Biomedical subjects

Jean Bauer

Publications and source records attributed to Jean Bauer.

6 recordsLinked to original sources

PubMed2006

Monitoring multiple angiogenesis-related molecules in the blood of cancer patients shows a correlation between VEGF-A and MMP-9 levels before treatment and divergent changes after surgical vs. conservative therapy.

Anti-angiogenic therapies are currently in cancer clinical trials, but to date there are no established tests for evaluating the angiogenic status of a patient. We measured 11 circulating angiogenesis-associated molecules in cancer patients before and after local treatment. The purpose of our study was to screen for possible relationships among the different molecules and between individual molecules and tumor burden. We measured VEGF-A, PlGF, SCF, MMP-9, EDB+ -fibronectin, sVEGFR-2, sVEGFR-1, salphaVbeta3, sTie-2, IL-8 and CRP in the blood of 22 healthy volunteers, 17 early breast, 17 early colorectal, and 8 advanced sarcoma/melanoma cancer patients. Breast cancer patients had elevated levels of VEGF-A and sTie-2, colorectal cancer patients of VEGF-A, MMP-9, sTie-2, IL-8 and CRP, and melanoma/sarcoma patients of sVEGFR-1. salphaVbeta3 was decreased in colorectal cancer patients. A correlation between VEGF-A and MMP-9 was found. After tumor removal, MMP-9 and salphaVbeta3 significantly decreased in breast and CRP in colorectal cancer, whereas sVEGFR-1 increased in colorectal cancer patients. In sarcoma/melanoma patients treated regionally with TNF and chemotherapy we observed a rise in VEGF-A, SCF, VEGFR-2, MMP-9, Tie-2 and CRP, a correlation between CRP and IL-8, and a decreased in sVEGFR-1 levels. In conclusion, among all factors measured, only VEGF-A and MMP-9 consistently correlated to each other, elevated CRP levels were associated with tumor burden, whereas sVEGF-R1 increased after tumor removal in colorectal cancer. Treatment with chemotherapy and TNF induced changes consistent with an angiogenic switch. These results warrant a prospective study to compare the effect of surgical tumor removal vs. chemotherapy on some of these markers and to evaluate their prognostic/predictive value.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

[Cancer screening: when and how?].

Advances in cancer biology have led to the development of screening tests that allow an early diagnosis. Cancer screening is not just the matter of a single individual patient, it is a matter of public health. Screening is commonly viewed as of no harm, when in fact harms are associated with the majority of cancer screening tests. A test should only be used when the potential of benefit clearly outweighs the risks for harm. The data in the literature are not always clear cut and in a lot of cases guidelines are somewhat controversial. What is known and what is unknown about screening tests is quite different from what is believed by the public. The aim of this work is to summarize the different methods and guidelines in cancer screening to help choosing the right test at the right time for the right person.

Decision Making↗

PubMed2005

[Dangerous liaisons: relation between oncologist and general practitioner].

Due to the nature of the disease, patients often have a privileged and close relationship with their oncologist, and the oncologist also with their patients. This may in turn be detrimental to the relation between the general practitioner and the patient. Patients will not return to their general practitioner until end of life care or a consultation at the patient's home if necessary. In order to maintain a balance between the caretakers and assure appropriate involvement of the family physician, continuous communication and exchange of information are essential. This review identifies some of the problems and potential conflicts, which may arise, and discusses how the interaction could be improved.

Continuity of Patient Care↗

PubMed2005

Trabectedin for women with ovarian carcinoma after treatment with platinum and taxanes fails.

PURPOSE: To assess the efficacy and toxicity of the marine-derived alkaloid trabectedin (ET-743) in patients with advanced ovarian cancer refractory to or experiencing disease relapse after platinum- and taxane-based chemotherapy. PATIENTS AND METHODS: Fifty-nine patients from four institutions either resistant (n = 30) or sensitive (n = 29) to prior platinum and taxanes were treated with a 3-hour infusion of trabectedin every 3 weeks. Patients were monitored weekly for toxicity and restaged every two cycles for response. Response was assessed according to Response Evaluation Criteria in Solid Tumors Group. RESULTS: The peer-reviewed objective response rate in platinum-sensitive patients was 43% (95% CI, 23% to 65%) with an estimated median time to progression of 7.9 months (95% CI, 7.5 to 14.1 months); in platinum-resistant patients two partial responses were observed. Responses were durable for up to 12.9 months (median, 5 months). The predominant toxicities at the recommended dose of 1,300 microg/m(2) were neutropenia, asthenia, and self-limited increase of aminotransferases never requiring treatment interruption. CONCLUSION: Trabectedin administered as a 3-hour infusion at 1,300 microg/m(2) is a safe new drug with promising activity in relapsed ovarian cancer, showing a 43% objective response rate in patients with platinum-sensitive disease, which favorably compares with other salvage treatments and warrants additional development either alone or in combination.

Adult↗

PubMed2004

Acquired hemophilia as first manifestation of breast carcinoma in a man under long-term spironolactone therapy.

A 69-year-old man under long-term spironolactone therapy (16 years) was hospitalized with spontaneous hematoma on the trunk and extremities. Coagulation studies disclosed an acquired hemophilia that was successfully treated with human factor VIII for a few days and immunosuppressive agents for several months. Physical examination revealed bilateral gynecomastia and an upper left quadrant breast nodule. Complete staging was unremarkable. Complete left mastectomy was performed. Histopathology showed invasive ductal carcinoma, expressing positivity for estrogen and progesterone receptors. The acquired hemophilia was considered to be a paraneoplasic syndrome. The question of a linkage between long-term spironolactone therapy and breast carcinoma is discussed.

Aged↗

PubMedDate not supplied

Pharmacokinetics of satraplatin (JM216), an oral platinum (IV) complex under daily oral administration for 5 or 14 days.

BACKGROUND: Satraplatin (JM216; bis-acetatoammine-dichlorocyclohexylamine platinum (IV)) is a platinum (Pt) complex developed in an attempt to circumvent tumour resistance and which can be administered by the oral route. The fate of platinum delivered by this oral formulation administered at various doses under the 5 or 14 days schedule, has been studied to a limited extent. PATIENTS AND METHODS: Total (Ptot) and ultrafilterable (PtUF) platinum were determined in 19 patients enrolled in phase I (PI) and II (PII) studies (PI, n = 14, advanced cancer; PII, n = 5, untreated small cell lung carcinoma). JM216 doses were 10 to 50 mg m-2 day-1 x 14 d (days) (dose escalation in PI) and 120 mg m-2 day-1 x 5d (fixed dose in PII), administered to fasted patients in a standardized way. Ptot and PtUF levels were determined by atomic absorption spectrometry on d1 and d14, followed over 28 days in PI; and on d1, followed over 5 days in PII. Pharmacokinetic parameters were derived by a noncompartmental approach. RESULTS: JM216 is rapidly absorbed with a Tmax obtained within 2.5-3 hours and 1-2 hours for Ptot and PtUF, respectively. The pharmacokinetics of JM216 was linear across the tested doses in PI, with the exposure of Ptot on d14 being better correlated with dose per BSA (Body surface area) (r = 0.91) than that of PtUF (r = 0.61). In PI, Cmax on d1 increased proportionally to the dose (r = 0.82 and r = 0.72 for Ptot and PtUF, respectively). Apparent clearances in PI were 1.1 +/- 0.5 L h-1 and 37.0 +/- 33 L h-1 for Ptot and PtUF, respectively. Prolonged terminal half-lives were observed after the last JM216 administration with mean values of 216 +/- 37 hours and 107 +/- 89 hours, for Ptot and PtUF respectively. The accumulation ratio (Cmaxd14/Cmaxd1) indicated a higher accumulation of Ptot (3.5 +/- 1.6) than of PtUF (1.8 +/- 1) under multiple dose regimen. The apparent volumes of distribution (terminal phase) were similar in the PI and PII studies: 326 +/- 112 L and 3094 +/- 1493 L, and 557 +/- 267 L and 4154 +/- 2147 L, for Ptot and PtUF, respectively. In PI, the nadir of thrombocytopenia was related both to the cumulated dose of JM216 (r = 0.81) and to the AUC of Ptot on d14 (r = 0.77), whereas the AUC of PtUF was not predictive (r = 0.48). The Cmax of Ptot and PtUF on d1 was related to neutropenia (r = 0.61 and r = 0.65, respectively) and to thrombocytopenia (r = 0.77 and r = 0.74, respectively). No relationships were found between leukocytes or neutrophils percent decrease and the AUCs or total, dose of JM216. CONCLUSION: JM216 is an orally bioavailable platinum-containing chemotherapeutic agent yielding predictable total levels of platinum which appears to accumulate in plasma after multiple administration over 14 days. These results should be set in relation to clinical efficacy and tolerance, to optimise the dose regimen of JM216 in further studies.

Administration, Oral↗