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International audience; Introduction: Central Nervous System (CNS) Solitary Fibrous Tumor (SFT) / Hemangiopericytoma (HPC) is a fibroblastic mesenchymal tumor of the meninges that accounts for < 1% of intracranial tumours. The natural history of CNS SFT / HPC is characterized by a high rate of local (60%) and distant (20%) failure following gross total resection (GTR), and treatment options are limited. The identification of new genomic markers could be of interest to improve the understanding and management of CNS SFT / HPC. We present the results of a search for molecular alterations by next-generation sequencing (NGS) in a patient diagnosed with CNS SFT / HPC who experienced rapid distant failure. Case Description: A 64-year-old Caucasian man was diagnosed with a right hemisphere extra-axial frontal tumor after being referred for persistent headaches in October 2017. The patient underwent surgical resection followed by adjuvant radiation therapy of the operative cavity. A diagnosis of grade III HPC of the CNS was established. A diffuse metastatic recurrence with multiple bone lesions occurred rapidly after the initiation of radiation therapy. In July 2018, a CT-guided biopsy of the left iliac crest confirmed a highly proliferative metastatic recurrence and a FoundationOne CDx TM test was performed, which showed a somatic mutation of the tumor suppressor gene TP53 (Tumor Protein p53) (R175H). The microsatellite status was stable and the Tumor Mutational Burden (TMB) was low (1 Muts/Mb). A massive disease evolution of the disease occurred in September 2018. The patient died in November 2018 after neurological decline. Conclusion: This case report shows that an anatomopathological examination alone is insufficient to correctly classify these rare tumors and predict their aggressiveness. In this case report, the somatic mutation of TP53 (R175H) was associated with a very poor prognosis (survival of 13 months). Further studies including systematic NGS of CNS SFT / HPC are warranted to investigate the role of TP53 in prognostic assessment to adapt future treatment strategies.

Additional file 1: [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) procedures (adapted from AVATAXHER trial)

National audience; Weight change (gain or loss) is not uncommon in patients treated for breast cancer, especially when they receive chemotherapy. Weight changes observed during chemotherapy treatment performed before the 2000s, were associated with poor prognosis, but this relation is less found in more recent studies. Changes in body composition of women treated whith current chemotherapies remains to be determined. Post-treatment regular and moderate physical activity would reduce the risk of recurrence and mortality by 24-50%, both in obese and normal-weight women.

Background To evaluate the efficacy of continuous wound infiltration with ropivacaine to reduce acute postoperative pain in patients undergoing mastectomy for carcinoma of the breast. Materials and methods A randomized, double-blind, placebo-controlled trial was conducted. One hundred fifty patients were randomly assigned to receive continuous ropivacaine (0.2%) (group A, n = 74) or saline solution (0.9%) (group B, n = 76) at 10 mL/h for 48 h through a multilumen catheter placed during the surgical procedure. Postoperative morphine consumption and visual analog scale (VAS) pain scores were recorded. A quality of life score (Quality of life questionnaire Core 30) and a VAS score were obtained at 1, 3, and 6 mo after surgery. Results The difference in mean morphine consumption between the two groups was close to significance during the first 48 h postsurgery (P = 0.056; 10.8 ± 16.5 versus 4.8 ± 10.4 mg). At day 1, patients in the ropivacaine-infusion group had lower morphine consumption than the control group (P = 0.0026). The link between local ropivacaine infiltration and a decrease in mean postoperative VAS scores reached significance for the first 24 h postsurgery (P = 0.039). No significant difference was found between the two arms for VAS pain scores (P = 0.36) or for quality of life (overall QLQ-C30 score, P = 0.09) at 1, 3, or 6 mo. Conclusions Continuous wound infiltration with ropivacaine is efficacious in reducing postoperative pain. Quality of life and chronic pain at 1, 3, and 6 mo were not improved by ropivacaine wound infiltration.

BackgroundThe standard care for HER2-positive breast cancer is chemotherapy plus a HER2-directed therapy. This can lead to treatment-induced cardiotoxicity. On the other hand, the practice of physical activity is known to improve cardiac function; thus HER2-positive breast cancer patients could draw particular benefit from physical activity during treatment. However, at the time of diagnosis for breast cancer, the majority of patients are insufficiently active according to physical activity recommendations of World Health Organisation, and it is difficult to remain or become active during the treatment. There is a lack of data in the literature on the optimal program to propose to patients to encourage them to be active during treatment. The aim of our study is to assess the feasibility of a home-based physical activity program during neoadjuvant chemotherapy and trastuzumab for HER2-positive breast cancer.MethodsThe APACAN2 study is a single-centre, non-randomized interventional trial. Patients with HER2-positive breast cancer treated with anthracycline-based neoadjuvant chemotherapy and trastuzumab are eligible for enrolment. The supervised home-based physical activity program takes place during neoadjuvant chemotherapy (NACT). It combines aerobic and strengthening exercises. The primary endpoint is the proportion of patients reaching the international physical activity recommendations, i.e. 150 minutes of moderate-intensity activity per week at the end of NACT. The study started in April 2018 and seventy patients are expected to be recruited.DiscussionIn the literature, the majority of studies on practice of physical activity in breast cancer focus on adjuvant chemotherapy or on the period after the end of treatment. To the best of our knowledge, the APACAN2 study is the first to evaluate a home-based physical activity program during neoadjuvant chemotherapy for HER2-positive breast cancer.Trial Registration NumberClinicaltrials.gov: NCT02963363, registered on July 11, 2016. Identifier with the French National Agency for the Safety of Medicines and Health Products N°ID RCB 2016-A01344-47, registered in August 2016. Protocol: version 8, 24 February 2021.

Purpose The proportion of older populations living with cancer is on the increase. Maintaining or improving their quality of life (QoL) has become an important goal in the treatment of cancer and has become an endpoint in clinical trials. Melatonin regulates a wide variety of physiological functions and is involved in the initiation of sleep and the improvement of QoL. With age, the secretion of melatonin decreases and could lead to a deterioration in QoL. Methods Literature searches were conducted using the PubMed database. The search terms and derivatives of “metastatic cancer”, “older patients”, “quality of life” and “melatonin” were used. Titles and abstracts were screened to identify whether studies were relevant for full-text screening. Results There is major concern about the symptoms older cancer patients encounter during treatment because they can impact their QoL. Melatonin supplementation presents several benefits for older patients: improvement in survival, decrease in symptoms induced by cancer and cancer treatment, and also improvements in quality of life. Conclusion It therefore seems appropriate to study the impact of melatonin supplementation during cytotoxic therapy on QoL among elderly patients with metastatic cancer. The use of melatonin as a therapeutic strategy seems particularly suitable for elderly patients, a population known to secrete significantly less melatonin. However, to date, no studies have been conducted in this population.

Background A decrease in thermogenesis is suspected to be implicated in the energy expenditure reduction during breast cancer treatment. This study aimed to investigate the impact of chemotherapy on the metabolic activity of brown adipose tissue (BAT) and the link with weight variation. Methods This was an ancillary analysis of a multicentre trial involving 109 HER2+ breast cancer patients treated with neoadjuvant chemotherapy. A centralised review of 18F-FDG uptake intensity (SUVmax) in specific BAT regions (cervical and supraclavicular) was conducted on two PET-CT scans for each patient (before and after the first course of chemotherapy). Results Overall, after one course of chemotherapy a significant decrease of 4.4% in 18F-FDG-uptake intensity was observed. It was not correlated to initial BMI, age or season. During chemotherapy, 10.1% (n = 11) of the patients lost weight (− 7.7 kg ± 3.8 kg; ie, − 9.4% ± 3.7%) and 29.4% (n = 32) gained weight (+ 5.1 kg ± 1.7 kg; ie, + 8.5% ± 2.6%). Among these subgroups, only the patients who had gained weight underwent a significant decrease (13.42%) in 18F-FDG uptake intensity (p = 0.042). Conclusion This study is the first to highlight in a large cohort of patients the negative impact of chemotherapy on brown adipose tissue activity. Weight gain during chemotherapy could thus potentially be explained in part by a decrease in brown adipose tissue activity.