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Besançon, France

Dobi E.,Besancon University Hospital Center | Dobi E.,University of Franche Comte | Monnien F.,Besancon University Hospital Center | Kim S.,Besancon University Hospital Center | And 15 more authors.
Clinical Colorectal Cancer | Year: 2013

Background: Signal transducer and activator of transcription 3 (STAT3) is involved in epithelial growth factor receptor (EGFR) signaling in a KRAS-independent manner. Phosphorylated STAT3 (pSTAT3) expression in patients with metastatic colorectal cancer (mCRC) treated with anti-EGFR-containing salvage chemotherapy has never been investigated. Patients and Methods:: The first endpoint of this retrospective study was to evaluate the impact of pSTAT3 on the time to progression (TTP) in 94 patients with mCRC treated with anti-EGFR-based therapies in the second- or third-line setting between July 2004 and November 2009. The influence of pSTAT3 on objective response rate and overall survival (OS) was also reported. Nuclear expression of pSTAT3 status was evaluated by immunohistochemical tests on formalin-fixed and paraffin-embedded tumor samples obtained before therapy. Results: Positive expression of pSTAT3 was observed in 24.5% of the tumor samples. The probability of achieving an objective response was 13% among patients with positive nuclear expression of pSTAT3 compared with 41% for patients displaying pSTAT3-negative tumors (P =.02). In a multivariate logistic regression model, high-grade skin rash, wild-type KRAS status, and negative pSTAT3 status significantly improved TTP and OS. Conclusion: These results underscore an impact of pSTAT3 on the clinical efficacy of anti-EGFR-containing chemotherapy regimens and support the prospective assessment of this biomarker. © 2013 Elsevier Inc. All rights reserved.

Bellanger A.-P.,njoz University Hospital | Bruneel F.,Medical Intensive Care Unit | Barbot O.,njoz University Hospital | Mira J.-P.,University of Paris Descartes | And 4 more authors.
Journal of Travel Medicine | Year: 2010

We present a case of severe malaria due to Plasmodium malariae. Genetic testing showed that the patient was homozygous for five important gene polymorphisms previously shown to be associated with increased susceptibility to, and/or severity of, severe sepsis. Our case suggests that P. malariae may cause life-threatening disease, and that disease severity may be linked, at least in part, to multiple susceptibility genes. © 2010 International Society of Travel Medicine.

Mansi L.,EA4267 UFR 33 | Mansi L.,njoz University Teaching Hospital | Mansi L.,French Institute of Health and Medical Research | Demarchi M.,njoz University Teaching Hospital | And 13 more authors.
International Journal of Gynecological Cancer | Year: 2016

Objectives The goal of this study was to determine the benefit in terms of time disease control (TDC) achieved by the succession of chemotherapy beyond the third line in patients treated for recurrent epithelial ovarian cancer. Secondary objectives were to identify patients who benefited from treatments beyond 3 lines and to estimate overall survival and disease-free progression lengths. Materials and Methods The cohort of 122 patients was identified from a pharmacy database of patients treated with chemotherapy between 1992 and 2010. The evaluation of benefit obtained by each line was based on TDC duration, defined as the interval between the beginning of the treatment and the date of progressive disease or death. Results Median TDC durations was 4.15 (0-54.7), 4 (0-21.7), 3.34 (0-29.6), 4.97 (0-29.2), and 3.13 months (0-15) for the fourth to eighth lines, respectively. Time to disease control was longer than 6 months in 34% to 40% of patients treated by lines 4 to 8. The most important factor influencing TDC length beyond the third line was the TDC duration observed in the 2 previous lines of therapy. Median overall survival after the third line was 15.3 months (95% confidence interval, 12-20 months). Factors associated with longer overall survival after 3 lines were performance status lower than 2 (P = 0.0058), no hepatic metastasis (P = 0.0098), no pulmonary metastasis (P = 0.0003), and platinum sensitivity (P = 0.04) Conclusions These results may justify the administration of chemotherapy beyond the third line, in particular when the 2 previous lines are effective and resulted in disease control longer than 6 months. © 2016 by IGCS and ESGO.

Chaumard N.,Center Regional Of Lutte Contre Le Cancer Leon Berard | Limat S.,njoz University Hospital | Villanueva C.,njoz University Teaching Hospital | Nerich V.,njoz University Hospital | And 7 more authors.
Breast | Year: 2012

Background: The study's objective was to assess the predictive factors of anemia induced by chemotherapy in early breast cancer patients. Patients and methods: Patients treated by adjuvant or neo-adjuvant anthracyclin-based regimens with or without taxanes between 1998 and 2006 in a French university hospital were studied. Chemotherapy included. Anemia was defined as a hemoglobin (Hb) concentration lower than 12 g/dL. Multivariate analysis by logistic regression was used to search for baseline risk factors linked to the occurrence of anemia. Results: Among 378 patients, anemia was observed in 64% of cases. The occurrence of anemia was significantly related to 6 risk factors: exposure to taxanes (HR 11.5, 95% CI, 2.5-52.6), high dose of anthracyclin (epirubicin 100 mg/m 2)(HR 4.3; 95% CI, 2.8-8), Hb at baseline < 13.5 g/d (HR 4.3; 95% CI, 2.6-7.1), mastectomy (HR 2.5; 95% CI, 1.4-3.3), age >60 (HR 2.5; 95% CI, 1.4-5) years old (HR 2.5; 95% CI, 1.4-5) and Body Mass Index (BMI) ≤ 25 kg/m 2 (HR 1.7; 95% CI, 1.0-2.8). Conclusion: Taking into account the following factors: type of chemotherapy, BMI, age, Hb at baseline should allow a better identification of patients at risk of anemia. © 2011 Elsevier Ltd.

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