Pazopanib (Votrient) dans le traitement du cancer du rein et des sarcomes des tissus mous.

in Revue Médicale de Liège (2012), 67(7-8), 437-42

Renal cell carcinoma accounts for 3% of all malignant tumors. Until a few years ago, immunotherapy (Interferon and/or Interleukin-2) was the only approved systemic treatment in the metastatic setting ... [more ▼]

Renal cell carcinoma accounts for 3% of all malignant tumors. Until a few years ago, immunotherapy (Interferon and/or Interleukin-2) was the only approved systemic treatment 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 and VEGFR inhibitors. They are now the standard treatment in first and second line. Pazopanib, a VEGFR tyrosine kinase inhibitor, is one of the treatment options recommended for patients with metastatic renal cell carcinoma, in first line and after cytokines failure. Since more recently, pazopanib is also approved in the treatment of metastatic soft tissue sarcoma, after failure of at least one line of chemoterapy. In this paper, we will review the mechanism of action and the clinical results of pazopanib in renal cell carcinoma and sarcoma. [less ▲]

Assessment of Response to Therapy for Bone Metastases : Is it still a challenge in oncology ?

in PET Clinics (2010), 5(3), 311-326

Le cancer du sein "triple négatif"

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 ▲]

ANTICORPS MONOCLONAUX ET CANCER DU SEIN: Actualités thérapeutiques

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 ▲]

Angiosarcome sur lymphoedeme chronique: un cas de syndrome de Stewart-Treves.

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 ▲]

Le cas clinique du mois. Reaction de rappel d'irradiation induite par l'administration de cyclophosphamide.

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 ▲]

Actualités thérapeutiques en oncologie sénologique: place actuelle et perspectives des traitements cibles

in Revue Médicale de Liège (2007), 62 Spec No

The introduction of targeted therapies has largely modified the treatment strategies in oncology. Two targets are currently used for defining the systemic treatment of breast cancer: hormone receptors and ... [more ▼]

The introduction of targeted therapies has largely modified the treatment strategies in oncology. Two targets are currently used for defining the systemic treatment of breast cancer: hormone receptors and HER2 overexpression. Trastuzumab, a monoclonal antibody, is the only registered antiHER2 treatment in Belgium. The association of trastuzumab with chemotherapy is now the recommended adjuvant treatment for early breast cancer overexpressing HER2. Other antiHER2 medications are available and some will probably be registered soon. Angiogenesis is another potential target for improving the treatment results. The CHU Liege, as a reference center for the systemic treatment of solid tumors, participates in many international trials in order to validate these new approaches. The highest quality of care is required to be in compliance with the conduct of these clinical trials. Another benefit for the patient is the easy access to last generation medical treatments, generally not accessible in our health care system in Belgium outside of clinical trials. [less ▲]

Traitement du cancer du sein chez la personne âgée

in Revue Médicale Suisse (2004), 62

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d ... [more ▼]

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d'autonomie. De plus, selon les facteurs histopronostiques (récepteurs aux oestrogènes et à la progestérone, la surexpression du cerb-B2) on décidera éventuellement du schéma thérapeutique le plus approprié. Chez la personne âgée, la chirurgie (mastectomie ou tumorectomie), la radiothérapie et l'hormonothérapie trouvent leur place. Au-delà de 70 ans, la place de la chimiothérapie est incertaine. En effet, les patientes de plus de 70 ans sont sous-représentées dans les études randomisées. [less ▲]