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Bouali W, Erk N, Sert B, Harputlu E. Evaluating the simultaneous electrochemical determination of antineoplastic drugs using LaNiO 3/g-C 3N 4@RGH nanocomposite material. Talanta 2024; 278:126486. [PMID: 38944941 DOI: 10.1016/j.talanta.2024.126486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/15/2024] [Accepted: 06/27/2024] [Indexed: 07/02/2024]
Abstract
A novel electrochemical sensor based on LaNiO3/g-C3N4@RGH nanocomposite material was developed to simultaneously determine Ribociclib (RIBO) and Alpelisib (ALPE). Ribociclib and Alpelisib are vital anticancer medications used in the treatment of advanced breast cancer. The sensor exhibited excellent electrocatalytic activity towards the oxidation of RIBO and ALPE, enabling their simultaneous detection. The fabricated sensor was characterized using various techniques, including energy dispersive X-ray (EDX), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XR), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS), which confirmed the successful synthesis of the LaNiO3/g-C3N4@RGH composite material. Electrochemical characterization revealed enhanced conductivity and lower resistance of the modified electrode compared to the bare electrode. The developed sensor exhibited high repeatability, reproducibility, stability, and selectivity toward RIBO detection. Furthermore, the sensor displayed high sensitivity with low detection limits of 0.88 nM for RIBO and 6.1 nM for ALPE, and linear ranges of 0.05-6.2 μM and 0.5-6.5 μM, respectively. The proposed electrochemical sensor offers a promising approach for simultaneously determining RIBO and ALPE in pharmaceutical formulations and biological samples with recovery data of 98.7-102.0 %, providing a valuable tool for anticancer drug analysis and clinical research.
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Affiliation(s)
- Wiem Bouali
- Ankara University, Faculty of Pharmacy, Department of Analytical Chemistry, 06560, Ankara, Turkey; Ankara University, The Graduate School of the Health Sciences, 06110, Ankara, Turkey.
| | - Nevin Erk
- Ankara University, Faculty of Pharmacy, Department of Analytical Chemistry, 06560, Ankara, Turkey.
| | - Buse Sert
- Tarsus University, Faculty of Engineering, Department of Engineering Fundamental Sciences, 33400, Tarsus, Turkey
| | - Ersan Harputlu
- Tarsus University, Faculty of Engineering, Department of Engineering Fundamental Sciences, 33400, Tarsus, Turkey
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Xu S, Tang Y, Li Y, Yang J, Gu W, Hao X, Yuan C. Discovery of diverse sesquiterpenoids from Magnolia grandiflora with cytotoxic activities by inducing cell apoptosis. Bioorg Chem 2023; 139:106707. [PMID: 37421692 DOI: 10.1016/j.bioorg.2023.106707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
Phytochemical study of Magnolia grandiflora led to the isolation of 39 sesquiterpenoids, including 15 new compounds (1-15). Compounds 1 and 2 are discovered to be the first 13-norgermacrane type sesquiterpenoids in natural products. Compound 15 is a rare 5,6-seco-guaiane type sesquiterpene and its possible biogenic precursor is presumed to be compound 20. Subsequent structural modification for compound 28 led to 21 derivatives, among which 15 derivatives were new compounds. All compounds were tested for the inhibitory effects on three tumor cell lines, and 17 compounds were active with the IC50 values ranging from 1.91 ± 0.39 μM to 12.29 ± 1.68 μM. The structure-activity relationships implied that an α, β-unsaturated lactone group was an important active group for the cytotoxicity. Two most active compounds (19 and 29) with low toxicity on normal human liver cell line were selected for further mechanism study. Compound 29 could induce apoptosis on Colo320DM cells through influencing the key apoptotic related proteins, such as PARP, Cleaved PARP, cleaved Caspase-3, and pro-Caspase 3. In addition, compound 19 with the best cytotoxic activity on HEL cells also could induce the apoptosis in dose- and time-dependent manners. In summary, our investigation implied that compounds 19 and 29 are two new potential anti-cancer candidates for ongoing study in the future.
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Affiliation(s)
- Shuangyu Xu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China
| | - Yunyan Tang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China
| | - Yanan Li
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China
| | - Jue Yang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China
| | - Wei Gu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China
| | - Xiaojiang Hao
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China; State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming 650201, People's Republic of China.
| | - Chunmao Yuan
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guiyang 550014, People's Republic of China; School of Pharmacuetical Sciences, Guizhou Medical University, Guiyang 550025, People's Republic of China; Natural Products Research Center of Guizhou Province, Guiyang 550014, People's Republic of China.
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Gimenez L, Grosclaude P, Druel V, Costa N, Delpierre C, Molinier L, Delord JP, Rougé Bugat ME. Study protocol of the CREDO randomised controlled trial: evaluation of a structured return home consultation for patients suffering from metastaticcancer. BMJ Open 2023; 13:e062219. [PMID: 36717134 PMCID: PMC9887714 DOI: 10.1136/bmjopen-2022-062219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Patients suffering from cancer are often managed by multiple health professionals. General practitioners with specific skills in oncology could facilitate care coordination between hospital and general practice in the management of these patients. To explore this hypothesis, we run a randomised clinical trial, called 'Concertation de REtour à DOmicile, CREDO'. The main objective is to explore the effectiveness of a 'return home' consultation compared with standard care. The number of unscheduled visits to care centres is used to evaluate the effectiveness of the treatment. METHODS AND ANALYSIS CREDO is a multicentre, randomised, open-label, prospective trial. It takes place in two specialised cancer care centres in southern France (Occitania region). Patient inclusion criteria are: be over 18 years old; be treated with a first cycle of metastatic chemotherapy in a specialised cancer care centre; have a metastatic solid cancer and be returning home after treatment. Patients are randomised in two arms: standard-arm (conventional management) or intervention-arm (CREDO management). In the intervention arm, a 'return home' consultation is carried out in three steps. First, the investigating GP (GP with specific skills in oncology) from the specialised care centre collects information about the patient and patient's management choices. Then, the investigating GP conducts an interview with the patient's referring GP to quickly communicate and discuss information about the patient. Finally, the investigating GP summarises these exchanges and transmits this information to the care centres chosen by the patient.All the patients are followed for 1 year.Statistical and medicoeconomic analysis are planned. ETHICS AND DISSEMINATION This clinical trial is registered under ClinicalTrials.gov identifier and was approved by the ethics committee of South-Western French Committee for the Protection of Persons (number: 2016-A01587-44) and from the French National Drug Safety Agency (ANSM, number: 2016111500034).An international publication of the final results and conference presentations will be planned. TRIAL REGISTRATION NUMBER NCT02857400.
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Affiliation(s)
- Laëtitia Gimenez
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, Toulouse, France
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
- Maison de Santé Pluriprofessionnelle Universitaire La Providence, Toulouse, France
| | - Pascale Grosclaude
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
- Institut Universitaire du Cancer Toulouse - Oncopole (IUCT-O), Toulouse, France
| | - Vladimir Druel
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, Toulouse, France
| | - Nadège Costa
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
- Service d'Economie de la santé - CHU de Toulouse, Toulouse, France
| | - Cyrille Delpierre
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
| | - Laurent Molinier
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
- Service d'Economie de la santé - CHU de Toulouse, Toulouse, France
| | - Jean-Pierre Delord
- Institut Universitaire du Cancer Toulouse - Oncopole (IUCT-O), Toulouse, France
| | - Marie-Eve Rougé Bugat
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, Toulouse, France
- UMR 1295 INSERM - Université Toulouse III Paul Sabatier, Toulouse, France
- Maison de Santé Pluriprofessionnelle Universitaire La Providence, Toulouse, France
- Institut Universitaire du Cancer Toulouse - Oncopole (IUCT-O), Toulouse, France
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Gimenez L, Druel V, Bonnet A, Delpierre C, Grosclaude P, Rouge-Bugat ME. Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners. BMC PRIMARY CARE 2022; 23:283. [PMID: 36396990 PMCID: PMC9673376 DOI: 10.1186/s12875-022-01891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND To promote improved coordination between general practice and hospital, the French clinical trial CREDO ("Concertation de REtour à DOmicile") is testing an innovative experimental consultation for patients with metastatic cancer who are returning home. This consultation involves the patient, the patient's referring GP (GPref) and a GP with specific skills in oncology (GPonc) in a specialized care center. The objective of our study is to explore the satisfaction of GPsref about this consultation, in the phase of interaction between GPonc and GPref. METHODS This observational, cross-sectional, multicenter study explored the satisfaction of GPsref who had participated in this type of consultation, via a telephone survey. RESULTS One Hundred GPsref responded to the questionnaire between April and September 2019 (overall response rate: 55%). 84.5% were satisfied with the consultation, and the majority were satisfied with its methods. Half of the GPsref learned new information during the consultation, three-quarters noted an impact on their practice, and 94.4% thought that this type of coordination between the GPref and the oncology specialist could improve general practice - hospital coordination. CONCLUSIONS For GPs, the CREDO consultation seems to be practical and effective in improving the coordination between general medicine and hospital. GPs would benefit from such coordination for all patients with cancer, several times during follow-up and at each occurrence of a medically significant event.
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Affiliation(s)
- Laëtitia Gimenez
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, 133 Route de Narbonne, 31062, Toulouse Cedex, France.
- Faculté de médecine, CERPOP - UMR 1295 INSERM - Université Toulouse III Paul Sabatier, 37 allées Jules Guesde -, 31000, Toulouse, France.
- Maison de Santé Pluriprofessionnelle Universitaire La Providence, 1 avenue Louis Blériot -, 31500, Toulouse, France.
| | - Vladimir Druel
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, 133 Route de Narbonne, 31062, Toulouse Cedex, France
| | - Anastasia Bonnet
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, 133 Route de Narbonne, 31062, Toulouse Cedex, France
| | - Cyrille Delpierre
- Faculté de médecine, CERPOP - UMR 1295 INSERM - Université Toulouse III Paul Sabatier, 37 allées Jules Guesde -, 31000, Toulouse, France
| | - Pascale Grosclaude
- Faculté de médecine, CERPOP - UMR 1295 INSERM - Université Toulouse III Paul Sabatier, 37 allées Jules Guesde -, 31000, Toulouse, France
- Institut Universitaire du Cancer Toulouse - Oncopole, 1, avenue Irène Joliot-Curie -, 31059, Toulouse Cedex 9, France
| | - Marie-Eve Rouge-Bugat
- Département Universitaire de Médecine Générale - Université Toulouse III Paul Sabatier, 133 Route de Narbonne, 31062, Toulouse Cedex, France
- Faculté de médecine, CERPOP - UMR 1295 INSERM - Université Toulouse III Paul Sabatier, 37 allées Jules Guesde -, 31000, Toulouse, France
- Maison de Santé Pluriprofessionnelle Universitaire La Providence, 1 avenue Louis Blériot -, 31500, Toulouse, France
- Institut Universitaire du Cancer Toulouse - Oncopole, 1, avenue Irène Joliot-Curie -, 31059, Toulouse Cedex 9, France
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Bardajee GR, Sharifi M, Mahmoodian H. Novel CMC-CdTe / ZnS QDs Nanosensor for the Detection of Anticancer Drug Epirubicin. J Fluoresc 2021; 31:651-658. [PMID: 33599913 DOI: 10.1007/s10895-021-02687-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
Epirubicin (EPI) is one of the standard anticancer drugs that apply for various cancers treatment. However, the accumulation of EPI in the human body can be highly toxic, and it causes inevitable harm to organs. As a result, the evaluation of low concentrations of this drug in body samples requires sensitive, rapid, and accurate analysis methods. The fluorescence method is an efficient way in comparison of the traditional methods such as liquid chromatography, capillary electrophoresis, and electrochemical methods. Herein, we synthesized a novel fluorescence nanosensor named CMC-CdTe/ZnS based on using quantum dots (QDs). The structure of the prepared nanosensor is confirmed by different analysis methods such as FT-IR, TGA, and TEM. Besides that, the fluorescence intensity response of CMC-CdTe/ZnS QDs in the presence of Epirubicin drug is investigated. Based on obtained results, not only this nanosensor developed, but also the fluorescence quenching was explained by the typical Stern-Volmer equation. The best linear quenching equation for entitled nanosensor in the presence of Epirubicin is F0/F = 0.0346Q + 1.08 (R2 = 0.99), and the detection limit of Epirubicin is around 0.04 × 10-6 mol/L at 25 °C. All of the results display that this method could be reliable and suitable approach for determination of Epirubicin in commercial samples as well.
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Affiliation(s)
| | - Mahdieh Sharifi
- Department of Chemistry, Payame Noor University, PO BOX 19395-3697, Tehran, Iran
| | - Hossein Mahmoodian
- Department of Chemistry, Payame Noor University, PO BOX 19395-3697, Tehran, Iran
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Vaysse C, Fize AL, Despas F, Chantalat E, Serrano E, Beyne-Rauzy O, Rougé-Bugat ME. Small Private Online Course in Teaching Oncology-Feedback After 1 Year: What Lessons? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:65-71. [PMID: 31410821 DOI: 10.1007/s13187-019-01598-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In response to the complexity of medical care in oncology, 2 years ago, we designed a new teaching method (SPOC, Small Private Online Course) to improve cancer treatment and its management by emphasizing the community-hospital interface. The educational objective of this study was to evaluate after 1 year if the interest for this teaching remained constant over the long term to meet both educational and financial requirements. We designed a questionnaire including 18 questions grouped in 3 main parts describing the profile of the participants, his/her own experience, and the current utilization of the SPOC. Of 1574 participants of the 2 first sessions, 182 (11.5%) completed the questionnaire after 1 year. The majority of respondents were between the ages of 31 and 60 and belonged to a paramedical group (47.81%). After 1 year, 84.6% participants were satisfied or very satisfied with the content of the SPOC, 83.6% would recommended it, and 67% would be interested in using an updated SPOC again. Only 4.9% kept some contacts with other participants and 4.9% with teachers. 31.3% considered that the SPOC had a medium impact on their professional activity, 33.5% a lot, and 2.7% completely whereas 24.7% considered that it had little impact. The evaluation at 1 year showed that this digital learning method had a global positive impact on the professional practice of the participants. This study highlighted the empowerment of participants after this kind of teaching, but the network between participants was not enhanced.
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Affiliation(s)
- Charlotte Vaysse
- Surgery Oncology Department, Centre Hospitalier Universitaire Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.
- Université Paul Sabatier Toulouse III, Toulouse, France.
| | - Anne-Laure Fize
- PHUC CAPTOR WP4 Research Program, Université Paul Sabatier Toulouse III, Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
| | - Fabien Despas
- Université Paul Sabatier Toulouse III, Toulouse, France
- Medical and Clinical Pharmacology Unit, Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | - Elodie Chantalat
- Surgery Oncology Department, Centre Hospitalier Universitaire Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Université Paul Sabatier Toulouse III, Toulouse, France
| | - Elie Serrano
- Université Paul Sabatier Toulouse III, Toulouse, France
| | - Odile Beyne-Rauzy
- Université Paul Sabatier Toulouse III, Toulouse, France
- Department of Internal Medicine, Centre Hospitalier Universitaire Toulouse, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Marie-Eve Rougé-Bugat
- Université Paul Sabatier Toulouse III, Toulouse, France
- General Practice Department, Université Paul Sabatier Toulouse III, Toulouse, France
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Roger S, Edeline J, Campillo-Gimenez B, Ventroux E, Rouge-Bugat ME, Chapron A. Adverse events of targeted therapies reported by patients with cancer treated in primary care. Eur J Gen Pract 2021; 26:202-209. [PMID: 33399025 PMCID: PMC7801082 DOI: 10.1080/13814788.2020.1846713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Targeted Therapies (TT) are among the therapeutic innovations for cancer treatment in outpatient settings. TT-related Adverse Events (AEs) are a source of loss of opportunity for patients if their management is inappropriate. Objectives The objective of this study was to describe the AE frequency and severity as reported by patients with cancer who received TT in ambulatory settings. A second objective was to describe the role of the general practitioner (GP) in the management of AEs. Methods All patients who started TT at a French Regional Cancer Centre in 2017–2018 were eligible for this 12-month prospective study. A self-administered questionnaire was distributed at inclusion and returned after three months. In the questionnaire, patients listed all AEs that occurred during this period and rated their severity. Occurrence and severity were compared with the rating by a specialised nurse. Patients also indicated the health professional they contacted first for the reported AE. Results Among the 247 eligible patients, 15 were excluded and 144 responded to the questionnaire. Fourteen different TTs have been prescribed. Asthenia (92.4%) and anorexia (64.6%) were the most frequent AE. Patients’ AE severity rating was more severe than the nurse’s rating for all drugs (p < 0.001). Patients first contacted their GP for 15.6% of AEs, whereas 20.7% of AEs were not reported to any health professional. Conclusion Patients experienced an average of 4 AEs. AE severity rating was significantly different between patients and nurses. Patients do not always communicate AEs to health care professionals.
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Affiliation(s)
- Samuel Roger
- Department of General Practice, University Rennes, Rennes, France.,CHU Rennes, INSERM, CIC 1414 (Centre d'investigation clinique de Rennes), University Rennes, Rennes, France
| | - Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Boris Campillo-Gimenez
- INSERM, LTSI U1099, Rennes, France.,Clinical Research Department, Centre Eugene Marquis, Rennes, France
| | - Elodie Ventroux
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | | | - Anthony Chapron
- Department of General Practice, University Rennes, Rennes, France.,CHU Rennes, INSERM, CIC 1414 (Centre d'investigation clinique de Rennes), University Rennes, Rennes, France
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Gimenez L, Druel V, Roques S, Vasseur J, Grosclaude P, Delpierre C, Rouge-Bugat ME. Inventory of tools for care coordination between general practice and hospital system for patients suffering from cancer in active phase of treatment: A scoping review. Eur J Cancer Care (Engl) 2020; 29:e13319. [PMID: 32930478 DOI: 10.1111/ecc.13319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/15/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION During the active phase of treatment, major difficulties appear in the transmission and quality of the information communicated to the General Practitioner (GP). Our objective was to carry out an inventory of the coordination tools used to improve exchanges between the hospital and the GP in the management of the patient suffering from cancer during this phase. MATERIAL AND METHOD A scoping review was conducted using MEDLINE databases via PubMed, The Cochrane Library, Web of Science. Articles published between 1998 and 2018, in English and French, were analysed. RESULTS Over 4,863 articles were extracted, and 11 studies were included. They highlight an increase in the quality of patient care after the introduction of information sheets or training by video vignettes with GPs. They demonstrate the importance of using standardised letters between health professionals. The role of a "leader physician" is discussed, and its first evaluations are positive. An increase in information transmitted to GPs leads to a better satisfaction of patients and GPs. CONCLUSION Communication tools are essential for the transmission of information, but direct and oral communication between all health professionals seems to be a point to be further developed.
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Affiliation(s)
- Laëtitia Gimenez
- Département Universitaire de Médecine Générale, Université Toulouse III Paul Sabatier, Toulouse Cedex, France.,UMR 1027 INSERM - Université Toulouse III Paul Sabatier, Faculté de médecine, Toulouse, France.,Maison de Santé Pluriprofessionnelle Universitaire La Providence, Toulouse, France
| | - Vladimir Druel
- Département Universitaire de Médecine Générale, Université Toulouse III Paul Sabatier, Toulouse Cedex, France.,UMR 1027 INSERM - Université Toulouse III Paul Sabatier, Faculté de médecine, Toulouse, France
| | - Sandra Roques
- Département Universitaire de Médecine Générale, Université Toulouse III Paul Sabatier, Toulouse Cedex, France
| | - Jonathan Vasseur
- Département Universitaire de Médecine Générale, Université Toulouse III Paul Sabatier, Toulouse Cedex, France
| | - Pascale Grosclaude
- UMR 1027 INSERM - Université Toulouse III Paul Sabatier, Faculté de médecine, Toulouse, France.,Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse Cedex 9, France
| | - Cyrille Delpierre
- UMR 1027 INSERM - Université Toulouse III Paul Sabatier, Faculté de médecine, Toulouse, France
| | - Marie-Eve Rouge-Bugat
- Département Universitaire de Médecine Générale, Université Toulouse III Paul Sabatier, Toulouse Cedex, France.,UMR 1027 INSERM - Université Toulouse III Paul Sabatier, Faculté de médecine, Toulouse, France.,Maison de Santé Pluriprofessionnelle Universitaire La Providence, Toulouse, France.,Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse Cedex 9, France
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Neuzillet Y, Albrand G, Caillet P, Paillaud E, Mongiat-Artus P. [Specificity of the management of metastatic renal cancer in the older patient]. Prog Urol 2020; 29:874-895. [PMID: 31771770 DOI: 10.1016/j.purol.2019.08.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 08/19/2019] [Indexed: 01/27/2023]
Abstract
AIM To define the necessary arrangements of medical treatment with anti-angiogenics, mTOR inhibitor or systemic immunotherapies in the management of metastatic renal cell carcinoma in elderly patients. METHOD Bibliographical search was performed from the Medline bibliographic database (NLM Pubmed tool) and Embase focused on: metastatic renal cell carcinoma, elderly, treatment. RESULTS The selection criteria for the medical treatment of metastatic renal cell carcinoma in elderly patients are the IMDC score, necessarily complemented by performance status, the tolerability profile of treatments, more frequent drug interactions, treatment adherence, management capacity of side effects, and patient preference. Each of these criteria is detailed in critical ways. CONCLUSION The efficacy and tolerability of medical treatments for metastatic renal cancer have not been reported as different depending on age. No dosage adjustment is recommended in principle. However, prevention and early treatment of side effects of treatment should be strengthened in elderly patients.
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Affiliation(s)
- Y Neuzillet
- Service d'urologie et de transplantation rénale, hôpital Foch, université de Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
| | - G Albrand
- Service UCOG-IR, pavillon 1C Louis-Lortet, hospices civils de Lyon, centre hôpitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - P Caillet
- Service de gériatrie, unité d'oncogériatrie, hôpital européen Georges-Pompidou, université de Paris-Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France
| | - E Paillaud
- Service de gériatrie, unité d'oncogériatrie, hôpital européen Georges-Pompidou, université de Paris-Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France
| | - P Mongiat-Artus
- Inserm UMR, S1165, service d'urologie, unité de chirurgie et d'anesthésie ambulatoires, hôpital Saint-Louis, université de Paris-7-Denis-Diderot, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Bacrie J, Laurans M, Iorio P, Fourme E, Volters AB, Bozec L, Lerebours F, Dubot C, Bensaoula O, Benzidane B, Pierga JY, Lefeuvre D. Febrile neutropenia in adjuvant and neoadjuvant chemotherapy for breast cancer: a retrospective study in routine clinical practice from a single institution. Support Care Cancer 2018; 26:4097-4103. [PMID: 29855772 DOI: 10.1007/s00520-018-4280-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Febrile neutropenia (FN) is one of the most common and most critical adverse effects of chemotherapy. Despite many existing guidelines based on the use of granulocyte-colony stimulating factor (G-CSF), FN continues to impair the quality of life and interfere with the treatment of many patients. The purpose of this study was to assess the incidence and management of FN associated with chemotherapy for early breast cancer in routine clinical practice. METHODS All patients with early-stage breast cancer (ESBC) treated by chemotherapy at Institut Curie, Hôpital René Huguenin, in 2014 were retrospectively included. The incidence and management of FN were reported. Risk factors associated with FN were studied by robust-error-variance Poisson regression. RESULTS A total of 524 patients received either neoadjuvant (N = 130) or adjuvant chemotherapy (N = 394). Most patients (80%) were treated with a combination of 5-fluorouracil, epirubicin, and cyclophosphamide (FEC100; 3 cycles) followed by docetaxel 100 mg/m2 (D; 3 cycles). The overall incidence of FN was 17%. Eighteen percent of patients received primary prophylaxis (PP) for FN with G-CSF, using pegfilgrastim in 64% of cases and 74% of patients over the age of 70 received PP. Less than 5% of patients who received PP experienced FN. Recurrent FN after secondary prophylaxis was observed in 9% of patients. Forty-seven percent of cases of FN occurred after the first cycle and 30% occurred after the fourth cycle, corresponding to D ± trastuzumab (T). The FEC100 regimen was associated with a relative risk of FN of 1.98 (p = 0.09). Autoimmune (AI) and inflammatory diseases were associated with a higher risk of FN (RR 3.08; p < 0.01). No significant difference in the incidence of FN was observed between adjuvant and neoadjuvant chemotherapy. FN was managed on an outpatient basis in 72% of cases. Outpatients with FN were mainly treated by a combination of amoxicillin-clavulanic acid and ciprofloxacin. Dose reduction or chemotherapy regimen modification were necessary in 25% of patients after FN. No toxic death was reported. CONCLUSION The incidence of FN induced by adjuvant/neoadjuvant chemotherapy in ESBC is higher in routine clinical practice than in clinical trials. AI or inflammatory diseases were significant independent risk factors for FN. Primary prophylaxis in patients at risk (elderly, comorbid patients), especially treated with the FEC regimen, is the keystone of management of this adverse effect. Prevention and management of FN to ensure the patient's safety and quality of life are a major issue for both medical oncologists and supportive care physicians.
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Affiliation(s)
- Joy Bacrie
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France.
| | - Marc Laurans
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France
| | - Pauline Iorio
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France
| | | | | | - Laurence Bozec
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France
| | | | - Coraline Dubot
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France
| | - Okba Bensaoula
- Institut Curie, Hôpital René Huguenin, Saint Cloud, France
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11
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Vaysse C, Chantalat E, Beyne-Rauzy O, Morineau L, Despas F, Bachaud JM, Caunes N, Poublanc M, Serrano E, Bugat R, Rougé Bugat ME, Fize AL. The Impact of a Small Private Online Course as a New Approach to Teaching Oncology: Development and Evaluation. JMIR MEDICAL EDUCATION 2018; 4:e6. [PMID: 29506968 PMCID: PMC5859739 DOI: 10.2196/mededu.9185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/26/2017] [Accepted: 01/02/2018] [Indexed: 05/31/2023]
Abstract
BACKGROUND Oncology involves complex care and multidisciplinary management of patients; however, misinformation and ineffective communication remain problematic. OBJECTIVE The educational objective of our study was to develop a new teaching method to improve cancer treatment and management by emphasizing the link between hospitals (inpatients) and their surrounding communities (outpatients). METHODS A team of 22 professionals from public and private institutions developed a small private online course (SPOC). Each offering of the course lasted 6 weeks and covered 6 topics: individual health care plans, cancer surgery, ionizing radiation, cancer medicines, clinical research, and oncological supportive care. For participants in the course, we targeted people working in the cancer field. The SPOC used an active teaching method with collaborative and multidisciplinary learning. A final examination was offered in each session. We evaluated participants' satisfaction rate through a questionnaire and the success of the SPOC by participants' completion, success, and commitment rates. RESULTS Of the total participants (N=1574), 446 completed the evaluation form. Most participants were aged 31 to 45 years. Participants included 56 nurses, 131 pharmacists, 80 from the medical field (including 26 physicians), 53 from patients' associations, 28 health teachers, and 13 students (medical and paramedical). Among the participants, 24.7% (90/446) had an independent medical practice, 38.5% (140/446) worked in a public institution, and 36.8% (134/446) worked in a private institution. After completing the SPOC sessions, 85.9% (384/446) thought they had learned new information, 90.8% (405/446) felt their expectations were met, and 90.4% (403/446) considered that the information had a positive impact on their professional practice. The completion rate was 35.51% (559/1574), the success rate was 71.47% (1025/1574), and the commitment rate was 64.67% (1018/1574). Concerning the cost effectiveness of SPOC compared with a traditional classroom of 25 students, online education became more effective when there were more than 950 participants. CONCLUSIONS SPOCs improved the management of oncology patients. This new digital learning technique is an attractive concept to integrate into teaching practice. It offered optimal propagation of information and met the students' expectations.
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Affiliation(s)
- Charlotte Vaysse
- Surgery Oncology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Faculté de Médecine, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Elodie Chantalat
- Surgery Oncology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Faculté de Médecine, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Odile Beyne-Rauzy
- Faculté de Médecine, Université Paul Sabatier Toulouse III, Toulouse, France
- Department of Internal Medicine, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Louise Morineau
- Pôle Hospitalo-Universitaire en Cancérologie, Cancer Pharmacology of Toulouse-Oncopole and Region (Work Package 4 Research Program), Institut Universitaire du Cancer de Toulouse-Oncopole, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Fabien Despas
- Faculté de Médecine, Université Paul Sabatier Toulouse III, Toulouse, France
- Medical and Clinical Pharmacology Unit, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jean-Marc Bachaud
- Radiotherapy Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Nathalie Caunes
- Support Care Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Muriel Poublanc
- Clinical Research Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Elie Serrano
- Faculté de Médecine, Université Paul Sabatier Toulouse III, Toulouse, France
- Pôle Hospitalo-Universitaire en Cancérologie, Cancer Pharmacology of Toulouse-Oncopole and Region (Work Package 4 Research Program), Institut Universitaire du Cancer de Toulouse-Oncopole, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Roland Bugat
- Pôle Hospitalo-Universitaire en Cancérologie, Cancer Pharmacology of Toulouse-Oncopole and Region (Work Package 4 Research Program), Institut Universitaire du Cancer de Toulouse-Oncopole, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Marie-Eve Rougé Bugat
- General Practice Department, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Anne-Laure Fize
- Pôle Hospitalo-Universitaire en Cancérologie, Cancer Pharmacology of Toulouse-Oncopole and Region (Work Package 4 Research Program), Institut Universitaire du Cancer de Toulouse-Oncopole, Université Paul Sabatier Toulouse III, Toulouse, France
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12
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Rougé Bugat M, Dufossé V, Paul C, Oustric S, Meyer N. Communicating information to the general practitioner: the example of vemurafenib for metastatic melanoma. J Eur Acad Dermatol Venereol 2015; 30:e192-e194. [DOI: 10.1111/jdv.13500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M.E. Rougé Bugat
- Université Paul Sabatier Toulouse III; Toulouse France
- Inserm UMR 1027; Toulouse France
- Département Universitaire de Médecine Générale; Toulouse France
| | - V. Dufossé
- Université Paul Sabatier Toulouse III; Toulouse France
- Département Universitaire de Médecine Générale; Toulouse France
| | - C. Paul
- Université Paul Sabatier Toulouse III; Toulouse France
- Inserm UMR 1037; Toulouse France
- Dermatologie; Institut Universitaire du Cancer de Toulouse; Toulouse France
| | - S. Oustric
- Université Paul Sabatier Toulouse III; Toulouse France
- Inserm UMR 1027; Toulouse France
- Département Universitaire de Médecine Générale; Toulouse France
| | - N. Meyer
- Université Paul Sabatier Toulouse III; Toulouse France
- Inserm UMR 1037; Toulouse France
- Dermatologie; Institut Universitaire du Cancer de Toulouse; Toulouse France
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