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J P Ferriere

Publications and source records attributed to J P Ferriere.

11 recordsLinked to original sources

Does survival increase in metastatic breast cancer with recently available anticancer drugs?

Metastatic breast cancer (MBC) is incurable in most cases. While multiple treatments are available, the median survival is still approximately 2 years. We planned to assess the apparent impact of taxanes and aromatase inhibitors (letrozole, anastrozole, and exemestane) on the survival of 857 MBC patients for more than 30 years. Patients classed into decades by metastatic disease onset date did not survive significantly longer in recent years. This does not exclude some marked improvements with time: 1) in the same period, the disease-free interval for MO patients increased progressively and significantly with time; 2) the overall relapse ratio in MO patients was 20% lower in the 1990-2000 decade compared with 1980-1990; 3) since 1995, treatment for metastasis has been significantly lighter with periods of chemotherapy separated by hormonotherapy or observation in the case of negative receptors. Analyzing individual therapies, availability of taxanes since 1994 did not result in a significant increase of the overall survival. Conversely, receiving hormonotherapy was an important prognostic factor of the overall survival. Three groups were classified according to hormone therapy: group 1--tamoxifen, group 2--aromatase inhibitors, group 3--a combination of tamoxifen then aromatase inhibitors. The combination of tamoxifen then aromatase inhibitors favored a survival improvement from metastasis appearance to death compared with aromatase inhibitors alone and with tamoxifen alone. The sequential treatment of tamoxifen then aromatase inhibitors is presently discussed as a possible standard when used as adjuvant treatment. This sequential effect could also constitute a valuable concept for metastatic patients.

Aged↗

High-dose melphalan and autologous bone marrow support for treatment of ovarian carcinoma with positive second-look operation.

Patients with epithelial ovarian carcinoma (OVCA) and positive second-look operation (SLO) have a poor short-term prognosis. Treatment after SLO is still controversial and pilot studies are justified in an attempt to improve survival of these patients. As OVCA is known to be a chemosensitive tumor, it seems logical to treat these patients with high-dose chemotherapy with the support of an autologous bone marrow transplantation. Fourteen patients underwent primary surgery with tumor debulking followed by cis-platinum-based chemotherapy. SLO was performed in each patient and was microscopically positive in five and macroscopically positive with secondary debulking in nine. All patients were treated after SLO with high-dose melphalan (HDM), 140 mg/m2, and autologous bone marrow support. HDM was well tolerated, with a median time to granulocyte recovery of 21 days. There was no death due to treatment toxicity. The mean follow-up after SLO is 43 months. Five patients (35.7%) are disease free at 30 to 60 months after SLO with no further treatment and, thus, a good quality of life. Four patients are alive with recurrent disease. Five patients died of OVCA; actuarial 3-year survival is 64%. This therapeutic procedure is well tolerated and seems to provide long-term survival for patients with no complete response after first-line chemotherapy. Therefore, it might also be applied to patients at high risk of recurrence after a negative SLO.

Adenocarcinoma↗

Second-look laparotomy in managing epithelial ovarian carcinoma.

Fifty-one patients treated for an epithelial ovarian carcinoma underwent a second-look operation (SLO) from August 1979 to December 1984. Previously, an initial laparotomy had been performed for staging and maximum cytoreductive surgery. This was followed by 6 to 12 courses of combination chemotherapy including cisplatin. Findings at SLO and outcome are discussed as regards extent of initial surgery, preoperative assessment and secondary debulking procedure. In this work, the findings at SLO were often predictable, and related to the adequacy of initial surgery and to a clinical complete response. Nevertheless, after incomplete initial cytoreductive surgery, SLO appears the best procedure to assess the status of the peritoneal cavity and the efficacy of chemotherapy. Negative SLO after incomplete initial surgery assessed a complete response rate of 34% induced by the cisplatin-based chemotherapy. Survival rate of patients with a negative SLO was 93% at 3 years, which demonstrated the highly significant value of SLO in prognosis. Conversely, patient survival with positive findings at SLO was very low, whatever resection can be made. As this work and similar studies by others showed that it could improve patient survival, an attempt should be made to a secondary debulk of residual tumor, and it seems interesting to perform further such secondary resections until definite conclusions can be drawn about this procedure.

Actuarial Analysis↗

beta-Thromboglobulin in patients with breast cancer.

beta-Thromboglobulin (beta TG) plasma levels were determined in 52 female breast cancer patients at different stages and in 39 healthy controls (22 women and 17 men) of similar age distribution. Beta TG levels were high (mean +/- SD:61.6 +/- 59.1 ng/ml) in patients before any treatment compared to controls (mean +/- SD:21.2 +/- 7.4 ng/ml) and the difference was statistically significant (p less than 0.001). No correlation with disease stage was observed. No other coagulation parameters were abnormal except fibrinogen, which increased. Fibrinogen degradation products (FDP) also increased but only in metastatic patients. Chemotherapy appeared to induce a considerable decrease in initial values at the end of the first cycle without modifying the platelet count. In addition, an attempt was made to correlate the beta TG plasma level investigated serially for several months with disease evolution.

Adult↗

Variations in committed stem cells (CFU-GM and CFU-TL) in the peripheral blood of cancer patients treated by sequential combination chemotherapy for breast cancer.

The present work compared the blood variations in some committed stem cells (CSC), and corresponding differentiated WBC during the first three courses of a 6-day sequential chemotherapy given to 16 breast cancer patients for 28 days each. The granulomonocytic and lymphocytic colony-forming unit levels in blood were significantly lowered in cancer patients before treatment. These CSC appeared to have cyclic variations following each course of chemotherapy. In granulomonocytic colony-forming units, a nadir was observed by Day 15, followed by a sharp rebound above the initial values by Days 22 to 24, which was not affected in magnitude by the continuation of treatment. In lymphocytic colony-forming units, the Day 1 level increased with the continuation of chemotherapy. The initial decrease was less marked, but by Day 15 a minimal level was also observed, followed by a progressive increase to reach a maximum by Day 28. Leukocytes and granulocytes reached a nadir by Days 16 to 17 and recovered by Day 25. The cyclic evolution of monocytes was less apparent as was that of lymphocytes; however, there was less restoration of monocytes and lymphocytes than of granulocytes at the end of the resting period. This study showed: (a) an apparent relationship between the level of CSC in blood, and subsequent variations in the corresponding mature cells of the same lineage; and (b) a weak interval of time between the nadir and peaks of CSC and the corresponding mature cells, which was more evident in the granulocytic lineage. These observations seemed to be of physiological importance, but the possible prediction value of peripheral granulomonocytic colony-forming unit peak magnitude following treatment remains to be established.

Adult↗

[In vitro cloning of human tumor stem cells].

This study summarizes a one-year work experience in the area of human tumor stem cells cloning techniques. We found that it was more advisable to use an enzymatic method for dissociating solid tumors. The breast tumors possessing an unfavourable histoprognostic grade were found to grow up more easily in culture, which is a confirmation of known relationships between cell differentiation degree and cell proliferation. The high frequency of failures in the obtention of colonies did not allow to use this technique in daily clinical practice to study the in vitro sensitivity to drugs of a definite tumor. An improvement in the conditions of culture and the comparison with other in vitro methods for the prediction of response to oncostatics--particularly the incorporation of radioactive precursors (Livingston and coll., 1980)--will be attempted in future work.

Cell Separation↗

Correlation between active E-rosettes and antigens defined on peripheral lymphocytes by OKT 4 and OKT 8 monoclonal antibodies.

A relationship has been sought between the classical marker, active E-rosette and the surface antigens of T-lymphocytes, defined by OKT 4 and 8 monoclonal antigens, in the peripheral blood of normal human people. It was found that no significant correlation existed in the case of OKT 4 antigen; conversely the OKT 8-positive cells were significantly enriched after E-rosette-forming cell isolation (about 2.5 times in comparison with the negatively selected cells). In this latter case, some partial correlation could exist between SRBC-high affinity of T-lymphocytes and the subsets defined by OKT 8 antigen.

Antibodies, Monoclonal↗