LAPATAX: A randomized phase II trial of FEC-docetaxel combined with lapatinib and/or trastuzumab as neoadjuvant therapy of HER2- positive breast cancer-EORTC 10054 trial.

Background: Patients with HER2 +ve breast cancer suitable for neoadjuvant chemotherapy (NAC) have been shown in a series of clinical trials to have the best outcome when treated with anthracyclines (A), taxanes (T), and trastuzumab (Tz). Recent evidence confirms that adjuvant Tz is more effective when given concomitantly rather than sequentially with T (Perez SABCS 2009). Whilst there remains uncertainty as to the most efficacious A-T regimen and duration of Tz, there is widespread use in Europe of FEC-D [3 cycles of 5-FU 500 mg/m2, epirubicin 100 mg/m2 and cyclophosphamide 500 mg/m2 (FEC100) followed by 3 cycles of docetaxel 100 mg/m2 (D) q3w] following the results of PACS-01. The advent of TKI anti-HER2 agents such as L could offer superior outcomes if combined with NAC. However, a phase I study in heavily pre-treated advanced breast cancer reported difficulties in combining lapatinib (L) with D 100 mg/m2 (LoRusso JCO 2008). Methods: EORTC 10054 is designed as a two-part study to compare FEC-D with either Tz, L or their combination as NAC for patients with HER2 +ve large operable or locally advanced breast cancer. Before and on-treatment frozen tumor and blood samples will be taken to better define which tumours are particularly sensitive to either Tz and/or L. Stage 1: (complete) a dose- finding study has confirmed that with primary prophylactic G-CSF, D 100 mg/m2 can be safely and effectively given with L 1,250 mg daily continuously. The dose-limiting toxicity was myelosuppression, and there was no significant diarrhoea or cardiac toxicity (ESMO 2009 abstr P- 5073). Stage 2: (opening Q1 2010) will enroll 150 patients from European centres into a 3-arm randomized trial whose primary endpoint is pathological complete response. All patients will receive FEC-D before primary surgery: 3 cycles of FEC (without anti-HER2 therapy) followed by 3 cycles of D plus either Tz (conventional weekly schedule), monotherapy L, or the combination of Tz and L, using doses based on the EGF100161 dose-finding study in 1st line metastatic therapy of D+L+Tz. After surgery all patients will receive standard 3-weekly Tz, radiotherapy and endocrine therapy as per local guidelines.

B1-insensitive T2 preparation for improved coronary magnetic resonance angiography at 3 T.

At 3 T, the effective wavelength of the RF field is comparable to the dimension of the human body, resulting in B1 standing wave effects and extra variations in phase. This effect is accompanied by an increase in B0 field inhomogeneity compared to 1.5 T. This combination results in nonuniform magnetization preparation by the composite MLEV weighted T2 preparation (T2 Prep) sequence used for coronary magnetic resonance angiography (MRA). A new adiabatic refocusing T2 Prep sequence is presented in which the magnetization is tipped into the transverse plane with a hard RF pulse and refocused using a pair of adiabatic fast-passage RF pulses. The isochromats are subsequently returned to the longitudinal axis using a hard RF pulse. Numerical simulations predict an excellent suppression of artifacts originating from B1 inhomogeneity while achieving good contrast enhancement between coronary arteries and surrounding tissue. This was confirmed by an in vivo study, in which coronary MR angiograms were obtained without a T2 Prep, with an MLEV weighted T2 Prep and the proposed adiabatic T2 Prep. Improved quantitative and qualitative coronary MRA image measurement was achieved using the adiabatic T2 Prep at 3 T.

Colombes, 17/2/20, France contre Pays de Galles [phase de jeu du match de rugby remporté par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58044

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58046

Colombes, 17/2/20, France contre Pays de Galles [phase de jeu du match de rugby remporté par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58050

Colombes, 17/2/20, France contre Pays de Galles [phase de jeu du match de rugby remporté par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58054

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58055

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58056

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58059

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58060

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58061

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58062

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58063

Colombes, 17/2/20, match France contre Pays de Galles [rugby, phase de jeu de la rencontre gagnée par Galles 6 à 5] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58065