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Erb‐b2 receptor tyrosine kinase 2 (ERBB2)‐activating mutations are therapeutically actionable alterations found in various cancers, including metastatic breast cancer (MBC). We developed multiplex digital PCR assays to detect and quantify ERBB2 mutations in circulating tumor DNA from liquid biopsies. We studied the plasma from 272 patients with hormone‐receptor‐positive, human epidermal growth factor receptor 2‐negative (HR+/HER2−) MBC to detect 17 ERBB2 mutations using a screening assay. The assay was developed on the three‐color Crystal dPCR™ naica® platform with a two‐step strategy for precise mutation identification. We found that nine patients (3.3%) harbored at least one ERBB2 mutation. The mutation rate was higher in patients with lobular histology (5.9%) compared to invasive breast carcinoma of no special type (2.6%). A total of 12 mutations were found with the following frequencies: L755S (25.00%), V777L (25.00%), S310Y (16.67%), L869R (16.67%), S310F (8.33%), and D769H (8.33%). Matched tumor samples from six patients identified the same mutations with an 83% concordance rate. In summary, our highly sensitive multiplex digital PCR assays are well suited for plasma‐based monitoring of ERBB2 mutational status in patients with MBC.

Introduction: Recurrence of splenic volvulus after splenopexy in children is rare. A consensus on the optimal surgical strategy in splenic volvulus is lacking. Case Presentation: An 11-year-old female presented left upper quadrant abdominal pain for 24 hours following a short-lived appearance of an epigastric bulge. A CT-scan demonstrated findings consistent with splenic volvulus, without distal arterial flow. She underwent an exploratory laparoscopy, splenic detorsion, and splenopexy to the abdominal wall using two non-resorbable, knotless, unidirectional barbed sutures. The patient was discharged on day 2 after the procedure. A 6-month follow-up ultrasound showed a normally perfused spleen. Then months after the operation she presented with the same abdominal symptoms. A CT scan confirmed the recurrence of the splenic volvulus. She underwent a second laparoscopy, splenic detorsion, and splenopexy with a tailor-made mesh bag anchored to the abdominal wall. She recovered well from that operation. At 10 months of follow up she has had no recurrent of symptoms and the spleen is well vascularized by ultrasound. Conclusion: Simple splenopexy using direct sutures to abdominal wall may not be sufficient to create adequate adhesions and prevent recurrence. The use of a mesh may have a higher success rate.

À partir d’une série d’entretiens et d’un corpus de documents, l’article analyse la manière dont les professionnels qui produisent et promeuvent des souvenirs numériques mobilisent des discours éthiques pour défendre leurs produits à travers deux exemples : d’une part, celui de la construction des algorithmes qui sélectionnent les souvenirs et, d’autre part, celui de l’incitation au partage des souvenirs. Ces deux exemples permettent de mettre en évidence les ressorts matériels des positionnements éthiques adoptés par les professionnels des souvenirs numériques, qui fonctionnent comme des arguments de justification a posteriori. L’article se conclut en inscrivant ce travail symbolique de requalification de contraintes matérielles en positions éthiques dans les stratégies d’« ethics-washing » (Green, 2021) des industries de la tech.

Abstract Background The aims of the “médecin traitant” or referring physician (RP) reform, introduced in France in 2004, were to improve the organisation and quality of care and to allow for greater equity, particularly in terms of prevention. The objective of our study was to evaluate the effect of having a declared RP on the uptake of screening for breast and cervical cancers, and to explore the mechanisms involved. Methods We used an existing dataset of 1,072,289 women, which combines data from the Health Insurance information systems, with census data. We built multivariable logistic regression models to study the effect of having a RP on the uptake of mammography and pap smear, adjusted for age, socio-economic level, health status and healthcare provision. We secondarily added to this model the variable “having consulted a General Practitioner (GP) within the year”. Finally, we evaluated the interaction between the effect of having a referring physician and the area of residence (metropolitan/urban/rural). Results Patients who had a declared RP had a significantly higher uptake of mammography and pap smear than those who did not. The strength of the association was particularly important in very urban areas. The effect of having visited a GP seemed to explain a part of the correlation between having a RP and uptake of screening. Conclusions Lower rates of gynaecological screening among women without an RP compared to those with an RP may partly reflect a specific behaviour pattern in women less adherent to the health care system. However, this result also shows the importance of the RP, who assumes the key role of relaying public health information in a more personalised and adapted way.

Assez méconnues dans leur diversité, les procédures d’initiative populaire sont de plus en plus présentes dans les constitutions des États. Permettant aux citoyens d’être plus directement impliqués dans le processus normatif et dans le contrôle de l’activité de leurs représentants, de telles procédures tentent de répondre à la défiance citoyenne et de donner plus de légitimité à la manière dont fonctionnent les démocraties. Dans les travaux de recherche, elles sont généralement appréhendées à travers l’étude d’un système juridique en particulier ou d’un type de mécanisme. Ainsi, les procédures de référendum d’initiative populaire, appelées « initiatives populaires directes », ont tendance à mobiliser les commentaires de la doctrine et des médias en raison de leur visibilité et de la radicalité de certains sujets adoptés. Les initiatives populaires indirectes, ou d’agenda, sont beaucoup moins étudiées et pourtant sont souvent présentes à l’échelle nationale et même supranationale, à l’instar de l’Initiative citoyenne européenne. Les initiatives suspensives ou abrogatives sont également prévues dans certains États mais, à l’exception de l’Italie et de la Suisse, font l’objet de peu de commentaires. Les procédures révocatoires, permettant notamment d’éprouver les choix effectués par les élus ou leur probité au cours d’un mandat, font l’objet d’études qui restent souvent cantonnées aux États-Unis. L’intérêt de cette contribution est de proposer une typologie des différentes formes d’initiatives populaires pour témoigner de la richesse des mécanismes consacrés en droit constitutionnel. Même si beaucoup de ces initiatives échouent à atteindre leur objectif premier, elles peuvent contribuer à sensibiliser les élus aux effets de leurs choix et comportements et attirer l’attention de l’ensemble de la communauté politique sur certains sujets.

Abstract Background To promote improved coordination between general practice and hospital, the French clinical trial CREDO (“Concertation de REtour à DOmicile”) is testing an innovative experimental consultation for patients with metastatic cancer who are returning home. This consultation involves the patient, the patient’s referring GP (GPref) and a GP with specific skills in oncology (GPonc) in a specialized care center. The objective of our study is to explore the satisfaction of GPsref about this consultation, in the phase of interaction between GPonc and GPref. Methods This observational, cross-sectional, multicenter study explored the satisfaction of GPsref who had participated in this type of consultation, via a telephone survey. Results One Hundred GPsref responded to the questionnaire between April and September 2019 (overall response rate: 55%). 84.5% were satisfied with the consultation, and the majority were satisfied with its methods. Half of the GPsref learned new information during the consultation, three-quarters noted an impact on their practice, and 94.4% thought that this type of coordination between the GPref and the oncology specialist could improve general practice - hospital coordination. Conclusions For GPs, the CREDO consultation seems to be practical and effective in improving the coordination between general medicine and hospital. GPs would benefit from such coordination for all patients with cancer, several times during follow-up and at each occurrence of a medically significant event.

Background: Taxanes are one of the most effective chemotherapies (CT) in breast cancer (BC), but the efficacy of taxanes rechallenge in early metastatic relapse has been poorly studied in patients previously treated by taxanes in the (neo)adjuvant setting. Our study aimed to analyse the efficacy of taxane rechallenge in case of early metastatic relapse in a multicentre retrospective observational study compared with other chemotherapies. Methods: We analysed the French national ESME metastatic BC (MBC) database and selected HER2- MBC patients who received CT in first-line treatment for a metastatic relapse occurring 3–24 months after previous (neo)adjuvant taxanes treatment. Results: Of 23,501 female patients with MBC in ESME, 1057 met the selection criteria. 58.4% received a taxane-based regimen (75.4% concomitant bevacizumab) and 41.6% received other CT.In hormone-receptor positive (HR+)/HER2- MBC, multivariate analysis showed no difference in OS between taxanes without bevacizumab compared to other CT (HZR = 1.3 [0.97; 1.74], but taxanes was significantly associated with worse PFS (HZR = 1.48 [1.14; 1.93]).In TNBC, taxanes without bevacizumab and carboplatin/gemcitabine were not superior to other CT for OS (HZR = 1.07 [0.79; 1.44] and HZR = 0.81 [0.58; 1.13], respectively), while for PFS, taxanes was inferior (HZR = 1.33 [1.06–1.67]) and carboplatin plus gemcitabine was superior to other CT (HZR = 0.63 [0.46; 0.87]).For both subtypes, the worse outcome observed with paclitaxel was no longer observed with the addition of bevacizumab. Conclusions: With the limitation of retrospective design, taxanes rechallenge in early metastatic relapse of BC may result in a worse PFS in TNBC and HR+/HER2- MBC, which was not observed with the addition of bevacizumab.