Sarcopenia has emerged as an important parameter to predict outcomes and treatment toxicity. However, limited data are available to assess sarcopenia prevalence in metastatic breast cancer and to evaluate its management. The SCAN study was a cross-sectional multicenter French study that aimed to estimate sarcopenia prevalence in a real-life sample of metastatic cancer patients. Sarcopenia was identified by low muscle mass (estimated from the skeletal muscle index at the third lumbar, via computed tomography) and low muscle strength (defined by handgrip strength). Three populations were distinguished based on EWGSOP criteria: a sarcopenic group with low muscle mass AND strength, a pre-sarcopenic group with low muscle mass OR strength and a normal group with high muscle mass AND strength. Among 766 included patients, 139 patients with breast cancer and median age of 61.2 years (29.9–97.8 years) were evaluable; 29.5% were sarcopenic and 41.0% were pre-sarcopenic. Sarcopenic patients were older (P < 0.01), had a worse PS-score (P < 0.05), and a higher number of metastatic sites (P < 0.01), the majority being hepatic and bone. A moderate agreement between the oncologist's diagnosis and sarcopenia evaluation by muscle mass and strength was recognized (Cohen's kappa = 0.45). No associations were found between sarcopenia and adverse event occurrence in the 12 patients for whom these were reported. Sarcopenic patients were underdiagnosed and nutritional care and physical activity were less proposed. It is necessary to evaluate sarcopenia due to its impact on patient prognosis, and its utility in guiding patient management in metastatic breast cancer.

Immune checkpoint inhibitors improve the treatment of many solid tumors and have shown encouraging results in advanced squamous cell carcinoma (SCC), yet only a minority of patients respond to immune checkpoint inhibitor monotherapy. We conducted the PEVOsq trial, an open-label, nonrandomized, multicenter, basket phase 2 trial to evaluate the combination of pembrolizumab and vorinostat in recurrent/metastatic SCC of various origins. The primary endpoint was the objective response rate (ORR) in each tumor cohort during treatment as per the investigators’ assessment. Secondary endpoints included safety and antitumor activity evaluation in terms of centrally confirmed ORR, progression-free survival, overall survival and duration of response. In the efficacy population (n = 107), the ORR was met in cervical (39%), anal (31%) and vulvar/vaginal (19%) cancer cohorts, but not in head and neck SCC (19%) or penile (18%) cancer cohorts (overall ORR = 26%). Median progression-free survival was 4.0 months (95% confidence interval: 2.6–4.3), and median overall survival was 11.1 months (95% confidence interval: 9.2–17.4). In the safety population, 101 (91%) of 111 patients developed at least one treatment-related adverse event, with 39% and 5.4% of patients experiencing at least one grade 3 and grade 4 treatment-related adverse event, respectively. Vorinostat-related toxicity prompted a dose reduction/interruption in 66% of patients. Whole-exome sequencing analyses revealed several potential predictive biomarkers of response to treatment. Further studies in a larger number of patients are required to validate these findings. ClinicalTrials.gov identifier: NCT04357873.

To explore the implementation, structure, and challenges of multimodal prehabilitation programs in gastrointestinal (GI) oncology across France, in a context where evidence supports its benefits but national standardization is lacking. A national cross-sectional survey was conducted from April to July 2024. The 54-item questionnaire, developed by a multidisciplinary group, assessed team demographics, patient selection, intervention modalities, pathway coordination, and barriers to implementation. Descriptive statistics were used for data analysis. Among 92 respondent teams, 19 (20.7 %) reported having a structured prehabilitation pathway. Most included nutritional (94.7 %) and physical activity (74 %) interventions, while only 5.3 % provided systematic psychological support. Program eligibility was generally based on nutritional risk, surgical magnitude, and patient frailty, but varied widely. Prehabilitation was most often coordinated by surgeons (40 %) and dietitians (78.9 %), and typically delivered in day-hospital settings. Key challenges included insufficient human resources (60 %), coordination issues (49 %), and funding limitations (35 %). Despite these barriers, perceived utility and satisfaction with prehabilitation programs were high (median scores of 8/10 and 8.6/10, respectively). Prehabilitation in GI oncology is emerging but remains inconsistently applied across France. To scale these interventions equitably and effectively, national guidelines, enhanced coordination and institutional support are essential. Integration with existing perioperative pathways like ERAS and increased psychological support are also needed to improve patient outcomes. Only one center in our sample offered systematic psychological support.