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Philippe Beuzeboc

Publications and source records attributed to Philippe Beuzeboc.

At least 19 recordsLinked to original sources
PubMed2006

Management of a malignant urinary fistula by ureteral embolization with coils.

We report the case of a 42-year-old man with a synovial sarcoma of the prostate, metastatic at presentation, who after aggressive chemotherapy followed by extensive surgery developed a complex pelvic fistula involving the lower ureter, bladder, and enteral structures. The patient was a poor candidate for surgery because of his short life expectancy and poor health status. Conservative management with bilateral nephrostomy tubes did not allow sufficient fistulous output for symptomatic relief. Using the percutaneous access already in place, we performed bilateral ureteral embolization with coils. Complete ureteral occlusion was obtained with a minimally invasive procedure and allowed total symptomatic relief.

Adult↗
PubMed2006

Gemcitabine and cisplatin after radical cystectomy for bladder cancer in an adjuvant setting: feasibility study from the Genito-Urinary Group of the French Federation of Cancer Centers.

The impact of adjuvant chemotherapy in locally advanced bladder cancer is still not fully established. Between January 2000 and November 2001, 30 patients entered the trial to receive four cycles of a combination of gemcitabine 1,250 mg/m on day 1 and day 8 and cisplatin 70 mg/m on day 1, repeated every 3 weeks. Histologic diagnoses included pT2-pT3-pT4 tumors and/or pN1-pN2. Combination treatment with gemcitabine and cisplatin was considered feasible if 70% of the patients received a relative dose intensity of each drug of more than 90%. Twenty-seven patients received four cycles of combination treatment. The relative dose intensity of cisplatine and gemcitabine was 96 and 88%, respectively. No toxic death occurred. We conclude that giving four cycles of the gemcitabine-cisplatin regimen in the adjuvant setting after cystectomy is feasible with a manageable toxicity and a high relative dose intensity. Whether this approach may increase survival is currently assessed in a randomized trial.

Adult↗
PubMed2005

Trastuzumab (Herceptin) in metastatic transitional cell carcinoma of the urinary tract: report on six patients.

OBJECTIVE: To report our preliminary experience with trastuzumab (Herceptin) in the management of metastatic transitional cell carcinoma of the urinary tract. PATIENTS AND METHODS: From november 2001 to august 2002, six patients received trastuzumab for metastatic transitional cell carcinoma of the bladder (n=5) or renal pelvic cancer (n=1). Trastuzumab was administered as a first-line therapy in 2 patients, a second-line therapy in 3, and a third-line therapy in 1. Each patient received a weekly intravenous administration of trastuzumab (initial dose of 4 mg/kg, followed by 2mg/kg for other courses). A total of 6 courses was given. In 4 patients, trastuzumab was administered in association with paclitaxel (175 mg/m2) and carboplatin (area under the curve of 6). One patient received the same combination of trastuzumab and paclitaxel, but without carboplatin. The remaining patient received only trastuzumab. RESULTS: The trastuzumab-based regimen achieved partial regression of metastases in all patients. Initial regression of metastases varied between 30% and 80%. The therapy was well tolerated. Treatment-related toxicity was moderate in all patients, except for one who experienced transient grade 4 neutropenia. Five patients died from cancer. The interval between trastuzumab initiation and patient death ranged from 8 to 22 months. The remaining patient was still alive 28 months after trastuzumab initiation. CONCLUSIONS: Our preliminary data suggest that trastuzumab-based therapy may be safe and effective in metastatic transitional cell carcinoma of the urinary tract. Prospective trials are needed to further investigate this therapeutic option.

Aged↗
PubMed2005

Multicenter randomized phase II study of two schedules of docetaxel, estramustine, and prednisone versus mitoxantrone plus prednisone in patients with metastatic hormone-refractory prostate cancer.

PURPOSE: Mitoxantrone-corticosteroid is currently the standard palliative treatment in hormone-refractory prostate cancer (HRPC) patients. Recent clinical trials documented the high activity of the docetaxel-estramustine combination. We conducted a randomized phase II study to evaluate prostate-specific antigen (PSA) response (primary end point) and safety of two docetaxel-estramustine-prednisone (DEP) regimens and mitoxantrone-prednisone (MP). PATIENTS AND METHODS: One hundred thirty metastatic HRPC patients were randomly assigned to receive docetaxel (70 mg/m2 on day 2 or 35 mg/m2 on days 2 and 9 of each 21-day cycle) and estramustine (280 mg p.o. tid on days 1 through 5 and 8 through 12) or mitoxantrone 12 mg/m2 every 3 weeks; all patients received prednisone (10 mg daily). RESULTS: One hundred twenty-seven patients were assessable for PSA response and safety. A > or = 50% PSA decline was found in a greater percentage of patients in the docetaxel arms (67% and 63%) compared with MP (18%; P = .0001). Median time to PSA progression was five times longer with DEP than with MP (8.8 and 9.3 v 1.7 months, respectively; P = .000001). Overall survival was better in the docetaxel arms (18.6 and 18.4 months) compared with the MP arm (13.4 months), but not significantly so (P = .3). Crossover rates differed significantly among treatment arms (16%, 10%, and 48% in arms A, B, and C, respectively; P = .00001). Treatment-related toxicities were mild and mainly hematologic. CONCLUSION: The results of this randomized phase II study showed significantly higher PSA decline < or = 50% and longer times to progression in HRPC patients receiving DEP-based chemotherapy than MP, and that DEP could be proposed in this setting.

Adenocarcinoma↗
PubMed2005

Combination of gemcitabine and oxaliplatin in urothelial cancer patients with severe renal or cardiac comorbidities.

Clinical trials in urothelial cancer exclude a large population of patients. An observational study evaluated the behavior of frail patients not eligible for cisplatin- or carboplatin-based regimens. Urothelial cancer patients requiring chemotherapy with either chronic renal failure (creatinine clearance <60 ml/min), and/or performance status (PS) > or =2 and/or cardiac dysfunction were prospectively observed. The treatment associated gemcitabine 1200 mg/m and oxaliplatin 85 mg/m, bimonthly (GO). Over 2 years, 31 of 45 (69%) patients with urothelial cancer requiring chemotherapy were not eligible for cisplatin- or carboplatin-based chemotherapy. Sixteen (52%) had a PS > or =2, 23 (74%) had creatinine clearance <60 ml/min, and 20 (65%) had an underlying cardiopathy. A total of 178 cycles of GO were administered (median 6 per patient, range 2-12). No aggravation of renal or cardiac status was noted. Acute grade 3 and 4 neutropenia and thrombocytopenia were observed in 16 and 13% of patients, respectively, with one febrile neutropenia. The median progression-free and overall survival values were 4.2 and 9.5 months, respectively. The majority of urothelial cancer patients have severe renal or cardiac comorbidities, and we conclude that in this subset of patients the combination of gemcitabine and oxaliplatin is well tolerated, and its clinical activity warrants further evaluation.

Aged↗
PubMed2005

[Leiomyosarcoma of the renal pelvis].

Leiomyosarcoma of the renal pelvis is an exceptional tumour, as only 3 cases have been reported in the literature. The authors report a new case and discuss the differential diagnoses and prognosis of this lesion.

Aged↗
PubMed2004

Confrontation of immunohistochemistry and fluorescent in situ hybridization for the assessment of HER-2/ neu (c-erbb-2) status in urothelial carcinoma.

Specific treatments targeted toward oncogenes expressed in cancer cells are currently under development. Patients with urothelial carcinomas showing HER-2/ neu (human epidermal growth factor receptor 2) overexpression are candidates for such a specific treatment (trastuzumab). However, to be effective, this therapeutic approach requires an extremely reliable evaluation of HER-2/ neu status in tumors. In order to assess the status of expression of this gene and to optimize its assessment, we analyzed a series of 64 primary urothelial carcinomas using immunohistochemistry (IHC) with the CB11 monoclonal antibody coupled with fluorescent in situ hybridization (FISH) in 21 cases. Strong HER-2/ neu overexpression was detected using IHC in 15 of the 64 (23%) cases analyzed, and this rate rose to 33% for patients with metastases. HER-2/ neu overexpression, as revealed using IHC, is strongly associated (95%) with gene amplification assessed using FISH. Patients with urothelial carcinomas overexpressing HER-2/ neu using IHC are potential candidates for targeted chemotherapy.

Adenocarcinoma↗
PubMed2004

Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy.

The cell proliferation rate has been correlated to the response of breast carcinomas to preoperative chemotherapy (CT) and to disease outcome. However, this parameter is not yet used to select which tumours should be treated with preoperative CT. Furthermore, there is no consensus in the method used to evaluate cell proliferation. In poor prognosis breast carcinomas (PPBCs) treated by intensive preoperative CT, we compared the predictive value of S phase fraction (SPF), mitotic index (MI) and Ki67. We also evaluated the prognostic significance of the variation of the MI after CT. A series of 55 T2-T4N0N1M0 breast carcinomas were treated with 4 cycles of cyclophosphamide, 5-fluorouracil (5-FU) and doxorubicin. SPF was determined by flow cytometry on pre-therapeutic needle aspiration products. MI and Ki67 were evaluated on pre-therapeutic biopsy samples and on the tumours after CT. Fifteen patients (27%) had a pathological complete response (pCR), whereas 40 (73%) had residual disease. All three proliferative markers were found to have predictive value, but this value was higher for MI than for SPF (P = 0.04) and Ki67 (P = 0.03): the rate of pCR was 50% in cases with MI > 17/3.3 mm2, but was only 7% in cases with MI under this threshold (P = 0.0003). A significant decrease of MI (mean 10.97) was observed after CT (P = 0.001). Furthermore, we observed that even for patients with residual tumour, the variation of MI after CT was a prognostic parameter and overall survival. The sequential analysis of MI in breast cancers treated by preoperative CT thus provides a surrogate for predicting long-term outcome.

Adult↗
PubMed2004

Concurrent chemoradiotherapy for clinical stage T2 bladder cancer: report of a single institution.

OBJECTIVES: To report our experience with concurrent chemoradiotherapy for clinical Stage T2 bladder cancer. METHODS: From 1996 to 2002, 43 patients were treated with concurrent chemotherapy and radiotherapy for clinical Stage T2 bladder cancer. After complete bladder transurethral resection, all patients underwent chemotherapy, consisting of one daily infusion of cisplatin at a dose of 15 mg/m2 and 5-fluorouracil at a dose of 400 mg/m(2) on days 1 to 3 (first cycle) and days 15 to 17 (second cycle). Pelvic irradiation was administered at a dose of 24 Gy, using two daily fractions of 3 Gy on days 1, 3, 15, and 17. Random biopsies were performed 6 weeks after the end of the first two cycles. Patients with persistent invasive tumor underwent cystectomy; others received two additional cycles of concurrent chemoradiotherapy. RESULTS: The mean follow-up was 36.3 months (range 3 to 72). Nine patients underwent early cystectomy for nonresponse, and 2 patients underwent delayed cystectomy. The overall rate of cystectomy was 25.6%. The rate of specific survival at 3 and 5 years was 75% and 60%, respectively. The overall rate of recurrence-free survival at 3 and 5 years was 63% and 33%, respectively. Two factors correlated with patient survival: the presence of carcinoma in situ at first resection (P = 0.01) and the response after the first two cycles (half dose; P = 0.004). CONCLUSIONS: In our experience, concurrent chemoradiotherapy is less effective than primary cystectomy for clinical Stage T2 bladder cancer. This treatment may be unwarranted in patients with concomitant carcinoma in situ at the first resection.

Adult↗
PubMed2004

[Prostatic cancer].

Explore the source record for details and available documents.

Antineoplastic Agents↗
PubMed2003

International expert panel on the use of primary (preoperative) systemic treatment of operable breast cancer: review and recommendations.

Primary systemic therapy (PST) represents the standard of care in patients with locally advanced breast cancer. In addition, there is increasing information on PST in operable breast disease that supports the use of PST in routine practice. However, current regimens and techniques vary. To address this concern, a group of representatives from breast cancer clinical research groups in France, Germany, Italy, the United Kingdom, and the United States reviewed all available data on prospective randomized trials in this setting. Recommendations are made regarding terminology, indications, regimen, diagnosis before treatment, monitoring of efficacy, tumor localization, surgery, pathologic evaluation, and postoperative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Metastatic Breast Tumour Regression Following Treatment by a Gene-Modified Vaccinia Virus Expressing MUC1 and IL-2.

MUC1 is expressed by glandular epithelial cells. It is overexpressed in the majority of breast tumours, making it a potential target for immune therapy. The objectives of the present study were to evaluate the anti-tumour activity and tolerance of repeated administration of TG1031 (an attenuated recombinant vaccinia virus containing sequences coding for human MUC1 and the immune stimulatory cytokine IL-2) in patients with MUC1-positive metastatic breast cancer. This was an open-label, randomised study comparing two dose levels, 5 x 10E6 and 5 x 10E7, with 14 patients in each arm. The treatment was administered intramuscularly every 3 weeks for the first 4 doses and every 6 weeks thereafter, until progression. Two patients had a partial tumour regression ( > 50%), and 15 patients had stable disease as their best overall response until at least the 5th injection. Partial regression lasted for 11 months in one patient and for 12 months in the second patient who then underwent surgical resection of her hepatic metastases. The most frequent adverse events included inflammation at injection site: 7 patients, itching or pain at injection site: 5 patients, and moderate fever: 6 patients. One responding patient developed antinuclear, anti-DNA, and increased anti-TPO antibodies after the fifth injection, and which resolved at the end of treatment. The treatment regimes were well tolerated with a low toxicity profile. Although clinical efficacy remains limited, this study demonstrates the potential use of MUC1-based immune therapy in breast cancer.

Journal Article↗
PubMed2003

[Testicular germ cell tumors: prognosis].

OBJECTIVES: To assess the prognosis of germ cell tumours of the testis based on a series of 60 patients. MATERIAL AND METHODS: The files of 60 patients consecutively operated for germ cell tumour of the testis between February 1988 and January 2002 were reviewed. Tumours were classified as 35 seminomas (S) and 25 non-seminomatous germ cell tumours (NSGCT). In the S group, 32 patients received either prophylactic (28 pT1N0M0 tumours and 2 pT2N0M0 tumours) or therapeutic (1 pN2M0 tumour) adjuvant radiotherapy. The other 3 patients received BEP chemotherapy (1 pT3N0M0 tumour and 2 pN2M0 tumours). In the NSGCT group, 15 patients received adjuvant BEP chemotherapy (1 pT1N0M0 tumour, 5 pT2N0M0 tumours, and 7 pN2-3 and/or M+ tumours). Primary lymph node dissection was not performed in any patient, but 7 patients underwent lymph node dissection for residual masses after chemotherapy. RESULTS: The mean follow-up after orchidectomy was 85.2 months. One patient in the S group developed left supraclavicular recurrence of a pT1N0M0 tumour, requiring 3 complementary cycles of BEP. All patients were in complete remission at the end of follow-up. In the NSGCT group, there was one recurrence after secondary lymph node dissection, requiring 3 complementary cycles of BEP. Only one death (4%) occurred after 18 months. All other patients were in complete remission at the end of follow-up. CONCLUSIONS: The mortality rate of germ cell tumour of the testis was low in this series (0% for S and 4% for NSGCT at 7 years). These results are comparable to those reported in the literature. In our experience, stage pT1N0M0 NSGCT may be suitable for close surveillance, with no adjuvant therapy. It also does not appear justified to perform primary lymph node dissection in seminomas with lymph node involvement.

Antineoplastic Agents↗