The impact of tele-expertise in oncology: current state and future perspectives

BackgroundTele-expertise, the asynchronous exchange of medical expertise via secured digital platforms, is revolutionizing healthcare delivery. By overcoming geographical and logistical barriers, it enables timely access to specialized care and supports multidisciplinary decision-making, particularly in oncology. Its adoption has accelerated with the COVID-19 pandemic and regulatory changes, improving patient outcomes by facilitating efficient diagnosis and treatment.Materials and methodsAn anaysis of peer-reviewed studies published in the past decade was conducted using PubMed, MEDLINE, and the Cochrane Library. The inclusion criteria focused on studies evaluating tele-expertise for remote consultations, imaging interpretation, pathology evaluation, and multidisciplinary tumor boards. Methodological quality, including study design, sample size, and reliability of outcomes, was assessed. Cross-referencing and manual searches were performed to ensure comprehensive coverage.ResultsThe review demonstrated that tele-expertise improves access to specialized consultations, enhances diagnostic accuracy, and expedites clinical decision-making. Applications in oncology include remote imaging interpretation and support for multidisciplinary teams. Challenges identified include the transmission of large imaging files, the need for secure and robust IT infrastructure, and training healthcare providers. Ethical considerations, such as data privacy and medical liability, remain key barriers.ConclusionTele-expertise is transforming healthcare by enabling equitable access to specialized care and fostering collaboration in oncology. Addressing challenges related to infrastructure, training, and ethical issues is critical to maximizing its potential. The integration of AI and further advancements in telemedicine platforms will enhance its role in delivering high-quality, timely care globally

Alterations in Homologous Recombination-Related Genes and Distinct Platinum Response in Metastatic Triple-Negative Breast Cancers: A Subgroup Analysis of the ProfiLER-01 Trial

International audienc

Evolution de la prise en charge thérapeutique du cancer colo-rectal métastatique (de la belladone à la pharmacogénomique : exemple de l'essai COLOGEN)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Jumeaux numériques : futur de la médecine personnalisée en cancérologie

International audienc

Small cell cancer of the bladder: The Leon-Berard cancer centre experience

Background: Small cell bladder carcinoma is an uncommon tumor. In this retrospective study we report our experience dealing with this disease at the Leon-Berard Cancer Centre. Materials and Methods: We retrospectively analyzed various characteristics of small cell bladder carcinoma: patient demographics, histological diagnosis, disease stage, treatment effects and outcome, in 14 non-metastatic small cell bladder carcinoma patients treated at our institution between 1995 and 2006. Results: The mean age at diagnosis was 60 years (range, 45-77). All patients were male. Seventy-five per cent were smokers. All had locally advanced disease. Ten patients (71.4%) were treated by cystoprostatectomy and bilateral pelvic lymph node resection, one by cystoprostatectomy alone. Two patients received neoadjuvant chemotherapy and four received adjuvant chemotherapy. One patient was treated by radiotherapy with concomitant cisplatin after transurethral resection of bladder tumor (TURBT). One patient refused surgery and was treated by chemotherapy alone. One patient was lost to follow-up after TURBT. After 49-month median follow-up, 12 patients had relapsed. Disease-free survival was 5.7 months. The most frequent sites of relapse were the retroperitoneal lymph node (seven patients) and the liver (three patients). Nine patients died of metastasis. Median overall survival was 29.5 months. Survival probability at two years was 58%. Median overall survival was 34 months in the mixed small carcinoma group, as compared with 9.5 months in the pure small cell carcinoma group (P=0.01). Mean overall survival was 27.2 months for all patients and 38.6 months for patients treated with cystectomy and adjuvant chemotherapy. Conclusion: To date, the optimal treatment for locally advanced small cell bladder carcinoma is not clear. Cystectomy with neoadjuvant or adjuvant chemotherapy appears as a viable option

Transmission of breast cancer polygenic risk based on single nucleotide polymorphisms

International audience"The goal of the present study was to further refine how polygenic risk scores may be used in a large population and to quantify the transmission of risk score through generations.