Publications of Joëlle COLLIGNON
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See detailTranscriptome wide analysis of natural antisense transcripts shows potential role in breast cancer
Wenric, Stéphane ULiege; El Guendi, Sonia ULiege; CABERG, Jean-Hubert ULiege et al

Poster (2017, May)

Non-coding RNAs (ncRNA) represent at least 1/5 of the mammalian transcript amount, and about 90% of the genome length is actively transcribed. Many ncRNAs have been demonstrated to play a role in cancer ... [more ▼]

Non-coding RNAs (ncRNA) represent at least 1/5 of the mammalian transcript amount, and about 90% of the genome length is actively transcribed. Many ncRNAs have been demonstrated to play a role in cancer. Among them, natural antisense transcripts (NAT) are RNA sequences which are complementary and overlapping to those of protein-coding transcripts (PCT). NATs were punctually described as regulating gene expression, and are expected to act more frequently in cis than other ncRNAs that commonly function in trans. In this work, 22 breast cancers expressing estrogen receptors and their paired healthy tissues were analyzed by strand-specific RNA sequencing. To highlight the potential role of NATs in gene regulations occurring in breast cancer, three different gene extraction methods were used: differential expression analysis of NATs between tumor and healthy tissues, differential correlation analysis of paired NAT/PCT between tumor and healthy tissues, and NAT/PCT read count ratio variation between tumor and healthy tissues. Each of these methods yielded lists of NAT/PCT pairs that were demonstrated to be enriched in survival-associated genes on an independent cohort (TCGA). This work allows to highlight NAT lists that display a strong potential to affect the expression of genes involved in the breast cancer pathology. [less ▲]

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See detailComment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 2eme partie : l'interet des approches multimodales avec ou sans chirurgie.
VAN DAELE, Daniel ULiege; Honoré, Pierre ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2017), 72(4), 168-174

In recent years, the treatment of esophagus cancer has been completely changed, thus competing the dogma of surgery as the cornerstone treatment. Multimodality treatments as radio-chemotherapy directly ... [more ▼]

In recent years, the treatment of esophagus cancer has been completely changed, thus competing the dogma of surgery as the cornerstone treatment. Multimodality treatments as radio-chemotherapy directly followed by surgery, or delayed surgery, significantly improve patient survival compared to surgery alone. Neoadjuvant radiochemotherapy is associated with a higher complete pathologic response rate and improved survival compared to chemotherapy alone. Immediate surgery after radio-chemotherapy is challenged for patients who present a complete clinical response, especially in case of squamous cell carcinoma. Indeed, systematic resection is associated with a significant postoperative mortality rate and has not proven any survival advantage in complete clinical responders as opposed to delayed resection in case of locally persistent or recurrent disease. In squamous cell carcinoma, this could lead to organ preservation, thus avoiding the mortality and durable functional impairment of esophagectomy. This review will discuss the positioning of the multimodality treatment strategy with neoadjuvant radiochemotherapy and chemotherapy and also the strategy of organ preservation. [less ▲]

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See detailComment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 1ere partie : le point sur les approches chirurgicales et non chirurgicales.
VAN DAELE, Daniel ULiege; Honoré, Pierre ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2017), 72(2), 58-63

Esophageal cancers represent a highly heterogeneous entity mixing two different tumour types : AdenoCarcinoma (ADC) and Squamous Cell Carcinoma (SSC). Developing in the same organ, they are very often ... [more ▼]

Esophageal cancers represent a highly heterogeneous entity mixing two different tumour types : AdenoCarcinoma (ADC) and Squamous Cell Carcinoma (SSC). Developing in the same organ, they are very often considered as a unique pathology and, consequently, the same therapeutic strategy is indiscriminately applied. Esophageal cancer treatments are particularly complex and require a multidisciplinary approach. Despite impressive advances in the tumour statidifaction, surgery, radiotherapy and chemotherapy, the overall prognosis remains grim even at an early stage of the disease. In order to improve the treatment of esophageal cancers and the patientaeuros survival, we need to consider that ADC and SCC represent two different pathologies requiring specific therapeutic strategies. This review in two parts will present recent data from clinical trials under the scope of tumour histology to set up dedicated therapeutic strategies. In this first part, we explain the restricted role of surgical resection, the prognostic factors and the results of exclusive combined chemotherapy and radiation in localized esophageal cancer. [less ▲]

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See detailMT4-MMP and EGFR expression levels are key biomarkers for breast cancer patient response to chemotherapy and erlotinib.
Yip, Cassandre ULiege; Foidart, Pierre ULiege; Somja, Joan ULiege et al

in British Journal of Cancer (2017)

BACKGROUND: Triple-negative breast cancers (TNBC) are heterogeneous cancers with poor prognosis. We aimed to determine the clinical relevance of membrane type-4 matrix metalloproteinase (MT4-MMP), a ... [more ▼]

BACKGROUND: Triple-negative breast cancers (TNBC) are heterogeneous cancers with poor prognosis. We aimed to determine the clinical relevance of membrane type-4 matrix metalloproteinase (MT4-MMP), a membrane type matrix metalloproteinase that interacts with epidermal growth factor receptor (EGFR) overexpressed in >50% of TNBC. METHODS: We conducted a retrospective immunohistochemical analysis on human TNBC samples (n=81) and validated our findings in in vitro and in vivo assays. RESULTS: Membrane type-4 matrix metalloproteinase and EGFR are produced in 72.5% of TNBC samples, whereas those proteins are faintly produced by healthy tissues. Unexpectedly, tumour relapse after chemotherapy was reduced in samples highly positive for MT4-MMP. Mechanistically, this is ascribed to a higher sensitivity of MT4-MMP-producing cells to alkylating or intercalating chemotherapeutic agents, as assessed in vitro. In sharp contrast, MT4-MMP expression did not affect tumour cell sensitivity to paclitaxel that interferes with protease trafficking. Importantly, MT4-MMP expression sensitised cancer cells to erlotinib, a tyrosine kinase EGFR inhibitor. In a pre-clinical model, the growth of MT4-MMP overexpressing xenografts, but not of control ones, was reduced by epirubicin or erlotinib. The combination of suboptimal drug doses blocked drastically the growth of MT4-MMP-producing tumours. CONCLUSIONS: We demonstrate that MT4-MMP defines a sub-population of TNBC sensitive to a combination of DNA-targeting chemotherapeutic agents and anti-EGFR drugs.British Journal of Cancer advance online publication 14 February 2017; doi:10.1038/bjc.2017.23 www.bjcancer.com. [less ▲]

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See detailTranscriptome-wide analysis of natural antisense transcripts shows their potential role in breast cancer.
Wenric, Stéphane ULiege; ElGuendi, Sonia; CABERG, Jean-Hubert ULiege et al

in Scientific Reports (2017), 7(1), 17452

Non-coding RNAs (ncRNA) represent 1/5 of the mammalian transcript number, and 90% of the genome length is transcribed. Many ncRNAs play a role in cancer. Among them, non-coding natural antisense ... [more ▼]

Non-coding RNAs (ncRNA) represent 1/5 of the mammalian transcript number, and 90% of the genome length is transcribed. Many ncRNAs play a role in cancer. Among them, non-coding natural antisense transcripts (ncNAT) are RNA sequences that are complementary and overlapping to those of either protein-coding (PCT) or non-coding transcripts. Several ncNATs were described as regulating protein coding gene expression on the same loci, and they are expected to act more frequently in cis compared to other ncRNAs that commonly function in trans. In this work, 22 breast cancers expressing estrogen receptors and their paired adjacent non-malignant tissues were analyzed by strand-specific RNA sequencing. To highlight ncNATs potentially playing a role in protein coding gene regulations that occur in breast cancer, three different data analysis methods were used: differential expression analysis of ncNATs between tumor and non-malignant tissues, differential correlation analysis of paired ncNAT/PCT between tumor and non-malignant tissues, and ncNAT/PCT read count ratio variation between tumor and non-malignant tissues. Each of these methods yielded lists of ncNAT/PCT pairs that were enriched in survival-associated genes. This work highlights ncNAT lists that display potential to affect the expression of protein-coding genes involved in breast cancer pathology. [less ▲]

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See detailResistance to therapy in estrogen receptor positive and human epidermal growth factor 2 positive breast cancers: progress with latest therapeutic strategies.
LOUSBERG, Laurence ULiege; COLLIGNON, Joëlle ULiege; Jerusalem, Guy ULiege

in Therapeutic Advances in Medical Oncology (2016), 8(6), 429-449

In this article, we focus on the subtype of estrogen receptor (ER)-positive, human epidermal growth factor 2 (HER2)-positive breast cancer (BC). Preclinical and clinical data indicate a complex molecular ... [more ▼]

In this article, we focus on the subtype of estrogen receptor (ER)-positive, human epidermal growth factor 2 (HER2)-positive breast cancer (BC). Preclinical and clinical data indicate a complex molecular bidirectional crosstalk between the ER and HER2 pathways. This crosstalk probably constitutes one of the key mechanisms of drug resistance in this subclass of BC. Delaying or even reversing drug resistance seems possible by targeting pathways implicated in this crosstalk. High-risk patients currently receive anti-HER2 therapy, chemotherapy and endocrine therapy in the adjuvant setting. In metastatic cases, most patients receive a combination of anti-HER2 therapy and chemotherapy. Only selected patients presenting more indolent disease are candidates for combinations of anti-HER2 therapy and endocrine therapy. However, relative improvements in progression-free survival by chemotherapy-based regimens are usually lower in ER-positive patients than the ER-negative and HER2-positive subgroup. Consequently, new approaches aiming to overcome endocrine therapy resistance by adding targeted therapies to endocrine therapy based regimens are currently explored. In addition, dual blockade of HER2 or the combination of trastuzumab and phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOP) inhibitors targeting the downstream pathway are strategies to overcome resistance to trastuzumab. This may lead in the near future to the less frequent use of chemotherapy-based treatment options in ER-positive, HER2-positive BC. [less ▲]

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See detailLe carcinome de site primitif inconnu, une entité pas si rare ...
GONNE, Elodie ULiege; COLLIGNON, Joëlle ULiege; JERUSALEM, Guy ULiege et al

in Revue Médicale de Liège (2016), 71(10), 449-454

Les carcinomes de site primitif inconnu ou CaPI, forment un groupe d'entités pathologiques très hétérogènes de par leurs modes de révélation et leurs présentations cliniques. Le CaPI se définit par une ... [more ▼]

Les carcinomes de site primitif inconnu ou CaPI, forment un groupe d'entités pathologiques très hétérogènes de par leurs modes de révélation et leurs présentations cliniques. Le CaPI se définit par une tumeur épithéliale maligne, d'emblée métastatique, dont le site initial reste occulte au terme du bilan pré-thérapeutique exhaustif. Il représente 3 à 5% des tumeurs solides malignes de l'adulte. Son pronostic est sombre avec médiane de survie allant de 6 à 10 mois. La thérapeutique sera fonction de l'histologie tumorale, de la localisation métastatique et de la suspicion d'origine du primitif. En présence d'une néoplasie localisée, une prise en charge chirurgicale accompagnée ou non d'une radiothérapie sera proposée; en cas de dissémination métastatique multiple, une chimiothérapie systémique à base de sels de platine est recommandée. L'espoir réside dans l'analyse du profil moléculaire, afin de définir avec précision l'origine tumorale primitive et d'offrir la thérapeutique la mieux adaptée possible. [less ▲]

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See detailCirculating microRNA-based screening tool for breast cancer
Freres, Pierre ULiege; Wenric, Stéphane ULiege; BOUKERROUCHA, Meriem ULiege et al

in Oncotarget (2015)

Circulating microRNAs (miRNAs) are increasingly recognized as powerful biomarkers in several pathologies, including breast cancer. Here, their plasmatic levels were measured to be used as an alternative ... [more ▼]

Circulating microRNAs (miRNAs) are increasingly recognized as powerful biomarkers in several pathologies, including breast cancer. Here, their plasmatic levels were measured to be used as an alternative screening procedure to mammography for breast cancer diagnosis. A plasma miRNA profile was determined by RT-qPCR in a cohort of 378 women. A diagnostic model was designed based on the expression of 8 miRNAs measured first in a profiling cohort composed of 41 primary breast cancers and 45 controls, and further validated in diverse cohorts composed of 108 primary breast cancers, 88 controls, 35 breast cancers in remission, 31 metastatic breast cancers and 30 gynecologic tumors. A receiver operating characteristic curve derived from the 8-miRNA random forest based diagnostic tool exhibited an area under the curve of 0.81. The accuracy of the diagnostic tool remained unchanged considering age and tumor stage. The miRNA signature correctly identified patients with metastatic breast cancer. The use of the classification model on cohorts of patients with breast cancers in remission and with gynecologic cancers yielded prediction distributions similar to that of the control group. Using a multivariate supervised learning method and a set of 8 circulating miRNAs, we designed an accurate, minimally invasive screening tool for breast cancer. [less ▲]

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See detailMetabolomic, proteomic and preclinical imaging of patient-derived tumor xenografts for improving treatment of liver metastases patients
Perez Palacios, A; Blomme, Arnaud ULiege; Boutry, S et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 134

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See detailPrise en charge de la neutropénie fébrile chez le patient cancéreux
FRERES, Pierre ULiege; GONNE, Elodie ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2015), 70(4), 195-200

Les cancers sont de plus en plus fréquents et leurs traitements de plus en plus agressifs. En conséquence, médecins généralistes, urgentistes, hématologues et oncologues se trouvent régulièrement ... [more ▼]

Les cancers sont de plus en plus fréquents et leurs traitements de plus en plus agressifs. En conséquence, médecins généralistes, urgentistes, hématologues et oncologues se trouvent régulièrement confrontés à un effet secondaire sévère des traitements cytotoxiques, le neutropénie fébrile (NF). La NF est une complication gravissime de la chimiothérapie, car elle peut être rapidement mortelle et provoque un arrêt temporaire, voire définitif, des traitements. Dans cet article, nous résumons les dernières recommandations quant à la prise en charge thérapeutique des patients présentant une NF sous traitements anti-cancéreux. [less ▲]

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See detailCancer du sein: intérêt du bilan d’extension par imagerie lors du diagnostic initial et du suivi les trois premières années après le diagnostic
SCHROEDER, Hélène ULiege; Hanocq, Florence ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2015), 70(3), 140-147

In our region, repeated tumor staging by radiological procedures aiming to detect relapses and/or metastases from breast cancer is frequently performed. However, these procedures are not recommended by ... [more ▼]

In our region, repeated tumor staging by radiological procedures aiming to detect relapses and/or metastases from breast cancer is frequently performed. However, these procedures are not recommended by current international guidelines. We retrospectively analyzed the charts from 818 patients with a new diagnosis of breast cancer seen at CHU Liege between 2005 and 2009. We assessed the role of staging procedures at initial diagnosis and during follow-up the first 3 years after the diagnosis of breast cancer. Twenty-six patients presented with metastatic disease at diagnosis and 55 patients developed loco-regional relapses or metastases during follow-up. For asymptomatic patients, imaging procedures only detected tumor metastases or relapse without elevated tumor markers in 9 patients at initial diagnosis and 10 patients during follow-up. The diagnosis of an asymptomatic relapse and/or metastases had no positive impact on progression-free or overall survival. The anatomic extension identified patients at high risk for presenting distant metastases already at the time of initial diagnosis and the biological aggressiveness evaluated by Ki-67 was an important prognostic factor for early relapse. In view of these results, we do not recommend staging and searching for metastatic disease in asymptomatic patients presenting early stage breast cancer with low expression of the Ki-67 at the time of initial diagnosis. We also do not recommend repeated staging and searching for metastases by imaging in asymptomatic patients during routine follow-up. Staging should only be performed if a relapse is suspected during follow-up. [less ▲]

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See detailCancer du sein : de la thérapie ciblée à la médecine personnalisée
JERUSALEM, Guy ULiege; COLLIGNON, Joëlle ULiege; Josse, Claire ULiege et al

in Revue Médicale de Liège (2015), 70(5-6), 269-276

Dans cet article, les auteurs passent en revue les grands principes de prise en charge du traitement systémique du cancer du sein et posent la question suivante : jusqu'où réellement aujourd'hui ce ... [more ▼]

Dans cet article, les auteurs passent en revue les grands principes de prise en charge du traitement systémique du cancer du sein et posent la question suivante : jusqu'où réellement aujourd'hui ce traitement est-il individualisé ? Les nouvelles technologies permettent une analyse détaillée des anomalies génomiques au niveau des cellules cancéreuses. Malheureusement, nous n'avons pas encore compris comment utiliser au mieux ces données au bénéfice du patient. La majorité des modifications du génome sont des évènements relativement rares compliquant le développement de nouveaux médicaments dans le cadre d'une médecine de précision. De plus, les tumeurs présentent une grande hétérogénéité temporelle et spatiale dont il faudra tenir compte lors de ce développement. Une collaboration internationale intensive est en cours pour tenter de confirmer que la médecine de précision permet d'optimiser les résultats du traitement systémique dans le cancer du sein. [less ▲]

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See detailBIOPSIE DES LESIONS SUSPECTES CHEZ LES PATIENTS AYANT PRESENTE UN CANCER DU SEIN.
COLIN, Paul-Emile ULiege; SCHROEDER, Hélène ULiege; GONNE, Elodie ULiege et al

in Revue Médicale de Liège (2015), 70(11), 563-8

Discordances between hormone receptors and HER2 status in primary and metastatic breast cancer have been reported by several studies. In this context, systematic biopsies could be clinically relevant in ... [more ▼]

Discordances between hormone receptors and HER2 status in primary and metastatic breast cancer have been reported by several studies. In this context, systematic biopsies could be clinically relevant in breast cancer to confirm the biological characteristics of a suspicious lesion. In this article, illustrated by 2 case reports and based on a recent review on this topic, we discuss the clinical significance of receptor discordances and possible diagnosis of a secondary primary tumor. The role of these biopsies for the identification of new therapeutic targets is also envisaged as well as underlying mechanisms for receptors' modification like tumoral heterogeneity, clonal selection and technical artifacts. [less ▲]

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See detailEvaluation of BRCA1-related molecular features and microRNAs as prognostic factors for triple negative breast cancers.
Boukerroucha, Meriem ULiege; Josse, Claire ULiege; El Guendi, Sonia ULiege et al

in BMC Cancer (2015), 15(1), 755

BACKGROUND: The BRCA1 gene plays a key role in triple negative breast cancers (TNBCs), in which its expression can be lost by multiple mechanisms: germinal mutation followed by deletion of the second ... [more ▼]

BACKGROUND: The BRCA1 gene plays a key role in triple negative breast cancers (TNBCs), in which its expression can be lost by multiple mechanisms: germinal mutation followed by deletion of the second allele; negative regulation by promoter methylation; or miRNA-mediated silencing. This study aimed to establish a correlation among the BRCA1-related molecular parameters, tumor characteristics and clinical follow-up of patients to find new prognostic factors. METHODS: BRCA1 protein and mRNA expression was quantified in situ in the TNBCs of 69 patients. BRCA1 promoter methylation status was checked, as well as cytokeratin 5/6 expression. Maintenance of expressed BRCA1 protein interaction with BARD1 was quantified, as a marker of BRCA1 functionality, and the tumor expression profiles of 27 microRNAs were determined. RESULTS: miR-548c-5p was emphasized as a new independent prognostic factor in TNBC. A combination of the tumoral expression of miR-548c and three other known prognostic parameters (tumor size, lymph node invasion and CK 5/6 expression status) allowed for relapse prediction by logistic regression with an area under the curve (AUC) = 0.96. BRCA1 mRNA and protein in situ expression, as well as the amount of BRCA1 ligated to BARD1 in the tumor, lacked any associations with patient outcomes, likely due to high intratumoral heterogeneity, and thus could not be used for clinical purposes. CONCLUSIONS: In situ BRCA1-related expression parameters could be used for clinical purposes at the time of diagnosis. In contrast, miR-548c-5p showed a promising potential as a prognostic factor in TNBC. [less ▲]

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See detailEGFR activation and signaling in cancer cells are enhanced by the membrane-bound metalloprotease MT4-MMP.
Paye, Alexandra ULiege; Truong, Alice ULiege; Yip, Cassandre ULiege et al

in Cancer Research (2014), 74(23), 6758-70

MT4-MMP (MMP-17) is a GPI-anchored matrix metalloprotease expressed on the surface of cancer cells which promotes tumor growth and metastasis. In this report, we identify MT4-MMP as an important driver of ... [more ▼]

MT4-MMP (MMP-17) is a GPI-anchored matrix metalloprotease expressed on the surface of cancer cells which promotes tumor growth and metastasis. In this report, we identify MT4-MMP as an important driver of cancer cell proliferation through CDK4 activation and retinoblastoma protein (Rb) inactivation. We also determine a functional link between MT4-MMP and the growth factor receptor EGFR. Mechanistic experiments revealed direct association of MT4-MMP and its positive effects on EGFR phosphorylation in response to TGF- and EGF in cancer cells. Notably, the effects of MT4-MMP on proliferation and EGFR activation did not rely on metalloprotease activity. Clinically, MT4-MMP and EGFR expression were correlated in human triple negative breast cancer specimens. Altogether our results identify MT4-MMP as a positive modifier of EGFR outside-in signaling that acts to cooperatively drive cancer cell proliferation. [less ▲]

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See detailUse of mTOR inhibitors in the treatment of breast cancer: an evaluation of factors that influence patient outcomes.
Jerusalem, Guy ULiege; RORIVE, Andrée ULiege; COLLIGNON, Joëlle ULiege

in Breast Cancer (2014), 6

Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2) therapy, and other targeted agents ... [more ▼]

Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2) therapy, and other targeted agents. Recently, everolimus, a mammalian target of rapamycin (mTOR) inhibitor, combined with exemestane, an aromatase inhibitor, has been approved in Europe and the USA for patients suffering from estrogen receptor-positive, HER2-negative advanced breast cancer previously treated by a nonsteroidal aromatase inhibitor, based on the results of BOLERO-2 (Breast cancer trials of OraL EveROlimus). This study showed a statistically significant and clinically meaningful improvement in median progression-free survival. Results concerning the impact on overall survival are expected in the near future. This clinically oriented review focuses on the use of mTOR inhibitors in breast cancer. Results reported with first-generation mTOR inhibitors (ridaforolimus, temsirolimus, everolimus) are discussed. The current and potential role of mTOR inhibitors is reported according to breast cancer subtype (estrogen receptor-positive HER2-negative, triple-negative, and HER2-positive ER-positive/negative disease). Everolimus is currently being evaluated in the adjuvant setting in high-risk estrogen receptor-positive, HER2-negative early breast cancer. Continuing mTOR inhibition or alternatively administering other drugs targeting the phosphatidylinositol-3-kinase/protein kinase B-mTOR pathway after progression on treatments including an mTOR inhibitor is under evaluation. Potential biomarkers to select patients showing a more pronounced benefit are reviewed, but we are not currently using these biomarkers in routine practice. Subgroup analysis of BOLERO 2 has shown that the benefit is consistent in all subgroups and that it is impossible to select patients not benefiting from addition of everolimus to exemestane. Side effects and impact on quality of life are other important issues discussed in this review. Second-generation mTOR inhibitors and dual mTOR-phosphatidylinositol-3-kinase inhibitors are currently being evaluated in clinical trials. [less ▲]

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See detailLA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM : quand, comment et pourquoi ?
MARTINIVE, Philippe ULiege; VAN DAELE, Daniel ULiege; LENNERTS, Evelyne ULiege et al

in Revue Médicale de Liège (2014), 69(Supp 1), 37-46

Depuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation ... [more ▼]

Depuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation de la chirurgie d’exérèse en totalité du mésorectum (TME), le profil de récidive locale du cancer du rectum a été fortement modifié. Dans un tel contexte, la place de la radiothérapie doit être réévaluée en tenant compte de ces modifications. Dans cet article, nous proposons de faire la revue des différentes grandes études concernant les techniques et les indications d’un traitement de radiothérapie pré- ou post opératoire dans le contexte d’une chirurgie rectale TME. [less ▲]

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See detailLA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM CHEZ LA PERSONNE ÂGÉE: Quel bénéfice pour le traitement ?
MARTINIVE, Philippe ULiege; ALLEPAERTS, Sophie ULiege; VAN DAELE, Daniel ULiege et al

in Revue Médicale de Liège (2014), 69(Supp 1), 47-52

Dans les années à venir, nous serons de plus en plus amenés à prendre en charge des patients âgés en oncologie. Dans ce contexte, quelles sont les évidences scientifiques à notre disposition qui nous ... [more ▼]

Dans les années à venir, nous serons de plus en plus amenés à prendre en charge des patients âgés en oncologie. Dans ce contexte, quelles sont les évidences scientifiques à notre disposition qui nous permettent de prendre en charge de façon correcte cette population oncologique âgée ? Les patients âgés présentent souvent de multiples co-morbidités pouvant interférer avec le traitement oncologique rendant d’autant plus complexe leur prise en charge. Le pic d’inci - dence du cancer du rectum se situe autour des 80 ans, loin au-dessus de l’âge moyen des patients inclus dans les études cliniques. La survie globale des patients traités pour un cancer du rectum s’est améliorée au cours de la dernière décennie, essentiellement pour des patients de moins de 75 ans. Le trai - tement du cancer du rectum nécessite une approche multidis - ciplinaire. L’évaluation gériatrique en fait partie intégrante. Elle permet de définir au mieux la stratégie thérapeutique en fonction de l’état général du patient, de son contexte neuro- psychologique, fonctionnel et social. La radiothérapie joue un rôle majeur dans le traitement du rectum. Quelle est sa place chez les personnes âgées ? Bénéficient-elles également de la radiothérapie, comme la population jeune sélectionnée dans les études contrôlées ? Quel est l’impact de ce traitement sur la qualité de vie ? Voilà des questions essentielles auxquelles nous allons tenter d’apporter une réponse [less ▲]

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See detailLes traitements cibles remplaceront-ils la chimiotherapie?
COLLIGNON, Joëlle ULiege; JERUSALEM, Guy ULiege

in Revue Médicale de Liège (2012), 67 Spec No

The oncologist dream is to provide more benefit with lower toxicity. The increasing knowledge of molecular mechanism for survival and proliferation of cancer cells leads to the development of targeted ... [more ▼]

The oncologist dream is to provide more benefit with lower toxicity. The increasing knowledge of molecular mechanism for survival and proliferation of cancer cells leads to the development of targeted therapies with impressive results for some cancers even if not associated with chemotherapy. These targeted treatments could be monoclonal antibodies or tyrosine kinase inhibitors. Inactivation of only one oncogene can lead to the regression of tumours as well as the inhibition of only one pathway with one or more inhibitors. This result is related to the oncogenic addiction of these tumours. Examples are imatinib in CML and GIST, trastuzumab in HER2 positive breast cancer, gefitinib in mutated EGFR, crizotinib in EML4-ALK positive lung cancer and, also, vemurafenib in BRAF 600E mutated metastatic melanoma. We shall specifically discuss HER2 positive breast cancer, which represent some 15-20% of breast cancers and the recent targeted and bi-targeted therapies. Trastuzumab, an anti-HER2 monoclonal antibody has changed the prognosis of the disease improving survival in the metastatic and adjuvant setting. Lapatinib, a dual tyrosine kinase inhibitor of EGFR and HER2 is approved with capecitabine in trastuzumab resistant patients and in combination with letrozole in first line. Unfortunately, 20% of patients receiving adjuvant trastuzumab relapse and metastatic patients only transienly respond to trastuzumab or lapatinib combined with chemotherapy. New HER2 targeted drugs are currently in development like pertuzumab, T-DMI or mTOR and PI3K inhibitors. New strategies combining these drugs with or without chemotherapy showed interesting results in metastatic and neoadjuvant trials. The selection of patients who will most benefit from these combinations is still a challenge. Currently, chemotherapy in association with anti-HER2 therapy remains the most effective treatment option. [less ▲]

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