Claudius Regaud Cancer Center

Toulouse, France

Claudius Regaud Cancer Center

Toulouse, France

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Houede N.,University of Nimes | Pulido M.,Bergonie Cancer Institute | Mourey L.,Claudius Regaud Cancer Center | Joly F.,Francois Baclesse Cancer Center | And 9 more authors.
Oncologist | Year: 2014

Background. Preclinical studies demonstrated that nonnucleoside reverse transcriptase inhibitors used for the treatment of HIV could antagonize tumor development. This led us to assess the efficacy of efavirenz in patients with metastatic castration-resistant prostate cancer (mCRPC) in a multicenter phase II study.Methods. We used a Simon two-stage design and a 3-month prostate-specific antigen (PSA) nonprogression rate of 40% as a primary objective. Patients received 600 mg efavirenz daily with thepossibility of a dose increase in case ofPSAprogression. Exploratory analyses included pharmacokinetics of efavirenz plasma concentrations and correlations with clinical outcomes.Results. Among 53 assessable patients, we observed 15 instances of PSA nonprogression at 3 months, corresponding to a nonprogression rate of 28.3%(95%confidence interval:16.8%–42.3%). The exploratory analysis revealed that for the 7 patients in whom optimal plasma concentration of efavirenz was achieved, PSA progression was observed in only 28.6% compared with 81.8% of patients with suboptimal plasma concentrations of efavirenz.Conclusion. Although 600 mg efavirenz did not statistically improve the PSA nonprogression rate, our exploratory analysis suggests that higher plasma concentrations of this drug (i.e., use of increased dosages) may be of potential benefit for the treatment of mCRPC. © AlphaMed Press 2014.


PubMed | Parc Scientifique Unitec, Claudius Regaud Cancer Center, Francois Baclesse Cancer Center, University of Nimes and 5 more.
Type: Clinical Trial, Phase II | Journal: The oncologist | Year: 2014

Preclinical studies demonstrated that non-nucleoside reverse transcriptase inhibitors used for the treatment of HIV could antagonize tumor development. This led us to assess the efficacy of efavirenz in patients with metastatic castration-resistant prostate cancer (mCRPC) in a multicenter phase II study.We used a Simon two-stage design and a 3-month prostate-specific antigen (PSA) nonprogression rate of 40% as a primary objective. Patients received 600 mg efavirenz daily with the possibility of a dose increase in case of PSA progression. Exploratory analyses included pharmacokinetics of efavirenz plasma concentrations and correlations with clinical outcomes.Among 53 assessable patients, we observed 15 instances of PSA nonprogression at 3 months, corresponding to a nonprogression rate of 28.3% (95% confidence interval: 16.8%-42.3%). The exploratory analysis revealed that for the 7 patients in whom optimal plasma concentration of efavirenz was achieved, PSA progression was observed in only 28.6% compared with 81.8% of patients with suboptimal plasma concentrations of efavirenz.Although 600 mg efavirenz did not statistically improve the PSA nonprogression rate, our exploratory analysis suggests that higher plasma concentrations of this drug (i.e., use of increased dosages) may be of potential benefit for the treatment of mCRPC.


Ribes S.,SIMAD University | Didierlaurent D.,SIMAD University | Decoster N.,Magellium Ltd | Gonneau E.,SIMAD University | And 4 more authors.
IEEE Transactions on Medical Imaging | Year: 2014

An algorithm dedicated to automatic segmentation of breast magnetic resonance images is presented in this paper. Our approach is based on a pipeline that includes a denoising step and statistical segmentation. The noise removal preprocessing relies on an anisotropic diffusion scheme, whereas the statistical segmentation is conducted through a Markov random field model. The continuous updating of all parameters governing the diffusion process enables automatic denoising, and the partial volume effect is also addressed during the labeling step. To assess the relevance, the Jaccard similarity coefficient was computed. Experiments were conducted on synthetic data and breast magnetic resonance images extracted from a high-risk population. The relevance of the approach for the dataset is highlighted, and we demonstrate accuracy superior to that of traditional clustering algorithms. The results emphasize the benefits of both denoising guided by input data and the inclusion of spatial dependency through a Markov random field. For example, the Jaccard coefficient for the clinical data was increased by 114%, 109%, and 140% with respect to a K-means algorithm and, respectively, for the adipose, glandular and muscle and skin components. Moreover, the agreement between the manual segmentations provided by an experienced radiologist and the automatic segmentations performed with this algorithm was good, with Jaccard coefficients equal to 0.769, 0.756, and 0.694 for the above-mentioned classes. © 1982-2012 IEEE.


Huyghe E.,Toulouse University Hospital Center | Huyghe E.,University Paul Sabatier | Delaunay B.,Toulouse University Hospital Center | Njomnang Soh P.,University Paul Sabatier | And 5 more authors.
International Journal of Impotence Research | Year: 2013

To determine the risk factors for EDin men treated by prostate brachytherapy (PB) for localized prostate cancer and to propose a model to predict post-implant erectile function. Out of a series of 270 sexually active men treated by PB, 241 (89%) (mean age=66 years (range, 43-80)) accepted to participate in a mail-based study on erectile function. The risk factors for erectile dysfunction were determined by regression analysis and a predictive model was proposed. The performance of the model was determined in this population and subsequently verified in a population of 50 men treated by PB in another treatment center. The risk factors for ED after PB were age, the pre-implant IIEF score and prostate volume. In the studied population, the final model to predict a post-treatment IIEF-5 score, using these factors, had a sensitivity of 69% and a specificity of 68% associated to an area under the ROC curve (AUC) of 0.75. The same performance was obtained in another treatment center. Age, pre-implant IIEF-5 score and prostate volume may be used to predict post-implant erectile function in patients treated by PB. © 2013 Macmillan Publishers Limited.


Delaunay B.,Toulouse University Hospital Center | Soh P.N.,Toulouse University Hospital Center | Delannes M.,Claudius Regaud Cancer Center | Riou O.,Val dAurelle Cancer Center | And 5 more authors.
Brachytherapy | Year: 2014

Purpose: Penis brachytherapy (PB) remains an alternative in the cancer treatment. The objective of this study was to assess the oncologic outcomes, sexual function, and the sexual behavior of men treated by PB for a cancer of the penis. Methods and Materials: Between 1992 and 2009, 47 patients with a cancer of the penis were treated by PB (192Ir), in the Toulouse, Montpellier, and Barcelona cancer centers. The investigation into their sexuality was obtained by means of questionnaire. A total of 21 French patients were approached, of whom 19 (mean age=73.2 years) agreed to answer the questionnaire (participation rate=90.5%). Results: Oncologic data: The specific survival and the disease-free survival at 5 years was 87.6% (95% confidence interval, 72.4-94.7%) and 84% (95% confidence interval, 57.6-94.7%), respectively. The rate of preservation of the penis was 66% (n= 31). Sexual data: Among the 17 patients sexually active before brachytherapy, 10 patients remained sexually active after treatment (58.8%). Of the 18 patients who had erections before PB, 17 still had them after treatment (94.4%). Age was the main predictive factor. Conclusion: The PB seems to have a moderated impact on the sexual functions and the sexual behavior of the patients. © 2014 American Brachytherapy Society.

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