Traitement des progressions tumorales dans le cancer du poumon muté EGFR : à propos d'une cohorte de patients métastatiques suivis à l'Institut Bergonié
Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Lung cancer is the leading cause of cancer death in France. In above 75% of cases, disease is too advanced to permit curative treatments. Adenocarcinomas are the principal histologic type, with above 10% of epidermal growth factor (EGFR) mutations. These mutations lead to constitutive activation of this receptor. Tumors presenting EGFR mutations have a dramatically response rate to tyrosine kinase inhibitors (TKI). Responses occur during 10 to 12 months in median. After this period, all patients improve relapses because of emergence of tumor resistance. Several therapeutics strategies are proposed but there are not therapeutics standards for treatment of these resistances. The aim of this study was to analyze clinical and molecular characteristics of relapses of 69 patients treated at Bergonie Institute (Bordeaux) and to evaluate therapeutics strategies used. We have shown that oligometastatic patients might benefit of local treatments, with TKI continuation. For others relapses, a biopsy must be realized. Molecule assessment of these biopsies can guide treatments. Slow and asymptomatic progressions are often due to EGFR-dependant progressions, and can be treated with TKI continuation or chemotherapy and rechallenge. EGFR-independent relapses lead to rapid or symptomatic progressions and must be treated with chemotherapies. New treatments like new generation TKI or immunotherapies will change these strategies and might be considered in future trials.
Source: HAL
Author: Charlotte Domblides
Institution: Université de Bordeaux
Language: French
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2202078147