerroucha, M; Josse, Claire ULg; El Guendi, Sonia ULg et al

Poster (2015)

Detailed reference viewed: 30 (5 ULg)
Full Text
Peer Reviewed
See detailVISMODEGIB ET CARCINOMES BASOCELLULAIRES LOCALEMENT AVANCES
LEBAS, Eglantine ULg; RORIVE, Andrée ULg; EL HAYDERI, Lara ULg et al

in Revue Médicale de Liège (2015)

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in ... [more ▼]

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in the pathogenesis of basal cell carcinoma. Vismodegib is a selective inhibitor of this pathway and may be administered orally. Its main indication is locally advanced basal cell carcinoma, when other therapeutic options have failed or are contra-indicated. Vismodegib can also be used as prophylactic therapy in the Gorlin syndrome or basal cell nevomatosis. Its principal adverse effects are muscle spasms, alopecia and altered taste. They are frequent, but often moderate in intensity; they sometimes restrict continuation of treatment. Two clinical cases are presented, relating the efficacity and tolerance of this new therapeutic option. [less ▲]

Detailed reference viewed: 109 (16 ULg)
Full Text
Peer Reviewed
See detailEndothelial exosomes contribute to the antitumor response during breast cancer neoadjuvant chemotherapy via microRNA transfer.
Bovy, Nicolas ULg; Blomme, Benoît ULg; Freres, Pierre ULg et al

in Oncotarget (2015)

The interaction between tumor cells and their microenvironment is an essential aspect of tumor development. Therefore, understanding how this microenvironment communicates with tumor cells is crucial for ... [more ▼]

The interaction between tumor cells and their microenvironment is an essential aspect of tumor development. Therefore, understanding how this microenvironment communicates with tumor cells is crucial for the development of new anti-cancer therapies. MicroRNAs (miRNAs) are small non-coding RNAs that inhibit gene expression. They are secreted into the extracellular medium in vesicles called exosomes, which allow communication between cells via the transfer of their cargo. Consequently, we hypothesized that circulating endothelial miRNAs could be transferred to tumor cells and modify their phenotype. Using exogenous miRNA, we demonstrated that endothelial cells can transfer miRNA to tumor cells via exosomes. Using miRNA profiling, we identified miR-503, which exhibited downregulated levels in exosomes released from endothelial cells cultured under tumoral conditions. The modulation of miR-503 in breast cancer cells altered their proliferative and invasive capacities. We then identified two targets of miR-503, CCND2 and CCND3. Moreover, we measured increased plasmatic miR-503 in breast cancer patients after neoadjuvant chemotherapy, which could be partly due to increased miRNA secretion by endothelial cells. Taken together, our data are the first to reveal the involvement of the endothelium in the modulation of tumor development via the secretion of circulating miR-503 in response to chemotherapy treatment. [less ▲]

Detailed reference viewed: 309 (48 ULg)
Full Text
Peer Reviewed
See detailEACVI/HFA Cardiac Oncology Toxicity Registry in breast cancer patients: rationale, study design, and methodology (EACVI/HFA COT Registry)-EURObservational Research Program of the European Society of Cardiology.
Lancellotti, Patrizio ULg; Anker, Stefan D.; Donal, Erwan et al

in European Heart Journal - Cardiovascular Imaging (2015)

The goal of adjuvant anti-cancer therapies is cure with limited or no side effects, in particular long-term side effects with negative impact on quality of life. In the palliative setting disease control ... [more ▼]

The goal of adjuvant anti-cancer therapies is cure with limited or no side effects, in particular long-term side effects with negative impact on quality of life. In the palliative setting disease control, quality of life and overall survival are important end points. Partly due to improvements in treatment, the population of cancer survivors is large and growing. However, anti-cancer drug-related cardiotoxicity (ADRC) is the leading cause of treatment-associated mortality in cancer survivors. It is one of the most common post-treatment problems among 5- to 10-year survivors of adult cancer. This is particularly true for breast cancer, the most common cancer in women. The EACVI/HFA COT registry is designed for comprehensive data collection and evaluation of the current European practice in terms of diagnosis and management of ADRC in breast cancer patients. The COT registry will be carried out in two continuing phases, the pilot study phase involving 13 countries followed by the long-term registry in which all the 56 ESC countries will be invited to participate. With the COT registry, several critical information will be obtained: on predisposing factors for the development of ADRC, the rate of subclinical LV dysfunction and its transition to overt heart failure, the clinical impact and outcome of ADRC. [less ▲]

Detailed reference viewed: 37 (2 ULg)
Full Text
Peer Reviewed
See detailPrise en charge de la neutropénie fébrile chez le patient cancéreux
FRERES, Pierre ULg; GONNE, Elodie ULg; COLLIGNON, Joëlle ULg et al

in Revue Médicale de Liège (2015), 70(4), 195-200

Les cancers sont de plus en plus fréquents et leurs traitements de plus en plus agressifs. En conséquence, médecins généralistes, urgentistes, hématologues et oncologues se trouvent régulièrement ... [more ▼]

Les cancers sont de plus en plus fréquents et leurs traitements de plus en plus agressifs. En conséquence, médecins généralistes, urgentistes, hématologues et oncologues se trouvent régulièrement confrontés à un effet secondaire sévère des traitements cytotoxiques, le neutropénie fébrile (NF). La NF est une complication gravissime de la chimiothérapie, car elle peut être rapidement mortelle et provoque un arrêt temporaire, voire définitif, des traitements. Dans cet article, nous résumons les dernières recommandations quant à la prise en charge thérapeutique des patients présentant une NF sous traitements anti-cancéreux. [less ▲]

Detailed reference viewed: 137 (20 ULg)
Full Text
Peer Reviewed
See detailCancer du sein : de la thérapie ciblée à la médecine personnalisée
JERUSALEM, Guy ULg; COLLIGNON, Joëlle ULg; Josse, Claire ULg et al

in Revue Médicale de Liège (2015), 70(5-6), 269-276

Dans cet article, les auteurs passent en revue les grands principes de prise en charge du traitement systémique du cancer du sein et posent la question suivante : jusqu'où réellement aujourd'hui ce ... [more ▼]

Dans cet article, les auteurs passent en revue les grands principes de prise en charge du traitement systémique du cancer du sein et posent la question suivante : jusqu'où réellement aujourd'hui ce traitement est-il individualisé ? Les nouvelles technologies permettent une analyse détaillée des anomalies génomiques au niveau des cellules cancéreuses. Malheureusement, nous n'avons pas encore compris comment utiliser au mieux ces données au bénéfice du patient. La majorité des modifications du génome sont des évènements relativement rares compliquant le développement de nouveaux médicaments dans le cadre d'une médecine de précision. De plus, les tumeurs présentent une grande hétérogénéité temporelle et spatiale dont il faudra tenir compte lors de ce développement. Une collaboration internationale intensive est en cours pour tenter de confirmer que la médecine de précision permet d'optimiser les résultats du traitement systémique dans le cancer du sein. [less ▲]

Detailed reference viewed: 200 (20 ULg)
Full Text
Peer Reviewed
See detailA network meta-analysis of everolimus plus exemestane versus chemotherapy in the first- and second-line treatment of estrogen receptor-positive metastatic breast cancer.
Generali, Daniele; Venturini, Sergio; Rognoni, Carla et al

in Breast cancer research and treatment (2015), 152(1), 95-117

The goal of this study was to compare the efficacy and toxicity of chemotherapy to exemestane plus everolimus (EXE/EVE) through a network meta-analysis (NMA) of randomized controlled trials. NMA methods ... [more ▼]

The goal of this study was to compare the efficacy and toxicity of chemotherapy to exemestane plus everolimus (EXE/EVE) through a network meta-analysis (NMA) of randomized controlled trials. NMA methods extend standard pairwise meta-analysis to allow simultaneous comparison of multiple treatments while maintaining randomization of individual studies. The method enables "direct" evidence (i.e., evidence from studies directly comparing two interventions) and "indirect" evidence (i.e., evidence from studies that do not compare the two interventions directly) to be pooled under the assumption of evidence consistency. We used NMA to evaluate progression-free survival (PFS) and time to progression (TTP) curves in 34 studies, and response rate (RR) and the hazard ratios (HRs) of the PFS/TTP in 36 studies. A number needed to treat (NNT) analysis was also performed as well as descriptive comparison of reported toxicities. The NMA for PFS/TTP curves and for HR shows EXE/EVE is more efficacious than capecitabine plus sunitinib, CMF, megestrol acetate and tamoxifen, with an average of related-PFS/TTP difference ranging from about 10 months for capecitabine plus sunitinib to more than 6 months for tamoxifen. The NMA for overall RR shows that EXE/EVE provides a better RR than bevacizumab plus capecitabine, capecitabine, capecitabine plus sorafenib, capecitabine plus sunitinib, CMF, gemcitabine plus epirubicin plus paclitaxel, EVE plus tamoxifen, EXE, FEC, megestrol acetate, mitoxantrone, and tamoxifen. Finally, the NMA for NNT shows that EXE/EVE is more beneficial as compared to BMF, capecitabine, capecitabine plus sunitinib, CMF, FEC, megestrol acetate, mitoxantrone, and tamoxifen. The combination of EXE/EVE as first- or second-line therapy for ER+ve/HER2-ve metastatic breast cancer is more efficacious than several chemotherapy regimens that were reported in the literature. Toxicities also favored EXE/EVE in most instances. [less ▲]

Detailed reference viewed: 50 (0 ULg)
Full Text
Peer Reviewed
See detailChemotherapy options for patients suffering from heavily pretreated metastatic breast cancer.
Jerusalem, Guy ULg; RORIVE, Andrée ULg; COLLIGNON, Joëlle ULg

in Future oncology (London, England) (2015), 11(12), 1775-89

ABSTRACT The identification of additional chemotherapy agents for anthracycline- and taxane-pretreated advanced breast cancer (ABC) is an urgent medical need. Single agent chemotherapy is most times ... [more ▼]

ABSTRACT The identification of additional chemotherapy agents for anthracycline- and taxane-pretreated advanced breast cancer (ABC) is an urgent medical need. Single agent chemotherapy is most times administered because combined therapy is only associated with modest, if any, improvement in median progression-free survival. Randomized trials failed to show overall survival benefit compared with single agent chemotherapy. We hope to modify the natural history of ABC by the consecutive use of treatments with documented activity in heavily pretreated patients. Quality of life remains an important end point as cure is in general not possible. We first review the activity of the approved and the most frequently used agents in heavily pretreated ABC. Thereafter, the potential role and safety profile of etirinotecan pegol is discussed given the results recently released of a Phase III trial comparing this agent to Treatment of Physician's Choice. [less ▲]

Detailed reference viewed: 37 (1 ULg)
Full Text
Peer Reviewed
See detailCancer du sein: intérêt du bilan d’extension par imagerie lors du diagnostic initial et du suivi les trois premières années après le diagnostic
SCHROEDER, Hélène ULg; Hanocq, Florence ULg; COLLIGNON, Joëlle ULg et al

in Revue Médicale de Liège (2015), 70(3), 140-147

In our region, repeated tumor staging by radiological procedures aiming to detect relapses and/or metastases from breast cancer is frequently performed. However, these procedures are not recommended by ... [more ▼]

In our region, repeated tumor staging by radiological procedures aiming to detect relapses and/or metastases from breast cancer is frequently performed. However, these procedures are not recommended by current international guidelines. We retrospectively analyzed the charts from 818 patients with a new diagnosis of breast cancer seen at CHU Liege between 2005 and 2009. We assessed the role of staging procedures at initial diagnosis and during follow-up the first 3 years after the diagnosis of breast cancer. Twenty-six patients presented with metastatic disease at diagnosis and 55 patients developed loco-regional relapses or metastases during follow-up. For asymptomatic patients, imaging procedures only detected tumor metastases or relapse without elevated tumor markers in 9 patients at initial diagnosis and 10 patients during follow-up. The diagnosis of an asymptomatic relapse and/or metastases had no positive impact on progression-free or overall survival. The anatomic extension identified patients at high risk for presenting distant metastases already at the time of initial diagnosis and the biological aggressiveness evaluated by Ki-67 was an important prognostic factor for early relapse. In view of these results, we do not recommend staging and searching for metastatic disease in asymptomatic patients presenting early stage breast cancer with low expression of the Ki-67 at the time of initial diagnosis. We also do not recommend repeated staging and searching for metastases by imaging in asymptomatic patients during routine follow-up. Staging should only be performed if a relapse is suspected during follow-up. [less ▲]

Detailed reference viewed: 109 (11 ULg)
Full Text
Peer Reviewed
See detailTrebananib (AMG 386) plus weekly paclitaxel with or without bevacizumab as first-line therapy for HER2-negative locally recurrent or metastatic breast cancer: A phase 2 randomized study.
Dieras, Veronique; Wildiers, Hans; Jassem, Jacek et al

in Breast (Edinburgh, Scotland) (2015), 24

INTRODUCTION: This phase 2 randomized study evaluated trebananib (AMG 386), a peptide-Fc fusion protein that inhibits angiogenesis by neutralizing the interaction of angiopoietin-1 and -2 with Tie2, in ... [more ▼]

INTRODUCTION: This phase 2 randomized study evaluated trebananib (AMG 386), a peptide-Fc fusion protein that inhibits angiogenesis by neutralizing the interaction of angiopoietin-1 and -2 with Tie2, in combination with paclitaxel with or without bevacizumab in previously untreated patients with HER2-negative locally recurrent/metastatic breast cancer. METHODS: Patients received paclitaxel 90 mg/m2 once weekly (3-weeks-on/1-week-off) and were randomly assigned 1:1:1:1 to also receive blinded bevacizumab 10 mg/kg once every 2 weeks plus either trebananib 10 mg/kg once weekly (Arm A) or 3 mg/kg once weekly (Arm B), or placebo (Arm C); or open-label trebananib 10 mg/kg once a week (Arm D). Progression-free survival was the primary endpoint. RESULTS: In total, 228 patients were randomized. Median estimated progression-free survival for Arms A, B, C, and D was 11.3, 9.2, 12.2, and 10 months, respectively. Hazard ratios (95% CI) for Arms A, B, and D versus Arm C were 0.98 (0.61-1.59), 1.12 (0.70-1.80), and 1.28 (0.79-2.09), respectively. The objective response rate was 71% in Arm A, 51% in Arm B, 60% in Arm C, and 46% in Arm D. The incidence of grade 3/4/5 adverse events was 71/9/4%, 61/14/5%, 62/16/3%, and 52/4/7% in Arms A/B/C/D. In Arm D, median progression-free survival was 12.8 and 7.4 months for those with high and low trebananib exposure (AUCss >/= 8.4 versus < 8.4 mg.h/mL), respectively. CONCLUSIONS: There was no apparent prolongation of estimated progression-free survival with the addition of trebananib to paclitaxel and bevacizumab at the doses tested. Toxicity was manageable. Exposure-response analyses support evaluation of combinations incorporating trebananib at doses > 10 mg/kg in this setting. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00511459. [less ▲]

Detailed reference viewed: 28 (2 ULg)
Full Text
See detailLe regard (peu optimiste) du soignant sur la personne âgée
Schroyen, Sarah ULg; Missotten, Pierre ULg; Marquet, Manon ULg et al

in Medi-Sphere (2015), 469

L’âgisme (c’est-à-dire l’ensemble de nos stéréotypes liés à l’avancée en âge) a de nombreuses conséquences négatives tant pour le patient lui-même qu’au sein de la relation entre le patient et le ... [more ▼]

L’âgisme (c’est-à-dire l’ensemble de nos stéréotypes liés à l’avancée en âge) a de nombreuses conséquences négatives tant pour le patient lui-même qu’au sein de la relation entre le patient et le personnel soignant. Au cours de cet article, nous illustrerons les représentations du vieillissement prévalentes chez les soignants et aborderons brièvement les conséquences de l’âgisme sur leurs attitudes de soins. [less ▲]

Detailed reference viewed: 147 (34 ULg)
Full Text
Peer Reviewed
See detailAgeism and its clinical impact in oncogeriatry: state of knowledge and therapeutic leads
Schroyen, Sarah ULg; Adam, Stéphane ULg; JERUSALEM, Guy ULg et al

in Clinical Interventions in Aging (2015), 10

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to ... [more ▼]

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people’s mental and physical health in “normal” aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals’ attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients’ mental and physical health. [less ▲]

Detailed reference viewed: 140 (17 ULg)
Peer Reviewed
See detailPersonnel soignant et âgisme: quelles conséquences cliniques ?
Schroyen, Sarah ULg; Missotten, Pierre ULg; JERUSALEM, Guy ULg et al

Conference (2014, December 16)

Introduction : Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré1. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent exclues des essais ... [more ▼]

Introduction : Le cancer est un problème de santé majeur dont l’âge constitue un facteur de risque avéré1. Paradoxalement, les personnes âgées souffrant d’un cancer sont souvent exclues des essais cliniques et sous-traitées comparativement à des patients plus jeunes1. Un élément explicateur de ces constats est la stigmatisation liée à l’âge² (c.à.d. nos stéréotypes liés à l’âge, et donc l’âgisme). Méthodologie : Nous avons interrogé 76 infirmiers (-ères) travaillant en oncologie. A l’aide de fiches cli-niques, nous leur avons demandé s’ils encourageraient à des patients un traitement expérimental (40 vs 70 ans), une chimiothérapie ou une reconstruction mammaire (35, 55 ou 75 ans), tout paramètres cliniques étant équivalents par ailleurs. Résultats : L’encouragement d’un traitement expérimental est moins fréquente pour une personne de 70 ans comparativement à une personne de 40 ans (p<.001). De plus, le personnel soignant encourage moins fréquemment une chimiothérapie pour une personne de 75 ans comparativement aux per-sonnes de 55 et 35 ans (p<.001). Au niveau de la reconstruction mammaire, une différence est vi-sible dès 55 ans : la reconstruction mammaire est moins encouragée pour une personne de cet âge par rapport à une personne de 35 ans (p=.02) et encore moins encouragée pour une personne de 75 ans comparativement à une personne de 55 ans (p<.001). L’âge des infirmiers (M = 35.8) a une influence sur ces encouragement : plus ils sont âgés, plus ils encouragent le traitement chimiothérapeutique d’une per-sonne de 75 ans (p = .005) de même que le traitement expérimental pour une personne de 70 ans (p = .01). Conclusion : A l’instar d’autres études3, 4, nous confirmons que tant du point de vue esthétique que cura-tif, le personnel médical encourage moins fréquemment un traitement aux patients plus âgés compa-rativement aux plus jeunes. 1. Hurria, A., et al. (2012). J Natl Compr Canc Netw, 10, 162-209. 2. Penson, R. T., et al. (2004). The Oncologist, 9, 343-352. 3. Madan, A. K., et al. (2001). Acad Med, 76, 282-284. 4. Protière, C., et al. (2010). Crit Rev Oncol Hematol, 75, 138-150. [less ▲]

Detailed reference viewed: 106 (15 ULg)