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1. 6 months versus 12 months of adjuvant trastuzumab in early breast cancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial

Author

Piprot, C, Cals, L, Chaigneau, L, Demarchi, F, N'Guyen, T, Stein, U, Villanueva, C, Bréau, JL, Chouahnia, AK, Saintigny, P, Boué, F, deSaint-Hilaire, P, Guimont, I, Grossat, N, Valenza, B, Lévy, E, Médioni, J, Delbaldo, C, Grenier, J, Pouessel, D, Lavau-Denès, S, Falandry, C, Fournel-Fédérico, C, Freyer, G, Tartas, S, Trillet-Lenoir, V, Bons, F, Auclerc, G, Chièze, S, Raban, N, Tournigand, C, Trager-Maury, S, Bousquet, G, Cuvier, C, Giacchetti, S, Hocini, A, LeMaignan, C, Misset, JL, Avenin, D, Beerblock, C, Gligorov, J, Rivera, P, Roché, H, Bougnoux, P, Hajjaji, N, Capitain, O, Delva, R, Maillart, P, Soulié, P, Bonnefoi, H, Durand, M, Madranges, N, Mauriac, L, Chollet, P, Dillies, AF, Durando, X, Ferrière, JP, Mouret-Reynier, C, Nabholtz, JM, Van Praagh, I, Cottu, P, Diéras, V, Durieux, A, Galotte, M, Girre, V, Henry, S, Iurisci, I, Jouve, M, Laurence, V, Mignot, L, Piperno-Neumann, S, Tresca, P, Coudert, B, Ferrant, E, Mayer, F, Vanneuville, AC, Bonneterre, J, Servent, V, Vanlemmens, L, Vennin, P, Guastalla, JP, Biron, P, Dupuy-Brousseau, L, Lancry, L, Ray-Coquard, I, Rebattu, P, Trédan, O, Extra, JM, Rousseau, F, Tarpin, C, Fabbro, M, Luporsi, E, Uwer, L, Weber, B, Berton-Rigaud, D, Bourbouloux, E, Campone, M, Ferrero, JM, Follana, P, Largillier, R, Mari, V, Costa, B, Curé, H, Eymard, JC, Jovenin, N, Lebrun, D, Meunier, J, Yazbek, G, Gedoin, D, Laguerre, B, Lefeuvre, C, Vauléon, E, Chevrier, A, Guillemet, C, Leheurteur, M, Rigal, O, Tennevet, I, Veyret, C, Brain, E, Guiterrez, M, Mefti-Lacheraf, F, Petit, T, Dalenc, F, Gladieff, L, André, F, Delaloge, S, Domont, J, Ezenfis, J, Spielmann, M, Guillet, P, Boulanger, V, Provençal, J, Stefani, L, Alliot, C, Ré, D, Bellaiche-Miccio, C, Boutan-Laroze, G, Vanica, R, Dion, P, Sadki-Benaoudia, G, Marti, A, Villing, AL, Slama, B, Dutel, JL, Nguyen, S, Saad, R, Arsène, O, Merad-Boudia, Z, Orfeuvre, H, Egreteau, J, Goudier, MJ, Lamy, R, Leduc, B, Sarda, C, Salles, B, Agostini, C, Cauvin, I, Dufresne, A, Mangold, M, Lebouvier-Sadot, S, Audhuy, B, Barats, JC, Cluet-Dennetière, S, Zylberait, D, Netter, G, Gautier-Felizot, L, Cojean-Zelek, I, Plantade, A, Vignot, S, Guardiola, E, Marti, P, deHartingh, I, Diab, R, Dietmann, A, Ruck, S, Portois, C, Oddou-Lagranière, S, Campos-Gazeau, F, Bourcier, A, Priou, F, Geay, JF, Mayeur, D, Gabez, P, ElAmarti, R, Combe, M, Raichon-Patru, P, Amsalhem, P, Dauba, J, Paraiso, D, Guinet, F, Duvert, B, Litor, M, Kara-Slimane, F, Bichoffe, A, Denizon, N, Soyer, P, Morvan, F, Van-Hulst, S, Vincent, L, Alleaume, C, Ibanez-Martin, P, Youssef, A, Tadrist, Z, Carola, E, Pourny, C, Toccanier, JF, Al-Aukla, N, Mahour-Bacha, K, Salvat, J, Nouyrigat, P, Clippe, S, Gouttebel, MC, Vedrine, L, Clavreul, G, Collard, O, Mille, D, Goubely, Y, Hervé, R, Kirscher, S, Plat, F, Delecroix, V, Ligeza-Poisson, V, Coeffic, D, Fric, D, Garnier, C, Leyronnas, C, Kreitman, T, Teissier, E, Martin, P, Rohart deCordoue, S, ElKouri, C, Ramée, JF, Laporte, C, Bernard, O, Altwegg, T, Darut-Jouve, A, Dujols, JP, Darloy, F, Giraud, C, Pottier-Kyndt, V, Achour, N, Drony, S, Moriceau, M, Sarrazin, C, Legueul, JC, Mandet, J, Besson, D, Hardy-Bessard, AC, Cretin, J, Houyau, P, Achille, E, Genêt, D, Thévenot, H, Moran-Ribon, A, Pavlovitch, JM, Ardisson, P, Moullet, I, Couderc, B, Fichet, V, Burki, F, Auliard, A, Levaché, CB, Cailleux, P, Schaeffer, F, Albin, N, Sévin-Robiche, D, Domas, J, Ellis, S, Montcuquet, P, Baumont, GA, Bégue, M, Gréget, S, Ratoanina, JL, Vanoli, A, Bielsa, C, Bonichon-Lamichhane, M, Jaubert, D, Laharie-Mineur, H, Alcaraz, L, Legouffe, E, Bourgeois, H, Cartron, G, Denis, F, Dupuis, O, Ganem, G, Roche-Forestier, S, Delzenne, L, Chirat, E, Baticle, JL, Béguier, E, Jacquot, S, Janssen, E, Lauché, H, LeRol, A, Chantelard, JP, L'Helgoualc'h, GA, Antoine, EC, Kanoui, A, Llory, JF, Vannetzel, JM, Vignoud, J, Bruna, C, Facchini, T, Moutel-Corviole, K, Voloch, A, Ghoul, A, Loiseau, D, Barbet, N, Dohollou, N, Yakendji, K, Pivot, Xavier, Romieu, Gilles, Debled, Marc, Pierga, Jean-Yves, Kerbrat, Pierre, Bachelot, Thomas, Lortholary, Alain, Espié, Marc, Fumoleau, Pierre, Serin, Daniel, Jacquin, Jean-Philippe, Jouannaud, Christelle, Rios, Maria, Abadie-Lacourtoisie, Sophie, Venat-Bouvet, Laurence, Cany, Laurent, Catala, Stéphanie, Khayat, David, Gambotti, Laetitia, Pauporté, Iris, Faure-Mercier, Celine, Paget-Bailly, Sophie, Henriques, Julie, and Grouin, Jean Marie

Published
2019
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3. 6 months versus 12 months of adjuvant trastuzumab in early breast cancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial

Author

Xavier Pivot, Gilles Romieu, Marc Debled, Jean-Yves Pierga, Pierre Kerbrat, Thomas Bachelot, Alain Lortholary, Marc Espié, Pierre Fumoleau, Daniel Serin, Jean-Philippe Jacquin, Christelle Jouannaud, Maria Rios, Sophie Abadie-Lacourtoisie, Laurence Venat-Bouvet, Laurent Cany, Stéphanie Catala, David Khayat, Laetitia Gambotti, Iris Pauporté, Celine Faure-Mercier, Sophie Paget-Bailly, Julie Henriques, Jean Marie Grouin, C Piprot, L Cals, L Chaigneau, F Demarchi, T N'Guyen, U Stein, C Villanueva, JL Bréau, AK Chouahnia, P Saintigny, F Boué, P deSaint-Hilaire, I Guimont, N Grossat, B Valenza, E Lévy, J Médioni, C Delbaldo, J Grenier, D Pouessel, S Lavau-Denès, C Falandry, C Fournel-Fédérico, G Freyer, S Tartas, V Trillet-Lenoir, F Bons, G Auclerc, S Chièze, N Raban, C Tournigand, S Trager-Maury, G Bousquet, C Cuvier, S Giacchetti, A Hocini, C LeMaignan, JL Misset, D Avenin, C Beerblock, J Gligorov, P Rivera, H Roché, P Bougnoux, N Hajjaji, O Capitain, R Delva, P Maillart, P Soulié, H Bonnefoi, M Durand, N Madranges, L Mauriac, P Chollet, AF Dillies, X Durando, JP Ferrière, C Mouret-Reynier, JM Nabholtz, I Van Praagh, P Cottu, V Diéras, A Durieux, M Galotte, V Girre, S Henry, I Iurisci, M Jouve, V Laurence, L Mignot, S Piperno-Neumann, P Tresca, B Coudert, E Ferrant, F Mayer, AC Vanneuville, J Bonneterre, V Servent, L Vanlemmens, P Vennin, JP Guastalla, P Biron, L Dupuy-Brousseau, L Lancry, I Ray-Coquard, P Rebattu, O Trédan, JM Extra, F Rousseau, C Tarpin, M Fabbro, E Luporsi, L Uwer, B Weber, D Berton-Rigaud, E Bourbouloux, M Campone, JM Ferrero, P Follana, R Largillier, V Mari, B Costa, H Curé, JC Eymard, N Jovenin, D Lebrun, J Meunier, G Yazbek, D Gedoin, B Laguerre, C Lefeuvre, E Vauléon, A Chevrier, C Guillemet, M Leheurteur, O Rigal, I Tennevet, C Veyret, E Brain, M Guiterrez, F Mefti-Lacheraf, T Petit, F Dalenc, L Gladieff, F André, S Delaloge, J Domont, J Ezenfis, M Spielmann, P Guillet, V Boulanger, J Provençal, L Stefani, C Alliot, D Ré, C Bellaiche-Miccio, G Boutan-Laroze, R Vanica, P Dion, G Sadki-Benaoudia, A Marti, AL Villing, B Slama, JL Dutel, S Nguyen, R Saad, O Arsène, Z Merad-Boudia, H Orfeuvre, J Egreteau, MJ Goudier, R Lamy, B Leduc, C Sarda, B Salles, C Agostini, I Cauvin, A Dufresne, M Mangold, S Lebouvier-Sadot, B Audhuy, JC Barats, S Cluet-Dennetière, D Zylberait, G Netter, L Gautier-Felizot, I Cojean-Zelek, A Plantade, S Vignot, E Guardiola, P Marti, I deHartingh, R Diab, A Dietmann, S Ruck, C Portois, S Oddou-Lagranière, F Campos-Gazeau, A Bourcier, F Priou, JF Geay, D Mayeur, P Gabez, R ElAmarti, M Combe, P Raichon-Patru, P Amsalhem, J Dauba, D Paraiso, F Guinet, B Duvert, M Litor, F Kara-Slimane, A Bichoffe, N Denizon, P Soyer, F Morvan, S Van-Hulst, L Vincent, C Alleaume, P Ibanez-Martin, A Youssef, Z Tadrist, E Carola, C Pourny, JF Toccanier, N Al-Aukla, K Mahour-Bacha, J Salvat, P Nouyrigat, S Clippe, MC Gouttebel, L Vedrine, G Clavreul, O Collard, D Mille, Y Goubely, R Hervé, S Kirscher, F Plat, V Delecroix, V Ligeza-Poisson, D Coeffic, D Fric, C Garnier, C Leyronnas, T Kreitman, E Teissier, P Martin, S Rohart deCordoue, C ElKouri, JF Ramée, C Laporte, O Bernard, T Altwegg, A Darut-Jouve, JP Dujols, F Darloy, C Giraud, V Pottier-Kyndt, N Achour, S Drony, M Moriceau, C Sarrazin, JC Legueul, J Mandet, D Besson, AC Hardy-Bessard, J Cretin, P Houyau, E Achille, D Genêt, H Thévenot, A Moran-Ribon, JM Pavlovitch, P Ardisson, I Moullet, B Couderc, V Fichet, F Burki, A Auliard, CB Levaché, P Cailleux, F Schaeffer, N Albin, D Sévin-Robiche, J Domas, S Ellis, P Montcuquet, GA Baumont, M Bégue, S Gréget, JL Ratoanina, A Vanoli, C Bielsa, M Bonichon-Lamichhane, D Jaubert, H Laharie-Mineur, L Alcaraz, E Legouffe, H Bourgeois, G Cartron, F Denis, O Dupuis, G Ganem, S Roche-Forestier, L Delzenne, E Chirat, JL Baticle, E Béguier, S Jacquot, E Janssen, H Lauché, A LeRol, JP Chantelard, GA L'Helgoualc'h, EC Antoine, A Kanoui, JF Llory, JM Vannetzel, J Vignoud, C Bruna, T Facchini, K Moutel-Corviole, A Voloch, A Ghoul, D Loiseau, N Barbet, N Dohollou, and K Yakendji

Subjects
Adult, medicine.medical_specialty, Receptor, ErbB-2, Population, Breast Neoplasms, 030204 cardiovascular system & hematology, Drug Administration Schedule, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Breast cancer, Antineoplastic Agents, Immunological, Randomized controlled trial, Trastuzumab, law, Internal medicine, medicine, Adjuvant therapy, Humans, 030212 general & internal medicine, skin and connective tissue diseases, education, Infusions, Intravenous, Aged, education.field_of_study, business.industry, Hazard ratio, General Medicine, Middle Aged, Interim analysis, medicine.disease, Survival Analysis, Treatment Outcome, Chemotherapy, Adjuvant, Concomitant, Female, France, business, medicine.drug
Abstract

Summary Background In 2013, the interim analysis of the Protocol for Herceptin as Adjuvant therapy with Reduced Exposure (PHARE) trial could not show that 6 months of adjuvant trastuzumab was non-inferior to 12 months. Here, we report the planned final analysis based on the prespecified number of occurring events. Methods PHARE is an open-label, phase 3, non-inferiority randomised trial of patients with HER2-positive early breast cancer comparing 6 months versus 12 months of trastuzumab treatment concomitant with or following standard neoadjuvant or adjuvant chemotherapy. The study was undertaken in 156 centres in France. Eligible patients were women aged 18 years or older with non-metastatic, operable, histologically confirmed adenocarcinoma of the breast and either positive axillary nodes or negative axillary nodes but a tumour of at least 10 mm. Participants must have received at least four cycles of a chemotherapy for this breast cancer and have started receiving adjuvant trastuzumab-treatment. Eligible patients were randomly assigned to either 6 months or 12 months of trastuzumab therapy duration between the third and sixth months of adjuvant trastuzumab. The randomisation was stratified by concomitant or sequential treatment with chemotherapy, oestrogen receptor status, and centre. The primary objective was non-inferiority in the intention-to-treat population in the 6-month group in terms of disease-free survival with a prespecified hazard margin of 1·15. This trial is registered with ClinicalTrials.gov, number NCT00381901. Findings 3384 patients were enrolled and randomly assigned to either 12 months (n=1691) or 6 months (n=1693) of adjuvant trastuzumab. One patient in the 12-month group and three patients in the 6-month group were excluded, so 1690 patients in each group were included in the intention-to-treat analysis. At a median follow-up of 7·5 years (IQR 5·3–8·8), 704 events relevant to disease-free survival were observed (345 [20·4%] in the 12-month group and 359 [21·2%] in the 6-month group). The adjusted hazard ratio for disease-free survival in the 12-month group versus the 6-month group was 1·08 (95% CI 0·93–1·25; p=0·39). The non-inferiority margin was included in the 95% CI. No differences in effects pertaining to trastuzumab duration were found in any of the subgroups. After the completion of trastuzumab treatment, rare adverse events occurred over time and the safety analysis remained similar to the previously published report. In particular, we found no change in the cardiac safety comparison, and only three additional cases in which the left ventricular ejection fraction decreased to less than 50% have been reported in the 12-month group. Interpretation The PHARE study did not show the non-inferiority of 6 months versus 12 months of adjuvant trastuzumab. Hence, adjuvant trastuzumab standard duration should remain 12 months. Funding The French National Cancer Institute.

Published
2019

4. 6 months versus 12 months of adjuvant trastuzumab in early breast cancer (PHARE): final analysis of a multicentre, open-label, phase 3 randomised trial

Author

Pivot, Xavier, primary, Romieu, Gilles, additional, Debled, Marc, additional, Pierga, Jean-Yves, additional, Kerbrat, Pierre, additional, Bachelot, Thomas, additional, Lortholary, Alain, additional, Espié, Marc, additional, Fumoleau, Pierre, additional, Serin, Daniel, additional, Jacquin, Jean-Philippe, additional, Jouannaud, Christelle, additional, Rios, Maria, additional, Abadie-Lacourtoisie, Sophie, additional, Venat-Bouvet, Laurence, additional, Cany, Laurent, additional, Catala, Stéphanie, additional, Khayat, David, additional, Gambotti, Laetitia, additional, Pauporté, Iris, additional, Faure-Mercier, Celine, additional, Paget-Bailly, Sophie, additional, Henriques, Julie, additional, Grouin, Jean Marie, additional, Piprot, C, additional, Cals, L, additional, Chaigneau, L, additional, Demarchi, F, additional, N'Guyen, T, additional, Stein, U, additional, Villanueva, C, additional, Bréau, JL, additional, Chouahnia, AK, additional, Saintigny, P, additional, Boué, F, additional, deSaint-Hilaire, P, additional, Guimont, I, additional, Grossat, N, additional, Valenza, B, additional, Lévy, E, additional, Médioni, J, additional, Delbaldo, C, additional, Grenier, J, additional, Pouessel, D, additional, Lavau-Denès, S, additional, Falandry, C, additional, Fournel-Fédérico, C, additional, Freyer, G, additional, Tartas, S, additional, Trillet-Lenoir, V, additional, Bons, F, additional, Auclerc, G, additional, Chièze, S, additional, Raban, N, additional, Tournigand, C, additional, Trager-Maury, S, additional, Bousquet, G, additional, Cuvier, C, additional, Giacchetti, S, additional, Hocini, A, additional, LeMaignan, C, additional, Misset, JL, additional, Avenin, D, additional, Beerblock, C, additional, Gligorov, J, additional, Rivera, P, additional, Roché, H, additional, Bougnoux, P, additional, Hajjaji, N, additional, Capitain, O, additional, Delva, R, additional, Maillart, P, additional, Soulié, P, additional, Bonnefoi, H, additional, Durand, M, additional, Madranges, N, additional, Mauriac, L, additional, Chollet, P, additional, Dillies, AF, additional, Durando, X, additional, Ferrière, JP, additional, Mouret-Reynier, C, additional, Nabholtz, JM, additional, Van Praagh, I, additional, Cottu, P, additional, Diéras, V, additional, Durieux, A, additional, Galotte, M, additional, Girre, V, additional, Henry, S, additional, Iurisci, I, additional, Jouve, M, additional, Laurence, V, additional, Mignot, L, additional, Piperno-Neumann, S, additional, Tresca, P, additional, Coudert, B, additional, Ferrant, E, additional, Mayer, F, additional, Vanneuville, AC, additional, Bonneterre, J, additional, Servent, V, additional, Vanlemmens, L, additional, Vennin, P, additional, Guastalla, JP, additional, Biron, P, additional, Dupuy-Brousseau, L, additional, Lancry, L, additional, Ray-Coquard, I, additional, Rebattu, P, additional, Trédan, O, additional, Extra, JM, additional, Rousseau, F, additional, Tarpin, C, additional, Fabbro, M, additional, Luporsi, E, additional, Uwer, L, additional, Weber, B, additional, Berton-Rigaud, D, additional, Bourbouloux, E, additional, Campone, M, additional, Ferrero, JM, additional, Follana, P, additional, Largillier, R, additional, Mari, V, additional, Costa, B, additional, Curé, H, additional, Eymard, JC, additional, Jovenin, N, additional, Lebrun, D, additional, Meunier, J, additional, Yazbek, G, additional, Gedoin, D, additional, Laguerre, B, additional, Lefeuvre, C, additional, Vauléon, E, additional, Chevrier, A, additional, Guillemet, C, additional, Leheurteur, M, additional, Rigal, O, additional, Tennevet, I, additional, Veyret, C, additional, Brain, E, additional, Guiterrez, M, additional, Mefti-Lacheraf, F, additional, Petit, T, additional, Dalenc, F, additional, Gladieff, L, additional, André, F, additional, Delaloge, S, additional, Domont, J, additional, Ezenfis, J, additional, Spielmann, M, additional, Guillet, P, additional, Boulanger, V, additional, Provençal, J, additional, Stefani, L, additional, Alliot, C, additional, Ré, D, additional, Bellaiche-Miccio, C, additional, Boutan-Laroze, G, additional, Vanica, R, additional, Dion, P, additional, Sadki-Benaoudia, G, additional, Marti, A, additional, Villing, AL, additional, Slama, B, additional, Dutel, JL, additional, Nguyen, S, additional, Saad, R, additional, Arsène, O, additional, Merad-Boudia, Z, additional, Orfeuvre, H, additional, Egreteau, J, additional, Goudier, MJ, additional, Lamy, R, additional, Leduc, B, additional, Sarda, C, additional, Salles, B, additional, Agostini, C, additional, Cauvin, I, additional, Dufresne, A, additional, Mangold, M, additional, Lebouvier-Sadot, S, additional, Audhuy, B, additional, Barats, JC, additional, Cluet-Dennetière, S, additional, Zylberait, D, additional, Netter, G, additional, Gautier-Felizot, L, additional, Cojean-Zelek, I, additional, Plantade, A, additional, Vignot, S, additional, Guardiola, E, additional, Marti, P, additional, deHartingh, I, additional, Diab, R, additional, Dietmann, A, additional, Ruck, S, additional, Portois, C, additional, Oddou-Lagranière, S, additional, Campos-Gazeau, F, additional, Bourcier, A, additional, Priou, F, additional, Geay, JF, additional, Mayeur, D, additional, Gabez, P, additional, ElAmarti, R, additional, Combe, M, additional, Raichon-Patru, P, additional, Amsalhem, P, additional, Dauba, J, additional, Paraiso, D, additional, Guinet, F, additional, Duvert, B, additional, Litor, M, additional, Kara-Slimane, F, additional, Bichoffe, A, additional, Denizon, N, additional, Soyer, P, additional, Morvan, F, additional, Van-Hulst, S, additional, Vincent, L, additional, Alleaume, C, additional, Ibanez-Martin, P, additional, Youssef, A, additional, Tadrist, Z, additional, Carola, E, additional, Pourny, C, additional, Toccanier, JF, additional, Al-Aukla, N, additional, Mahour-Bacha, K, additional, Salvat, J, additional, Nouyrigat, P, additional, Clippe, S, additional, Gouttebel, MC, additional, Vedrine, L, additional, Clavreul, G, additional, Collard, O, additional, Mille, D, additional, Goubely, Y, additional, Hervé, R, additional, Kirscher, S, additional, Plat, F, additional, Delecroix, V, additional, Ligeza-Poisson, V, additional, Coeffic, D, additional, Fric, D, additional, Garnier, C, additional, Leyronnas, C, additional, Kreitman, T, additional, Teissier, E, additional, Martin, P, additional, Rohart deCordoue, S, additional, ElKouri, C, additional, Ramée, JF, additional, Laporte, C, additional, Bernard, O, additional, Altwegg, T, additional, Darut-Jouve, A, additional, Dujols, JP, additional, Darloy, F, additional, Giraud, C, additional, Pottier-Kyndt, V, additional, Achour, N, additional, Drony, S, additional, Moriceau, M, additional, Sarrazin, C, additional, Legueul, JC, additional, Mandet, J, additional, Besson, D, additional, Hardy-Bessard, AC, additional, Cretin, J, additional, Houyau, P, additional, Achille, E, additional, Genêt, D, additional, Thévenot, H, additional, Moran-Ribon, A, additional, Pavlovitch, JM, additional, Ardisson, P, additional, Moullet, I, additional, Couderc, B, additional, Fichet, V, additional, Burki, F, additional, Auliard, A, additional, Levaché, CB, additional, Cailleux, P, additional, Schaeffer, F, additional, Albin, N, additional, Sévin-Robiche, D, additional, Domas, J, additional, Ellis, S, additional, Montcuquet, P, additional, Baumont, GA, additional, Bégue, M, additional, Gréget, S, additional, Ratoanina, JL, additional, Vanoli, A, additional, Bielsa, C, additional, Bonichon-Lamichhane, M, additional, Jaubert, D, additional, Laharie-Mineur, H, additional, Alcaraz, L, additional, Legouffe, E, additional, Bourgeois, H, additional, Cartron, G, additional, Denis, F, additional, Dupuis, O, additional, Ganem, G, additional, Roche-Forestier, S, additional, Delzenne, L, additional, Chirat, E, additional, Baticle, JL, additional, Béguier, E, additional, Jacquot, S, additional, Janssen, E, additional, Lauché, H, additional, LeRol, A, additional, Chantelard, JP, additional, L'Helgoualc'h, GA, additional, Antoine, EC, additional, Kanoui, A, additional, Llory, JF, additional, Vannetzel, JM, additional, Vignoud, J, additional, Bruna, C, additional, Facchini, T, additional, Moutel-Corviole, K, additional, Voloch, A, additional, Ghoul, A, additional, Loiseau, D, additional, Barbet, N, additional, Dohollou, N, additional, and Yakendji, K, additional

Published
2019
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6. [Intracardiac metastasis of hepatocellular carcinoma: a case report]

Author

Philippe, Garrigues, Guillaume, Wartel, Marie-Hélène, Tugler, Annick, Lerol, Dominique, De Zuttere, and Dominique Champetier, de Ribes

Subjects
Diagnosis, Differential, Heart Neoplasms, Male, Carcinoma, Hepatocellular, Echocardiography, Heart Ventricles, Liver Neoplasms, Disease Progression, Heart Septum, Humans, Middle Aged, Tomography, X-Ray Computed
Published
2008

7. Development of a sterile cold-smoked fish model

Author

Jean-Jacques Joffraud, Frédérique Chevalier, and F. Lerol

Subjects
biology, Trout, Food spoilage, Food preservation, Sterilization, General Medicine, Contamination, Sterilization (microbiology), biology.organism_classification, Applied Microbiology and Biotechnology, Sensory analysis, food.food, Smoked salmon, Cold Temperature, Smoked fish, food, Salmon, Food Preservation, Radiation, Ionizing, Animals, Food science, Biotechnology
Abstract

It is difficult to create a successful sterile cold-smoked fish model, particularly when very fresh fish are not readily available. This study tested a low-dose ionization technique (1.5 and 3.0 kGy) as a means of eliminating residual flora and ensuring sterility without altering sensory qualities. Ionized cold-smoked salmon displayed no bacterial contamination during an 11 week storage period and was not considered as spoiled by a sensory panel. In comparison, non-ionized smoked salmon, although aseptically processed, contained a bacterial flora responsible for its spoilage. This model allows assessment of the spoilage potential or activity of isolated bacterial strains as well as independent studies of bacterial and non-bacterial reactions in cold-smoked fish.

Published
1999

11. 'DON'T MIX RACE WITH THE SPECIALTY': INTERVIEWING SOUTH ASIAN OVERSEAS- TRAINED GERIATRICIANS.

Author

Bornat, Joanna, Henry, Lerol, and Raghuram, Parvati

Subjects
SOUTH Asians, GERIATRICIANS, FOREIGN workers, ORAL history, INTERVIEWING
Abstract

The words quoted in the title, 'Don't mix with race with the specialty' were used by a senior South Asian geriatrician, one of over thirty South Asian overseas doctors interviewed during a research project on the experiences of South Asian geriatricians in the UK. These words present us with a quandary: how to understand accounts of career progression that ascribe the limitations to their status as elite migrants to the discipline in which they specialised rather than the much vaunted issue of racism within the NHS. This variation from what we expected to hear poses a challenge to analysis of oral history data. The article deals with the quandary in three ways. First it looks at the experience of the multiplicity of differences which this group of migrant doctors recounts. It then shifts to focus on how, within their interviews the experience of racism, is recounted and to what extent it is identified, silenced or subsumed. Finally, the article offers a three-layered analysis of the ways in which these interviews provide insights into how the dilemma presented by a sensitive topic such as race is managed and indeed created in the interview dialogue by migrants occupying an elite status. [ABSTRACT FROM AUTHOR]

Published
2009

12. Access To Specialty Care And Medical Services In Community Health Centers.

Author

Cook, Nakela L., Hicks, Lerol S., O'Malley, A. James, Keegan, Thomas, Guadagnoli, Edward, and Landon, Bruce E.

Subjects
*PUBLIC health, *COMMUNITY health services, *MEDICAL care of poor people, *PRIMARY health care, *MEDICAL personnel, *MEDICALLY uninsured persons, *SURVEYS, *MEDICARE
Abstract

Although community health centers (CHCs) provide primary health services to the medically underserved and poor, limited access to off-site specialty services may lead to poorer outcomes among underinsured CHC patients. This study evaluates access to specialty health services for patients receiving care in CHCs, using a survey of medical directors of all federally qualified CHCs in the United States in 2004. Respondents reported that uninsured patients had greater difficulty obtaining access to off-site specialty services, including referrals and diagnostic testing, than did patients with Medicaid, Medicare, or private insurance. [ABSTRACT FROM AUTHOR]

Published
2007
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13. Accurate Measurement of Activity Coefficient at Infinite Dilution by Inert Gas Stripping and Gas Chromatography

Author

H. Renon, Jean-Francois Fabries, Jean-Claude Masson, Henri Sannier, and Jean-Claude Lerol

Subjects
Countercurrent chromatography, Chromatography, Stripping (chemistry), Chromatography detector, Chemistry, General Engineering, Analytical chemistry, General Medicine, Gas chromatography, Inert gas, Chromatography column, High-performance liquid chromatography, Dilution
Published
1977
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15. In a Virginia Garden.

Author

Lerol, Ralph

Subjects
GARDENS
Abstract

Presents the poem "In a Virgin Garden," by Ralph Leroi.

Published
1920

16. [Leiomyosarcoma of the esophagus 8 years after the diagnosis of a leiomyoma].

Author

Johanet H, Marmuse JP, Timores A, Vissuzaine C, Toublanc M, Lerol A, Benhamou G, and Charleux H

Subjects
Adult, Esophageal Neoplasms diagnostic imaging, Female, Humans, Leiomyosarcoma diagnostic imaging, Neoplasms, Second Primary diagnostic imaging, Time Factors, Tomography, X-Ray Computed, Esophageal Neoplasms etiology, Leiomyoma etiology, Leiomyosarcoma etiology, Neoplasms, Second Primary etiology
Published
1991

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