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Biomedical subjects

J Jacquemier

Publications and source records attributed to J Jacquemier.

151 records · Page 9Linked to original sources
PubMedDate not supplied

Outpatient sequential high dose alkylation with stem cell support for patients with advanced breast cancer: a phase I-II study.

We evaluated the feasibility of administering, in an out-patient setting, a sequential high dose alkylating regimen with hematopoietic growth factor (HGF) and stem cell support to patients with advanced breast cancer. Peripheral blood stem cells (PBSC) were previously collected after chemotherapy and HGF. Two consecutive cycles of alkylating agents were planned: Thiotepa (T) then, 15 days later, BCNU (B). Three dose levels of each agent were administered in cohorts of consecutive patients: 400, 500 and 600 mg/m2 respectively. HGF and reinfusion of PBSC followed both cycles. Toxicity and response were evaluated according to the WHO recommendations. From April 1996 to August 1988, 30 women were enrolled: 8 in the first, 12 in the second and 10 in the third dose level. In all cases, B was administered after T with a median delay of 25 days because of grade 3/4 hematological toxicity. 4 patients did not receive B because of previous lung radiotherapy, persistent tricytopenia or insufficient PBSC collection. 19 patients with measurable lesions were considered for response. The objective response rate was 48% (11% CR, 37% PR). We recommended T and B at a dose of 600 mg/m2 to conduct a phase II study in metastatic breast cancer and even to administer B before T.

Antineoplastic Agents, Alkylating↗
PubMedDate not supplied

PS2 expression in BRCA1-associated breast cancers.

BACKGROUND: PS2-expression is controlled by estrogens and is a prognostic factor for long-term and post-relapse survival. Breast carcinomas associated with a BRCA1 mutation (BRCA1-BC'S) exhibit many specific features, particularly for ER expression. Our purpose was to determine if pS2-expression was different in BRCA1-BC's compared with sporadic breast cancers. MATERIALS AND METHODS: We studied, by immunohistochemistry pS2-cxpression in a series of 33 BRCA1-BC's and a series of 193 sporadic cases according to many parameter including hormone receptors (ER and PR). RESULTS: In BRCA1-BC's, pS2 was expressed in only 10/33 (30.3%) carcinomas, and 4/4 (100%) ER positive: among sporadic carcinomas, 133/193 (68.9%) cases were pS2-positive, 102/127(80.37%) ER positive; the difference was significant (p<0.0001). In univariate analysis, pS2-expression was correlated with many parameters including hormonal receptor status and absence of BRCA1 mutation. In multivariate analysis, pS2-expression was still correlated with ER but no more with BRCA1 mutation. CONCLUSION: pS2-expression in BRCA1-BC's was significantly different from sporadic breast cancer (p<0.0001) and correlated in a multivariate analysis with the same factors in sporadic and BRCA1-BC's but not with BRCA1 mutation.

Breast Neoplasms↗
PubMedDate not supplied

High-dose alkylating agents with autologous hematopoietic stem cell support and trastuzumab in ERBB2 overexpressing metastatic breast cancer: a feasibility study.

BACKGROUND: ERBB2 overexpression predicts a worse outcome for patients receiving high-dose chemotherapy (HDC). Trastuzumab improves response rate and survival in ERBB2 overexpressing metastatic breast cancer patients (MBC). We investigated the feasibility of combining high-dose alkylating agents with autologous hematopoietic stem cell (AHSC) support and trastuzumab in ERBB2 overexpressing MBC. PATIENTS AND METHODS: Eleven consecutive patients with pre-treated ERBB2 overexpressing MBC were enrolled. HDC regimen consisted of a single course of cyclophosphamide 120 mg/kg + melphalan 140 mg/m2 (CyMEL, n =8), a single course of Thiotepa 600 mg/m2 (TTP, n = 1) or a sequential combination of Thiotepa 600 mg/m2 followed on day 21 by BCNU 600 mg/m2 (TTP-BCNU, n =2). Trastuzumab (4mg/kg) was started 24 h after AHSC infusion and then administered weekly (2 mg/kg). RESULTS: Median time to neutrophil and platelet recovery was 10 and 14.5 days, respectively. Three patients experienced febrile neutropenia and in 2 Herpes virus infections were documented. Five grade III/IV mucositis/oesophagitis were recorded. One patient experienced a reversible atrial arrhythmia on day 2 of trastuzumab, and another patients had a nonsymptomatic decrease in LVEF >10% on week 12 of trastuzumab. No toxic death was recorded. Median time to progression was 5 months (1 to 38 +). CONCLUSION: Combining alkylating agent-based HDC and trastuzumab appears to be feasible in ERBB2 overexpressing MBC and warrants further investigation in a larger cohort.

Adult↗
PubMedDate not supplied

[Bi-tissular malignant tumors of the lung. 2 cases].

Two new cases of multiple components pulmonary carcinoma are described: a pneumoblastoma and a epitheliosarcoma. Differenciating clinical features and nosological problems are recelled, allowing to discuss the classification of these two observations.

Aged↗
PubMedDate not supplied

Breast cancer response to adjuvant chemotherapy in correlation with erbB2 and p53 expression.

The expression of the erbB2 and p53 proteins was examined by immunohistochemistry in a series of 81 cases of primary breast carcinomas treated with an adjuvant chemotherapy with a median follow-up of 5 years. Expression of erbB2 was present in 19 cases (23%), 50% of them with more than 70% of positive tumoral cells. Expression of p53 was present in 32 cases (39%), 50% of them with more than 30% of positive tumoral cells; coexpression of erbB2 and p53 was observed in 11 cases (13.5%). Disease-free and overall survival of the patients were correlated with the number of positive lymph nodes (p = 0.08, p = 0.015). No significant trend was observed in response to adjuvant chemotherapy in correlation with erbB2 or p53 expression or both, whatever the level of expression.

Adult↗
PubMedDate not supplied

Tolerance and feasibility of perioperative treatment with interferon-alpha 2a in advanced cancers.

BACKGROUND: Major surgery impairs the cellular immune response. In order to stimulate the immunological system during the perioperative period, we have studied the clinical and biological tolerance, and the immunological and histological effects of a perioperative treatment using progressive doses of Interferon-alpha 2a, from the third preoperative day (D-3) until the tenth postoperative day (D10). MATERIALS AND METHODS: Twenty-three patients undergoing a major surgical procedure for advanced cancer were included. The clinical and biological parameters evaluated were the body temperature and the blood cell counts. Immunological effects were evaluated by counting the total number of lymphocytes, lymphocyte subsets, natural killer cells (NK), and by analysis of the NK activity, and lymphokine-activated killer cell (LAK) assay. RESULTS: Hyperthermia was the most toxic effect of Interferon-alpha but the overall toxicity was minor, even at the highest dose level. In the early postoperative period there was a significant decrease in total lymphocytes, and in most lymphocyte subset counts when compared with D-3. Overall NK and LAK activities significantly increased from D-3 to D-1 (p < 0.02). A postoperative decrease in NK activity was noted that was not significant when compared to pretherapeutic values, whereas a significant decrease in LAK activity did occur on D4 despite the interferon treatment (p < 0.03). Since we found a dose-dependent effect on some lymphocyte subsets, there was not a clear dose-dependent effect on NK and LAK activities. CONCLUSIONS: Perioperative alpha 2a administration is a safe treatment in advanced cancer patients that may allow a postoperative preservation of NK activity and a destruction of potential circulating metastatic cells. Further studies are ongoing on perioperative immunotherapy in advanced cancer patients.

Adolescent↗