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Resume Les cancers du penis sont rares, representes en grande majorite par le carcinome epidermoide, le virus HPV y est associe dans 30 a 40 % des cas. A un stade localement avance ou metastatique, la prise en charge de premiere ligne repose sur une polychimiotherapie a base de taxanes et de sels de platine. Le pronostic du cancer du penis avance ou metastatique reste sombre, la survie globale etant comprise entre 13,9 et 17,1 mois. Au-dela, les recommandations preconisent de facon heterogene des traitements de chimiotherapie ou des therapies ciblees anti-EGFR (epidermal growth factor receptor) dont les resultats, tout comme le niveau de preuve, sont limites. Une meilleure connaissance des voies oncogeniques impliquees dans le cancer du penis et une expression frequente de PD-L1 sont le rationnel pour l’elaboration de nouvelles strategies. Cette revue de la litterature presente les donnees, les recommandations et les etudes en cours dans le cancer du penis localement avance ou metastatique.

Until recently, the first-line treatments used in metastatic renal cell carcinoma were based on first-generation anti-VEGFR (vascular endothelial growth factor receptor) tyrosine kinase inhibitors (TKIs) as monotherapy. Trials combining immunotherapy (IO) (anti-CTLA4 + anti-PD-1) or immunotherapy with TKIs showed striking results in the first-line setting with improvement in overall response rates, progression-free survival and overall survival versus sunitinib. This allowed the combinations to gain registration in the US and Europe in the first-line advanced or metastatic clear-cell renal cell carcinoma setting. However, this improved activity comes at the cost of increased toxicity. Immunotherapy-related toxicities usually occur earlier within the first six months. With immunotherapy came a new range of toxicities making it more necessary to work with networks of specialists to better address autoimmune toxicity in particular. The safety profile is also impacted by the type of TKI used. In most cases, health-related quality of life (HRQoL) favours combinations over the comparator sunitinib. This article aims to review and assess the safety and HRQoL data on these new combinations.

The current COVID-19 pandemic is an exceptional health situation including for drug use. As there was no known effective drug for COVID-19 at the beginning of the pandemic, different candidates were proposed. In this short article, we present the French public pharmacovigilance activities during this health crisis. Although COVID-19 is a confounding factor per se, owing to its potential for multi-organ damage including the heart and kidney, the quality of the transmitted data in adverse drug reaction reports, the timeliness of feedback from clinicians, and the real-time pharmacological and medical analysis by the French network of the regional pharmacovigilance centers made it possible to swiftly identify relevant safety signals. The French National Agency of Medicine was thus able to validate the data and convey their findings very early. This decentralized organization based on medical and pharmacological evaluation of case reports has proven to be efficient and responsive in this unique and challenging healthcare emergency.

Penile cancers are rare, the vast majority is represented by squamous cell carcinoma, with HPV virus being found in 30 to 40% of cases. At a locally advanced or metastatic stage, first-line treatment relies on platinum and taxane based polychemotherapy. The prognosis for advanced or metastatic penile cancer remains poor, with overall survival ranging from 13.9 to 17.1 months. After the first line, guidelines recommend various chemotherapy treatments or targeted anti-EGFR therapies whose results as well as the level of evidence are limited. A better understanding of the oncogenic pathways involved in penile cancer and a frequent expression of PD-L1 are the rationale for the elaboration of new strategies. This review article presents the data, guidelines and ongoing studies in locally advanced or metastatic penile cancer.

Twice-daily check-up of the uterine contractions by the pregnant women is a recognized and accepted necessity. Using the "green" free-phone number to report the number of contractions, to answer the questions asked and to receive the instructions given has made it possible to reduce the prematurity rate and the duration of the consequent specific hospitalization. This new method of follow-up, applied to two identically recruited groups of pregnancies offers an undeniable low-cost improvement over the systems used previously.

The diagnosis of fetal infection, other than in association with premature rupture of the membranes, requires the evaluation of various parameters. Children suspected are four to five times greater in number than those truly threatened. A new and important parameter has emerged as a result of tocokinetic investigation: in one case out of two 48 hours before birth and in three cases out of four during the day before birth, fetal motility, together with cardiac reactivity or not, appear to be very markedly decreased when the newborn will in fact be found to be infected. Tocokinetic study is thus a new source of help in the obstetric/pediatric decisions which must be taken in this context.

The authors investigated the influence of Chlamydiae serology and the presence of a pelvic inflammatory state on the outcome of in-vitro fertilization on the basis of an analysis of 116 stimulation cycles. The study included 71 female patients suffering from infectious sterility of tubular origin with distal lesions. Chlamydiae trachomatis serology was considered to be positive at IgG titers in excess of 1/64. When the serum test was positive, there was a significant reduction in the number of clinical pregnancies and the cleavage rate. The percentage of ectopic pregnancies (6 ectopic pregnancies out of 29 clinical pregnancies) was very high, particularly if the serum test was positive and a pelvic inflammatory state persisting after antibiotic treatment contraindicated microsurgery. Surgery was performed only in favorable cases and did not appear to have any negative impact on the outcome. The presence of a non-stabilized pelvic infectious state was correlated with a significant increase in the drop-out rate and the number of post-menopausal gonadotropin required to achieve stimulation. The fact that unexpected spontaneous pregnancies may occur after an unsuccessful attempt must be taken into account when sterilization or salpingectomy are envisaged in an attempt to improve the outcome.