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Impact of KRAS G12C mutation in patients with advanced non-squamous non-small cell lung cancer treated with first-line pembrolizumab monotherapy. Lung Cancer 2022; 174:45-49. [PMID: 36323057 DOI: 10.1016/j.lungcan.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Few data are available on the impact of KRAS mutation in patients with advanced non-squamous non-small cell lung cancer (aNSCLC) treated with immunotherapy. This analysis assessed the impact of KRAS mutation on the efficiency of first-line pembrolizumab immunotherapy in aNSCLC patients with PD-L1 ≥ 50 %. METHODS This was a secondary analysis of the ESCKEYP study, a retrospective, national, multicenter study which included consecutively all metastatic NSCLC patients who initiated first-line treatment with pembrolizumab monotherapy from May 2017 (date of pembrolizumab availability in this indication in France) to November 22, 2019 (pembrolizumab-chemotherapy combination approval). Progression-free survival (PFS) and overall survival (OS) were calculated from the start of pembrolizumab treatment by the Kaplan-Meier method. Tumor response and PFS were assessed locally. RESULTS Among the 681 non-squamous aNSCLC PD-L1 ≥ 50 % patients treated with pembrolizumab in the first line, 227 (33.0 %) had a KRAS mutation (KRAS G12C, 12.5 %; KRAS non-G12C, 20.5 %). Except among non-smokers (KRAS G12C, 0 %; KRAS non-G12C, 2.9 %; no KRAS mutation, 9.2 %), patients presented no differences in terms of sex, age, number and sites of metastatic disease at diagnosis, use of corticosteroids, use of antibiotics, and for biological factors between wild-type KRAS, KRAS G12C and non-KRAS G12C groups. Median (95 % CI) PFS in months were 7.0 (3.7-14) for KRAS G12C, 4.8 (3.4-6.7) for KRAS non-G12C and 8.5 (7.3-10.6) for wild-type KRAS genotypes (p = 0.23). Median OS were 18.4 (12.6-NR), 20.6 (11.4-NR) and 27.1 (18.7-34.2) months, respectively (p = 0.57). CONCLUSION No difference in efficacy was observed in non-squamous aNSCLC patients treated with first-line pembrolizumab immunotherapy whether they presented a KRAS G12C, non KRAS G12C or wild-type KRAS genotype.
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High frequency of eosinophilia and viral reactivation in drug hypersensitivity in patients with severe acute respiratory syndrome coronavirus 2 infection. J Eur Acad Dermatol Venereol 2021; 36:e256-e257. [PMID: 34927763 DOI: 10.1111/jdv.17885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reasons for Discontinuation of dupilumab in Adult Atopic Dermatitis in Clinical Practice. Br J Dermatol 2021; 186:733-735. [PMID: 34748654 DOI: 10.1111/bjd.20883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
Dupilumab, an anti-IL-4ɑ monoclonal antibody, has shown a positive benefit-risk ratio when treating moderate to severe atopic dermatitis (AD) in clinical studies (1). High persistence on dupilumab has recently been reported in clinical-practice setting with 77% of patients remaining in treatment for 12 months in a retrospective study including 1,963 patients with AD but reasons for discontinuation were not investigated (2).
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Brief Report on the Efficacy of Nivolumab in Patients With Previously Treated Advanced Large-Cell Neuroendocrine Cancer of the Lung. JTO Clin Res Rep 2021; 2:100129. [PMID: 34590004 PMCID: PMC8474479 DOI: 10.1016/j.jtocrr.2020.100129] [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] [Received: 10/12/2020] [Revised: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 11/08/2022] Open
Abstract
Introduction The optimal management of large cell neuroendocrine cancer of the lung (LCNEC) is unclear, and data regarding anti–programmed cell death protein 1 (PD-1) antibodies are scarce. This study reports the clinical efficacy of a PD-1 inhibitor in patients with advanced LCNEC. Methods All patients with stage III to IV LCNEC treated with at least one previous cycle of chemotherapy between January 1, 2015 and December 31, 2018 were reviewed retrospectively. Patients were divided into two groups depending on their exposure to nivolumab as second-line treatment or beyond. The primary objective was to assess nivolumab’s efficacy. Results A total of 51 patients with advanced LCNEC from eight centers were analyzed, including 17 who received nivolumab. The PD-1 inhibitor was used as second-line treatment in 77% of cases, with a median number of eight doses (range: 1–62). After nivolumab treatment, the median overall survival was 12.1 months (95% confidence interval [CI]: 7.10–14.20). The objective response rate was 29.4% (95% CI: 10.3–56.0), and median progression-free survival was 3.9 months (95% CI: 1.68–7.17). The programmed death-ligand 1 status was unknown. There was no difference in the efficacy of first-line chemotherapy; the objective response rate was 23.5% (n = four of 17) in the nivolumab group versus 32.4% (n = 11 of 34) in the conventional treatment group, and progression-free survival was 3.5 months (95% CI: 1.7–4.4) versus 2.1 months (95% CI: 1.4–4.2), respectively. Conclusions In a real-world setting, nivolumab seems to be an effective second-line treatment in patients with advanced LCNEC. Large prospective studies in this setting are still required.
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Childhood epidermal necrolysis and erythema multiforme major: a multicentre French cohort study of 62 patients. J Eur Acad Dermatol Venereol 2021; 35:2051-2058. [PMID: 34157175 DOI: 10.1111/jdv.17469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The distinction between epidermal necrolysis [EN; including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and overlap syndrome] and erythema multiforme major (EMM) in children is confusing. We aimed to better describe and compare these entities. MATERIALS AND METHODS This French retrospective multicentre study included children ≤18 years old referred for EN or EMM between 1 January 2008 and 1 March 2019. According to pictures, children were reclassified into TEN/overlap, SJS or EMM/unclassified (SJS/EMM) groups and compared for epidemiological and clinical data, triggers, histology and follow-up. RESULTS We included 62 children [43 boys, median age 10 years (range 3-18)]: 16 with TEN/overlap, 11 SJS and 35 EMM. The main aetiologies were drugs in EN and infections (especially Mycoplasma pneumoniae) in EMM (P < 0.001), but 35% of cases remained idiopathic (TEN/overlap, 47%; SJS, 24%; EMM, 34%). The typical target lesions predominated in EMM (P < 0.001), the trunk was more often affected in EN (P < 0.001), and the body surface area involved was more extensive in EN (P < 0.001). Mucosal involvement did not differ between the groups. Two patients with idiopathic TEN died. Histology of EMM and EN showed similar features. The recurrence rate was 42% with EMM, 7% with TEN/overlap and 0 with SJS (P < 0.001). Sequelae occurred in 75% of EN but involved 55% of EMM. CONCLUSION Clinical features of EN and EMM appeared well demarcated, with few overlapping cases. Idiopathic forms were frequent, especially for EN, meaning that a wide and thorough infectious screening, repeated if needed, is indicated for all paediatric cases of EN/EMM without any trigger drug. We propose a comprehensive panel of investigations which could be a standard work-up in such situation. Sequelae affected both EN and EMM.
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Caractéristiques d’utilisation des huiles essentielles des patients avec un eczéma de contact prouvé aux huiles essentielles et évaluation d’une batterie huile essentielle : étude descriptive du DAG. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Modalités de réalisation des soins locaux de la nécrolyse épidermique : enquête de pratiques. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prise en charge des toxidermies survenant en contexte de COVID-19. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Drug reaction with eosinophilia and systemic symptoms (DRESS) : série de 53 cas pédiatriques français. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carrying out local care for epidermal necrolysis: survey of practices. J Eur Acad Dermatol Venereol 2020; 35:e155-e157. [DOI: 10.1111/jdv.16884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/11/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022]
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Management of ocular involvement in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: french national audit of practices, literature review, and consensus agreement. Orphanet J Rare Dis 2020; 15:259. [PMID: 32962748 PMCID: PMC7510143 DOI: 10.1186/s13023-020-01538-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 09/09/2020] [Indexed: 12/17/2022] Open
Abstract
Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can lead to severe ophthalmologic sequelae. The main risk factor is the severity of the initial ocular involvement. There are no recommendations for ocular management during acute phase. We conducted a national audit of current practice in the 11 sites of the French reference center for toxic bullous dermatoses and a review of the literature to establish therapeutic consensus guidelines. We sent a questionnaire on ocular management practices in SJS/ TEN during acute phase to ophthalmologists and dermatologists. The survey focused on ophthalmologist opinion, pseudomembrane removal, topical ocular treatment (i.e. corticosteroids, antibiotics, antiseptics, artificial tear eye drops, vitamin A ointment application), amniotic membrane transplantation, symblepharon ring use, and systemic corticosteroid therapy for ophthalmologic indication. Nine of 11 centers responded. All requested prompt ophthalmologist consultation. The majority performed pseudomembrane removal, used artificial tears, and vitamin A ointment (8/9, 90%). Combined antibiotic-corticosteroid or corticosteroid eye drops were used in 6 centers (67%), antibiotics alone and antiseptics in 3 centers (33%). Symblepharon ring was used in 5 centers (55%) if necessary. Amniotic membrane transplantation was never performed systematically and only according to the clinical course. Systemic corticosteroid therapy was occasionally used (3/9, 33%) and discussed on a case-by-case basis. The literature about ocular management practice in SJS/ TEN during acute phase is relatively poor. The role of specific treatments such as local or systemic corticosteroid therapy is not consensual. The use of preservatives, often present in eye drops and deleterious to the ocular surface, is to be restricted. Early amniotic membrane transplantation seems to be promising.
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Duration of nivolumab for pretreated, advanced non-small-cell lung cancer. Cancer Med 2020; 9:6923-6932. [PMID: 32412157 PMCID: PMC7541160 DOI: 10.1002/cam4.3120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/26/2022] Open
Abstract
Background A standard of care for pretreated, advanced non–small‐cell lung cancers (NSCLCs), nivolumab has demonstrated long‐term benefit when administered for 2 years. We aimed to better discern an optimized administration duration by retrospectively analyzing real‐life long‐term efficacy in a prospective cohort. Methods All nivolumab‐treated adults with advanced NSCLCs (01/09/2015 to 30/09/2016) from nine French centers were eligible. On 31/12/2018, patients who are alive ≥ 2 years after starting nivolumab were defined as long‐term survivors (LTSs) and were divided into three nivolumab treatment groups: <2, 2, or > 2 years. Co‐primary endpoints were LTSs’ progression‐free survival (PFS) and overall survival (OS). Results The median follow‐up was 32 months (95% CI, 31.0 to 34.0). The 3‐year OS rate for the 259 cohort patients was 16.6%. Among them, 65 were LTSs: 47 treated < 2 years, 7 for 2 years, and 11 > 2 years. Their respective characteristics were: median age: 59, 52, and 58 years; smoking history: 92.9, 100, and 100%; adenocarcinomas: 66, 57.1, and 54.5%. LTSs’ median (m)PFS was 28.4 months; mOS was not reached. LTSs’ objective response rate was 61.6%. mOS was 32.7 months for those treated < 2 years and not reached for the others. The > 2‐year group's 3‐year OS was longer. Twenty‐eight LTSs experienced no disease progression; 7 had durable complete responses. However, LTSs had more frequent and more severe adverse events. Conclusion In real‐life, prolonged nivolumab use provided long‐term benefit with 16.6% 3‐year OS and 25% LTSs. Survival tended to be prolonged with nivolumab continued beyond 2 years. Prospective randomized trials with adequate design are needed.
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First-line pembrolizumab for non-small cell lung cancer patients with PD-L1 ≥50% in a multicenter real-life cohort: The PEMBREIZH study. Cancer Med 2020; 9:2309-2316. [PMID: 32022459 PMCID: PMC7131849 DOI: 10.1002/cam4.2806] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background The KEYNOTE‐024 trial demonstrated that pembrolizumab, a PD‐1 inhibitor, significantly improves progression‐free survival (PFS) and overall survival (OS) in selected patients with previously untreated advanced non–small cell lung cancer (NSCLC) with a PD‐L1 tumor proportion score (TPS) ≥50% and without EGFR/ALK aberrations. The main aim of this study was to report the efficacy and safety profile of pembrolizumab in real‐life conditions. Method This was a French retrospective multicenter longitudinal study of 108 consecutive patients with advanced NSCLC, a PD‐L1 TPS ≥50% and without EGFR/ALK aberrations who were treated by pembrolizumab, in first line. Patient data were obtained from medical files. Results The main characteristics of the cohort were: median age [range] 66.7 [37‐87] years, 64.8% male, 23.1% with a performance status (PS) of 2, and 88.9% current or former smokers. Eighty‐seven percent had stage IV NSCLC at diagnosis, 9.2% untreated brain metastases at inclusion,. With a median follow‐up of 8.2 months, the median PFS was 10.1 months (95% CI, 8.8‐11.4). The objective response rate was 57.3% (complete response 2.7%, partial response 54.6%). Disease control rate was 71.1%. At 6 months, the OS rate estimated was 86.2%. Treatment‐related adverse events (AE) of grade 3 occurred in 8% of patients. There were no grade 4 or 5 AEs. Conclusion In a real‐life cohort of advanced NSCLC patients (including PS 2 and untreated brain metastases), with PD‐L1 TPS ≥50%, pembrolizumab demonstrates similar PFS to the pivotal clinical trial.
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Nécrolyse épidermique et érythème polymorphe majeur de l’enfant : caractéristiques épidémiologiques, cliniques et complications. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Efficacité du méthotrexate en adjonction d’un traitement par anti-histaminiques H1 dans le traitement de l’urticaire chronique spontanée sévère réfractaire aux anti-H1 seuls : essai de phase III, randomisé, en double aveugle (NCT01960283). Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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First line pembrolizumab for NSCLC with PD-L1 TPS > 50% in a first French real life cohort. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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[Delayed hypersensitivity to anti-tuberculosis drugs. Proposed practical management plan for exanthema: when to stop, which allergological investigations to perform, and how to restart treatment]. Ann Dermatol Venereol 2019; 146:313-318. [PMID: 30904277 DOI: 10.1016/j.annder.2019.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/06/2018] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
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Valaciclovir: a culprit drug for drug reaction with eosinophilia and systemic symptoms not to be neglected. Three cases. Br J Dermatol 2019; 180:666-667. [DOI: 10.1111/bjd.17207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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PNEUMO-PECO : étude prospective et multicentrique comparant la prise en charge ambulatoire des pneumothorax spontanés à la prise en charge hospitalière. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Syndrome d’hypersensibilité associé aux macrolides : une réalité. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Un long délai de survenue doit-il toujours être retenu comme un critère de DRESS ? Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Glomérulonéphrite extra-membraneuse et pemphigoïde bulleuse après piqûres multiples de frelons, chez un patient traité par adalimumab. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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MA08.10 Real-Life Intracerebral Efficacy of Nivolumab in Non-Small Cell Lung Cancer Patients with Brain Metastases. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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254 Timing Impact of Out-of-Hospital Intravenous Fluids in Sepsis. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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A large epidemiological study of erythema multiforme in France, with emphasis on treatment choices. Br J Dermatol 2018; 179:1009-1011. [DOI: 10.1111/bjd.16928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Comments on Ben Mansour et al: Additional cases of multifocal fixed drug eruption to ceftazidime. Pediatr Allergy Immunol 2018. [PMID: 29537668 DOI: 10.1111/pai.12886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Évaluation du kit ResistancePlus™ MG assay de SpeedDx pour la détection simultanée de Mycoplasma genitalium et de la résistance à l’azithromycine. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Analyse des raisons amenant à consulter dans un CeGIDD plutôt que chez un médecin pour un dépistage des IST. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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ABCT-IMMUNOBZH : évaluation de l’efficacité du nivolumab dans la vraie vie chez 259 patients porteurs d’un cancer bronchique non à petites cellules de stade avancé. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2018.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Estimating distribution and connectivity of recolonizing American marten in the northeastern United States using expert elicitation techniques. Anim Conserv 2018. [DOI: 10.1111/acv.12417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE The dermatological toxicity of cancer treatments is frequent and sometimes debilitating. Its reference classification, the NCI-CTCAE (National Cancer Institute-Common Terminology Criteria for Adverse Events), is sometimes difficult to use and does not include yet the newest toxicities. Our objective was to create a guide, TOXICAN, based on the CTCAE, which is easy to use in everyday practice and which facilitates the recognition and grading of these dermatological toxicities. METHODS This guide was developed by a working group ("GESTIM") comprising oncodermatologists, allergists, pathologists, and researchers from Nantes University Hospital. It was based on the dermatological toxicities found in the CTCAE and adapted to daily practice. These toxicities were grouped into categories and associated with photographs of typical cases to aid recognition. A simplified grading scale derived from the CTCAE was also created. This booklet was validated by means of user evaluation, and then the Delphi consensus method. RESULTS We selected 32 dermatological toxicities, including 12 created by our group, sorted into 7 categories: skin rash, dry skin/pruritus, hyperkeratotic papules, palmoplantar changes, hair and nail changes, mucosal changes, and others. Our simplified grading scale only differed from the CTCAE for one item, urticaria. Three items were modified after evaluation by the user group and 11 after application of the Delphi method. CONCLUSION The objective of our practical guide is to facilitate the use of the CTCAE for recognizing and grading dermatological toxicity of cancer treatments in order to provide optimal guidance for therapeutic adaptations. Its impact on clinical practice remains to be evaluated.
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Isotretinoin treatment and peanut allergy: a new case report and review of the literature. J Eur Acad Dermatol Venereol 2018; 32:e341-e343. [PMID: 29512201 DOI: 10.1111/jdv.14916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Real life second-line nivolumab in advanced non-small cell lung cancer: A French observational multicenter study of 259 patients (ABCT-IMMUNOBZH). ACTA ACUST UNITED AC 2018. [DOI: 10.15761/crr.1000164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Évaluation d’une batterie spécifique de patch-tests pour l’enquête allergologique des eczémas des paupières : étude prospective française du DAG. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vascularite cutanée induite par l’omalizumab. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dermites des mains chez les soignants de réanimation : causes et impact sur l’hygiène des mains. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maladie associée aux IgG4 révélée par une atteinte cutanée. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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P2.07-030 Real Life Second-Line Nivolumab in Advanced Non-Small-Cell-Lung Cancer: A French Observational Multicenter Study of 259 Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.11.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract P3-14-13: Total mastectomy and immediate breast reconstruction for breast cancer: A ten-year Canadian single institution experience. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-14-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Fear of high local recurrence rate associated with immediate breast reconstruction (IBR) following total mastectomy for breast cancer might be a contributing factor to the low rate of immediate reconstruction performed in Quebec. The aim of this study was to demonstrate the oncological safety of total mastectomy with immediate breast reconstruction.
A retrospective chart review of all patients who underwent total mastectomy with immediate breast reconstruction at the University of Montreal Hospital Center between 2006 and 2015 was performed.
375 patients (420 cases) met the inclusion criteria. The mean age was 51.5 years (25-77). The median follow-up was 45.6 months (0.4-115.2). Clinical cancer staging was done according to the American Joint Committee on Cancer (AJCC) criteria. 349 cases (83.1%) were classified as Stage < cIIb and 71 cases (16.9%) as ≥ cIIb. 73 patients (19.5%) received neoadjuvant chemotherapy, 113 (30.1%) received adjuvant chemotherapy and 91 (21.7%) received postoperative radiotherapy. Only 4 patients (3.5%) had a significant delay in receiving adjuvant chemotherapy and 4 patients (4.4%) had a delay in initiation of radiotherapy. In total, there were 12 (2.6%) local recurrences and 29 (7.7%) distant recurrences.
The results of this study demonstrate a low rate of local recurrence that is comparable to the current litterature. Total mastectomy in association with immediate breast reconstruction is therefore an oncologically safe approach for the treatment of breast cancer and should be more widely adopted by medical centers throughout Quebec.
Citation Format: Younan RJ, Al Khaldi M, Maalouf C, Guez M, Boulva K, robidoux A, Nassif E, Poljicak M, BouMerhi J, Bernier C, Patocskai E. Total mastectomy and immediate breast reconstruction for breast cancer: A ten-year Canadian single institution experience [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-14-13.
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Cohorte rétrospective de patients atteints de dermatite atopique sévère ayant reçu des traitements systémiques en vie réelle. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Traitement par isotrétinoïne : quid des allergiques au soja et à l’arachide ? Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Toxican : un outil à d’aide à la cotation des toxicités cutanées des traitements anticancéreux au quotidien. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Conséquences des dermites des mains chez les soignants. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Prise en compte de la préférence du patient dans la formulation galénique du traitement dans la dermatite atopique : étude pilote. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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[CONDYDAV: A multicentre observational study of patients presenting external genital warts in France]. Ann Dermatol Venereol 2016; 143:675-681. [PMID: 27659388 DOI: 10.1016/j.annder.2016.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Since 2007 in France, human papilloma virus (HPV) vaccination has been licensed for use as a vaccine against HPV 6, 11, 16 and 18. The impact on the epidemiology of external genital warts (EGWs) in a large population remains unclear. OBJECTIVES To determine epidemiologic and clinical features of patients presenting EGWs in France in the era of HPV vaccination. PATIENTS AND METHODS In this prospective, observational study, we analyzed clinical features and treatments between January 1st, 2012 and March 31, 2012 for patients consulting for EGWs at 15 STI clinics throughout France. RESULTS A total of 372 men and 111 women were included; mean age 31.2 years. The women were younger than the men (31.7 and 28.9 years respectively P<0.05). Among the patients, 416 (85.7%) were heterosexual, 13 bisexual and 54 (11.2%) homosexual, including one female. Males reported more sexual partners in the last 12 months (more than 3 partners in 32.6% versus 11.9%, P<0.01). Among the men, 230 had involvement of the penis alone and 46 had involvement of the anus alone. Seventy-six patients had EGWs of the anus, and of these 26 were MSM. In females, 76 had an infection of the vulva alone and 22 co-infection of the vulva and anus. MSM and females were at higher risk than heterosexual males for anal involvement (P<0.0001 and P=0.004, respectively). Three women had been vaccinated: two with Gardasil® and one with Cervarix®. Cryotherapy was the preferred treatment. CONCLUSION With the advent of HPV vaccination, a global strategy for the prevention and treatment of EGW should be implemented.
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A retrospective comparison study of the infra-mammary approach to the standard mastectomy scar in the 2nd stage of tissue expander to implant breast reconstruction. ANN CHIR PLAST ESTH 2016; 62:131-138. [PMID: 27553115 DOI: 10.1016/j.anplas.2016.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Staged expander-to-implant breast reconstruction is plagued by a high prevalence of complications. We have employed an alternative approach of using the infra-mammary crease (IMF) for expander-to-implant exchange. The IMF approach was thought to utilize healthier tissues, which are believed to be less affected by the process of tissue expansion, and reside distant from the field of the radiotherapy boost. METHODS A retrospective chart review was performed on all patients undergoing a staged implant-based breast reconstruction from 2009 to 2014. Patients were divided into those that received an IMF vs. a mastectomy scar (MS) approach in the second stage of expander-to-implant exchange. Patient characteristics and postoperative complications were extracted. RESULTS A total of 75 patients undergoing 96-staged reconstructions were included (70 cases MS vs. 26 cases IMF). Patient demographics and implant characteristics were similar between groups. There were no significant differences in overall complications between the groups (11.4% MS vs. 7.7% IMF, P=0.72). All cases of implant exposure occurred in the MS group and had a history of radiation. However, there was no statistical difference in implant exposure between groups (4.3% MS vs. 0% IMF, P=0.56) or in the irradiated patients subgroup (20% MS vs. 0% IMF, P=0.25). CONCLUSIONS In conclusion, the IMF approach for the second stage of expander-to-implant exchange is an alternative technique with a similar prevalence of complications as the traditional mastectomy scar approach. This technique may prove useful in reducing postoperative incisional dehiscence and implant exposure, especially in the context of radiotherapy.
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