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Le melanome est une tumeur maligne des melanocytes (du grec melas qui signifie noir ou fonce et kytos qui signifie cellule). Il est le cancer cutane dont la frequence augmente le plus dans le monde [1]. Chaque annee, en France, 4 000 a 5 000 cas sont decouverts, 1 000 personnes en meurent. Le developpement du melanome semble lie a plusieurs facteurs de risque : phenotype clair, exposition intense au soleil et coups de soleils repetes au cours de l’enfance, augmentation du nombre de grains de beaute (naevus), presence d’un grain de beaute (naevus), changeant d’aspect, antecedents familiaux ainsi que l’âge. Cette tumeur, facilement curable lorsqu’elle est prise en charge a un stade precoce de la maladie, devient particulierement redoutable au stade metastatique [2].

Le cancer du sein est le plus frequent des cancers de la femme dans les pays occidentaux. En France, avec 42 000 nouveaux cas en 2000, il represente 36 % des cas de cancers feminins. Son incidence a augmente de 100 % entre 1980 et 2000, passant de 21 000 nouveaux cas en 1980 a 42 000 en 2000. Durant la meme periode, le nombre de deces a progresse de 35 % et, grâce aux progres des traitements, la mortalite s’est stabilisee, le taux de mortalite etait de 19,7/100 000 en 2000. Plus recemment, une amorce de diminution de la mortalite se dessine et devrait se poursuivre avec la generalisation du depistage. Le cancer du sein reste cependant au premier rang des causes de deces par cancer chez la femme, avec 11 637 deces observes en 2000, et 11 172 en 2002.

CT is a noninvasive technique that has a major role at each stage of the management of patients with suspected or known lung cancer: in diagnosis; in staging the extension of cancer before surgery or medical treatment; in evaluating the response to the treatment, and in detecting complications [1,2].

Today it is recommended that all patients with the suspicion of bladder, either because of an episode of hematuria or a previous bladder papilloma, be examined endoscopically. Conventional cystoscopy remains the mainstay for diagnosis, management and follow-up of urothelial tumors, and repeated surveillance cystoscopy examinations are requisites to assess disease control. Particularly in man, this clinical cystoscopy has its own drawbacks, including patient discomfort and relatively high cost. Generally, conventional cystoscopy is planned under general anesthesia, with antibiotic therapy and an overnight hospital stay. In order to avoid these requirements, a less invasive and costly method may be represented by virtual endoscopy or 3D CT endoscopy. 3D CT endoscopy is a new term used to describe computersimulated endoscopy procedures derived from thin section-CT of gas-filled or contrast enhanced hollow viscus of the human body, and has been widely applied to the paranasal sinuses, the upper respiratory tract, the tracheobronchial tree, the gastric and the colonic tubes, the vascular structures and more recently to the urinary tract and especially the bladder, in which carcinoma must be conceived as a focal expression of epithelial abnormalities that may be quite diffuse.

Real endoscopy by imaging calls upon magnetic resonance imaging using an intra-luminal receiver. This receiver acte as a miniature surface micro-surface coil connected to the entry of the MM like a classical surface coil.

Technical improvements in high resolution CT acquisition and fast imaging MR imaging, coupled with advanced 2D or 3D computer graphics, have permitted interactive 3D visualization in medical imaging.

S 9788 is a novel triazinoaminopiperidine derivative which does not belong to any of the classes of compounds known to reverse multidrug resistance (MDR) [1]. This compound showed to be particulary active in overcoming MDR both in vitro on 48 murine and human tumor cell lines (1 to 300 times more potent than Verapamil and 0.6 to 119 times more potent than Cyclosporin) and in vivo [2].

The ominous prognosis of metastatic malignant melanoma has led to a large number of clinical treatment trials [1, 2]. Some improvement in terms of response rate seems to have been achieved, but the main question asked by clinicians remains: is there a biological predictive factor for the therapeutic response to IL-2 therapy ? It is now well established that IL-2 plays a pivotal role in the immune response, both in its own receptor expression and other cytokine release. To exert its biological effect, IL-2 interacts with specific membrane receptors. Three types of IL-2 binding sites have been described: a 55 kD protein (α-chain, TAC) low-affinity receptor unable to deliver a signal to the cell, a 70 kD (β-chain) intermediate-affinity receptor which can transduce a signal and a high-affinity receptor made up of both the p 55 and p 70 molecules. More recently a third receptor has been cloned: 7-chain. Moreover, activated T cells release a truncated form of the γ-chain molecule as a soluble Interleukin-2 receptor (sIL-2R) [3, 4]. We report here the study of immunological events both cellular and humoral following CDDP, IL-2 and Interferon-α in 31 patients treated for malignant metastatic melanoma.

This text is devoted to the various problems raised by the medical treatment of cancer. It includes papers on the biology of metastases, angiogenesis, the mechanisms of resistance to chemotherapy, immunotherapy, growth factors, new drugs, long-term results of chemotherapy and much more.

The Colony Forming Units in the Spleen (CFU-S), pluripotent stem cells in mice, are normally quiescent and it has been demonstrated that they are therefore relatively protected from the toxicity of drugs until they are triggered into cycle through a feed-back mechanism [1]. The existence of low molecular weight endogenous negative regulators was demonstrated using dialysable fetal calf bone marrow extracts that are able to inhibit the entry into cell cycle of the CFU-S pluripotent stem-cells challenged by Cytarabine & varied stimulations [2]. Fetal calf bone marrow and liver extracts were proved, through multistep purification, to contain the tetrapeptide acetyl-SDKP. A myeloprotection from myelotoxic drugs was anticipated to occur, using acetyl-SDKP as preventing a proportion of the stem cell pool to be prompted into cycle and therefore to be destroyed by the next application of the cytotoxic drug [3, 4]. Acetyl-SDKP (INN = Seraspenide) has been identified as a small peptide (4 amino-acids = Acetyl-Ser-Asp-Lys-Pro = Acetyl SDKP) and synthesized [5]. It plays a physiological hemoregulatory role in mice as suggested for instance by the observation that the CFU-S are induced into cycle when mice are given anti-acSDKP monoclonal antibodies [6, 7, 8]. It has been isolated from human placenta and it is found in man, where it is particularly aboundant in lymphopoietic and hemopoietic organs [9].

Neo-Adjuvant chemotherapy in breast cancer means that chemotherapy is used as the first therapeutic tool and that the locoregional treatment is considered as an adjuvant. The term has been contested and others were proposed, but induction treatment is too specific for the first chemotherapy combination used in leukemia to achieve complete remission. Primary treatment does not encompass the consolidation phase which belongs to our strategy so that even if it is not quite satisfactory we keep the term Neo-Adjuvant which has been coined in the seventies by E. Frei for head and neck cancers.

Psychoneuroimmunology is a fast-growing field that explores the relationship of psychological factors and the immune system. In particular, much research has focussed on the impact of psychological events on immune parameters. An equally interesting but less studied situation, however, is the occurrence of psychological side effects after administration of immune substances in humans. In this regard, lymphokines could be of particular interest, since they are regularly used to treat certain cancers. One such substance is Interleukin-2 (IL-2), which is often infused in metastatic cancer patients at substantial doses over several days. Such infusions represent a unique, « quasi-experimental » opportunity to study the psychological side effects accompanying the lymphokine. However, IL-2 is rarely the sole therapeutic agent used in the cancer setting (Siegel & Puri, 1991). In particular, α-Interferon (INF) is often co-administered.

Over the past decade, with the important development of neo-adjuvant chemotherapy associating cisplatin and 5 FU (CF), a major change in the indication of chemotherapy in head and neck cancer has taken place. There is still an ongoing discussion regarding the results in term of survical. Despite these controversies, some facts appear to be obvious: prognosis is better for patients with complete clinical response (CCR); rate of CCR is better in small tumors (T1 – T2) than in large tumors (T3 – T4).

Fotemustine is a new 2-chloroethyl-nitrosourea in which 1-amino-ethyl phosphonic acid — a bioisostere of alanine — has been grafted into a nitrosourea radical and whose synthesis was guided by two objectives: to facilitate its cell penetration using active amino acid transport system and to achieve better passage through the blood brain barrier, the octanol-water partition coefficient being within the limits of the maximum antitumor activity as evaluated by structure activity relationship studies [1].

Hepatic metastasis is the most frequent site of treatment failure in cancer patients, reaching proportions over 50 % in the evolution of intra-abdominal tumors. Spontaneous survival, after the liver has been involved is very poor, from 2 to 6 months according to the number of metastasis and the origin of the primary tumor. Curative surgery is rarely possible, ranging from 10 to 25 % of cases mainly for solitary or very limited number of hepatic metastasis and has a 10 to 15 % post-operative mortality rate. Systemic chemotherapy, before Fluorouracil/Folinic acid combination, had a 10–15 % response rate which seems to have been improved more recently to 30–50 % with the modulation of fluoropyrimidines activity.

We present the result of a study on the interest of CT and MRI for the following of gynecologic cancer after treatment, compared with clinical, surgical and histological data.