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Rabat, Morocco

Monet A.,Center dImagerie Fonctionnelle | Merino B.,Center dImagerie Fonctionnelle | Lupo R.,Service dOncologie
Clinical Nuclear Medicine | Year: 2010

A 67-year-old man underwent whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for lymphoma screening. The results demonstrated no evidence of lymphoma recurrence, but a focal increased uptake of F-18 FDG in the prostate. There was no history of urinary symptoms. A biopsy diagnosed a prostatic adenocarcinoma. Incidentally, focal intense FDG uptake in the prostate gland should always require further investigations to confirm the presence of prostate cancer. © 2010 by Lippincott Williams & Wilkins. Source

Belhadj Chaidi R.,Service de Medecine Interne | Thollot C.,Unite decho Doppler | Ferru A.,Service dOncologie | Roblot P.,Service de Medecine Interne | Landron C.,Service de Medecine Interne
Journal des Maladies Vasculaires | Year: 2013

Objectives: To assess adherence to French guidelines for curative treatment of thromboembolism in cancer patients, and to identify factors limiting their implementation. Patients and methods: Retrospective analysis of the medical files of cancer patients diagnosed with deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in one site between January 1st, 2010 and June 30th, 2011. Central venous catheter thrombosis and superficial vein thrombosis were excluded. Results: The series included 145 patients, among whom 113 (78%) had solid tumors (at a metastatic stage in 68% of cases) and 33 (22%) had hematologic malignancies. Low molecular weight heparin (LMWH) was prescribed as long-term treatment (>. 10. days) for 83 patients (57.2%) and a vitamin K antagonist (VKA) for 33 patients (22.7%). Bleeding required treatment modifications or discontinuation in 11 (7.5%) and 10 (6.8%) patients respectively. After 6. months, LMWH, VKA and fondaparinux were prescribed for 28, 27 and six (19.3%, 18.6% et 4.1%) patients respectively. Mean duration of anticoagulation was 176.8. days. Treatment was not affected by a history of venous thromboembolism, the presence of pulmonary embolism or proximal deep vein thrombosis but it was significantly shorter in case of thrombosis limited to muscular veins (115.5 vs 182.3. days, P<. 0.05). Overall, guidelines were fully implemented in only 68 (46.9%) patients, with regards to the choice of pharmacological class and duration of treatment. Conclusion: Adherence to national guidelines is insufficient and actions must be taken to improve the management of venous thromboembolism in cancer patients. © 2013 Elsevier Masson SAS. Source

Ferrand F.-R.,Service dOncologie | Pavic M.,Service de medecine interne et cancerologie
Revue de Medecine Interne | Year: 2014

The treatment of metastatic prostate cancer since the 1940s is based on the consideration of oncogenic addiction to its androgen receptor (AR). The significant improvement in survival outcomes over the past decade depends not only on the development of effective cytotoxic chemotherapy but also new molecules targeting the AR or decreasing testosterone levels, even in case of castration-resistant cancer. In this review, we summarize the structure and function of the RA, the mechanisms of androgen suppression, the concept of resistance to castration, historical targeted treatment on the AR and those recently marketed as abiraterone acetate and enzalutamide. © 2014 Société nationale française de médecine interne (SNFMI). Source

Besse B.,Institute Gustave Roussy | Planchard D.,Institute Gustave Roussy | Veillard A.-S.,Institute Gustave Roussy | Taillade L.,Service dOncologie | And 7 more authors.
Lung Cancer | Year: 2012

Background: Preliminary results indicated that bortezomib (B) (Velcade*) as a single agent may have activity in pretreated NSCLC patients with similar or lesser toxicity compared to chemotherapy. This phase II study was initiated to determine the efficacy of single-agent B in chemonaïve patients with advanced NSCLC. An early tumor assessment (after 6 weeks of therapy) was performed to allow for rapid and appropriate management of non-responding patients. Methods: Patients received B (1.5mg/m 2) twice a week for 2 consecutive weeks (days 1, 4, 8, and 11) followed by a 10-day rest period. The primary endpoint was non-progression rate (NPR) after 6 weeks of treatment. Secondary endpoints included response rate, progression-free survival (PFS), overall survival (OS), and safety. Exploratory analyses included FDG-PET response at 6 weeks and circulating tumors cell (CTC) assessment at day 1 of each cycle in a subset of patients. Results: 18 patients were enrolled from 06/06 to 02/07 from 3 French institutions. Demographics: male/female 15/3; median age 66 (54-79); PS 0/1/2, 3/12/3; pathology: adenocarcinoma 11, squamous cell carcinoma 5, large-cell carcinoma 2; smoking status never/former/current 1/10/7; stage IIIB/IV 2/16. Seventeen patients received B and 16 were assessable (1 early withdrawal and 1 progression at D26). The most frequent toxicity was fatigue (17 patients). Twelve patients (71%) had at least one grade 3 toxicity: 4 haematological, 1 infection, 5 gastro-intestinal toxicity, 9 fatigue, 1 neuropathy. The non-progression rate was 59% [33-82%] at 6 weeks (10/17 patients). No objective response was seen. With a median follow-up of 12.3 months, the median PFS and OS were 2.4 and 9.8 months respectively. Eleven deaths occurred. No PET response was observed, and CTC were detected only in 1 out of 8 patients evaluated. Conclusions: Although according to the protocol rules the trial should not be stopped, the lack of any objective response either by CT-scan or PET-CT, along with substantial toxicity, did not argue in favor of the current strategy of B as a single agent in the front-line setting of NSCLC. © 2011 Elsevier Ireland Ltd. Source

Varin R.,University Pierre and Marie Curie | Varin R.,Laboratoire MERCI | Mirshahi S.,Research and Development Stago | Mirshahi P.,University Pierre and Marie Curie | And 7 more authors.
Thrombosis Research | Year: 2013

Introduction Defective thrombolysis, a thrombotic risk factor, can be attributed to the formation of a compact clot poorly accessible to fibrinolytic enzymes. Venous thrombi, rich in red blood cells (RBCs), and arterial thrombi containing various amounts of RBCS, plasma and whole blood (WB) clot permeability and degradability were compared. The effect of rivaroxaban, a potent direct factor Xa inhibitor, was also evaluated. Materials and Methods Fibrin permeability was determined by flow measurement through the clot. Clot degradability was evaluated by the amount of D-dimer generated by clot perfusion with plasminogen and tissue plasminogen activator. Fibrin clot structure was assessed by confocal microscopy. Results WB clot permeability (KS) and degradability were 6.7- and 38-fold lower, respectively, compared with plasma clots. This is attributed to 1) occlusion of fibrin pores by RBCs and 2) a consistent increase in thrombin generation due to platelets and RBCs inducing formation of a tighter clot. Rivaroxaban added to plasma or WB before clotting, in reducing thrombin generation, led to the formation of a looser clot that is more degradable by fibrinolytic enzymes. Permeability and degradability of whole blood clots formed in the presence of rivaroxaban were very similar to those of plasma clots. Conclusion The resistance to fibrinolysis of WB clots was reduced considerably when clots were formed with rivaroxaban. These results may have implications for the development of antithrombotic agents. © 2012 Elsevier Ltd. Source

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