Cardiotoxicity from anti-leukemic therapies remains a major concern in pediatric hemato-oncology - often subclinical in the short term but potentially life-threatening in the long term. In children, who are exposed to cardiotoxic treatments at an early age and have long life expectancies, a proactive strategy for prevention, early detection, and management is essential. Anthracyclines remain a cornerstone of pediatric acute leukemia treatment but are associated with a risk of heart failure in approximately 10% of cases, particularly at cumulative doses exceeding 300mg/m2 of doxorubicin-equivalent. Dexrazoxane, once controversial, is now supported by robust data demonstrating both safety and cardioprotective efficacy. Its use is recommended alongside anthracyclines in patients receiving a cumulative dose≥300mg/m2 of doxorubicin-equivalent. Other agents - including tyrosine kinase inhibitors, immunotherapies, and CAR-T cells - also carry cardiotoxic potential, warranting tailored monitoring strategies. These multidisciplinary SFCE-endorsed recommendations emphasize the need for early and repeated assessment of cardiovascular risk factors throughout treatment. A dedicated heart team, involving pediatric cardiologists and pediatric hematologists, should coordinate active surveillance, including management of modifiable cardiovascular risk factors and systematic imaging with global longitudinal strain, which is more sensitive than ejection fraction in detecting subclinical dysfunction. Prospective pediatric studies are needed to define age-appropriate imaging thresholds, validate the role of cardiac biomarkers, and assess liposomal anthracycline formulations. If confirmed to be both safe and effective, such agents should be integrated into future treatment protocols to enhance long-term cardioprotection without compromising anti-leukemic efficacy.

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, but immune-related adverse events are common. Reactive arthritis-like syndromes remain rarely reported in this context.

Therapeutic advances have led to an increase in the number of patients living with cancer, requiring heightened vigilance for cardiovascular complications. This article discusses the monitoring and management of cardiovascular adverse events in cancer patients, particularly those receiving lorlatinib, a third-generation tyrosine kinase inhibitor used in the treatment of advanced non-small cell lung cancer with ALK gene rearrangement. Antitumor treatments such as lorlatinib can cause cardiac and metabolic complications, which has led to the development of cardio-oncology as a specialized discipline. The 5-year data from the CROWN phase III study confirms the efficacy of lorlatinib, but also show the occurrence of significant adverse events, including dyslipidemia (hypercholesterolemia/hypertriglyceridemia), weight gain and hypertension. A multidisciplinary group of experts has therefore drawn up practical proposals for the management of metabolic and cardiovascular side effects associated with lorlatinib. The article addresses the management of dyslipidemia, hypertension, conduction disorders and QT interval prolongation induced by lorlatinib. Finally, nutritional management is discussed, as is the role of adapted physical activity. In conclusion, this article highlights the importance of proactive monitoring and management of adverse cardiovascular events in patients treated with lorlatinib.

Targeted therapies (TT) represent a major breakthrough in oncology, with nearly one hundred agents now available, half of which are administered orally. While their efficacy is unquestionable, their safety profile, particularly cardiovascular (CV), requires close attention. Indeed, the frequency and presentation of these CV toxicities vary according to the TT: arterial hypertension with VEGFR inhibitors, thromboembolic events with abemaciclib, left ventricular dysfunction with osimertinib or BRAF/MEK inhibitors, QTc prolongation with ribociclib or vandetanib, and metabolic disorders (dyslipidemia, hyperglycemia) with PI3K/AKT/mTOR pathway inhibitors. Although severe events remain relatively uncommon, they may impact the continuation of a treatment crucial for cancer prognosis. Data from clinical trials, complemented by pharmacovigilance and real-world studies, now provide a clearer picture of these complications. Prevention and management rely on recent European Society of Cardiology recommendations including initial CV risk assessment (HFA-ICOS score), close clinical and paraclinical monitoring, and tailored management of toxicities. In this setting, cardio-oncology is emerging as an essential discipline, aiming to reconcile anticancer efficacy with cardiovascular safety. A multidisciplinary approach involving oncologists, cardiologists, primary care physicians, and patients is key. Patient education, optimization of risk factors, and individualized monitoring are the cornerstones of optimal care.

The objective was to establish an inventory of the use of complementary therapies, and more particularly acupuncture, in the management of adverse effects of anticancer treatments (ACTs) reported by patients actively treated for solid cancer, as well as to evaluate access to this practice and the experience reported by patients.

The management of locally advanced head and neck tumors is complex due to the multimodal nature of the treatment and the frequent presence of comorbidities in this patient population. International guidelines recommend the use of cisplatin concomitantly with radiotherapy; however, its administration is often limited by contraindications and potential toxicities. The management of treatment-related adverse effects, as well as the use of induction chemotherapy, remains heterogeneous. Therefore, we aimed to assess the current practices of French oncologists in order to identify potential needs and evaluate the relevance of issuing national recommendations to harmonize clinical practice.

Anti-PD1 and anti-PD-L1 inhibitors have become central to systemic therapy for solid tumors, reshaping indications and outcomes across multiple tumor types. Their widespread use, however, raises major economic, environmental, and societal challenges. Current regimens - fixed dose, defined frequency, and predetermined duration - are supported by limited clinical and paraclinical evidence. Consistent signals from pharmacokinetic and pharmacodynamic studies, retrospective cohorts and small prospective trials suggest that overtreatment is possible in a significant proportion of patients. In this context, therapeutic de-escalation should be evaluated along three axes: dose reduction, extension of dosing intervals, and adjustment of the total duration of treatment. This review summarizes the current state of knowledge on the pharmacokinetics and pharmacodynamics of checkpoint inhibitors, as well as retrospective and prospective clinical data exploring dose, frequency, and duration de-escalation across different tumor types. It also presents the main trials currently underway to evaluate these strategies and their clinical, economic, and societal impacts.

The therapeutic management of metastatic breast cancers has benefited in the past few years from important progress linked to the development of new molecules, inhibiting poly adenosine diphosphate ribose polymerase (PARP), cyclin-dependent kinases (CDK4/6) or immune checkpoints. More recently, the development of antibody-drug conjugates (ADC) targeting tumor cells, allows for the delivery of cytotoxic agents, at low doses, while increasing their concentration in the tumoral microenvironment. Currently, two ADC are available for the management of HER2-negative metastatic breast cancers, sacituzumab govitecan and trastuzumab deruxtecan. However, these ADC still induce significant grade 3/4 adverse events in more than 40% of the cases. Here, a practical review of the characteristics of these 2 ADC is proposed, with their mode of action and formulation, posology and place in the treatment schedules of HER2-negative metastatic breast cancers. The major results of phase III clinical trials are summarized, and a special focus is made on the management of toxicities.

Posterior Reversible Encephalopathy Syndrome (PRES) is one of the most common neurological complications in pediatric onco-hematology. Hematologic malignancies and cytotoxic chemotherapy are involved in its pathogenesis. It's a clinical and radiological entity: the diagnosis of PRES is based on both clinical symptoms and neuroimaging data.

New therapeutic options for gynecological cancers (in particular, targeted therapies and immunotherapies) are associated with potential cardiovascular toxicities that oncologists should be able to identify, detect and manage together with a cardiologist. The first step consists of evaluating the patient's individual cardiovascular risk, regardless of planned oncologic treatment, to determine whether this treatment can be initiated immediately or if cardiological advice is required. In a second step, the risk of cardiovascular toxicity of the selected treatment must be assessed, considering its intrinsic risk and the patient's comorbidities. Once treatment has started, appropriate monitoring should be implemented during administration, and after discontinuation. Beyond general recommendations, specific situations are detailed for initial workup and surveillance relating to most common protocols of chemotherapy, immunotherapy, targeted therapy and associations used in gynecological oncology. If cardiotoxicity occurs (hypertension, QT interval increase, left ventricular dysfunction, troponin increase, myocarditis), the oncologist must be aware of the principles of management, and distinguish between what he can manage on his own and what requires referring to specialists. Prior to rechallenge after cardiotoxicity, multidisciplinary discussion is mandatory to assess the patient's benefit/risk ratio.

The growing number of cancer cases induces increasing pressure on oncology and hematology departments, creating the need for alternatives such as hospitalization at home (HAH). The Carfil-HAD pilot study aimed to assess the feasibility and safety of administering short-duration intravenous carfilzomib infusions at home for the treatment of multiple myeloma. Among the 17 patients included, 15 received 128 infusions of Carfilzomib under a combined Outpatient Hospital (OH)/HAH scheme, are evaluable. Deviations from standard operating procedures were monitored, quality of life and satisfaction were evaluated, and a cost-effectiveness analysis compared the mixed OH/HAH model to exclusive OH care. The results confirmed feasibility: of 128 infusions, 42 were performed in OH and 86 in HAH without serious incident or interruption of care, with 96% of deviations classified as minor. Quality of life is not affected by the mixed care organization, and patient satisfaction was very high. From an economic perspective, the OH/HAH model generated savings of €610 per treatment cycle, nearly half the cost of hospital-based care. In conclusion, intravenous administration of carfilzomib in HAH is feasible and safe. This organization could be applied to other oncological therapies to offer a wider range of outpatient's care.

Although immune-mediated colitis is well known and is one of the most common toxicities of Immune Checkpoint Inhibitors (ICIs), the toxicity of these agents to the upper digestive tract is largely unknown and its incidence is probably underestimated. It can affect the stomach and/or the duodenum, and much more rarely the esophagus. Involvement of several segments is common, as is the association with colitis and possibly extra-digestive toxicity(ies). Severity is extremely variable, but severe forms are possible, particularly due to hydro-electrolytic and nutritional repercussions, possible haemorrhagic complications, and much more rarely, a risk of perforation. Many differential diagnoses must be considered. Therapeutic modalities are partly modeled on those of colitis, and the choices must be discussed and validated in multidisciplinary meetings, taking into account the entire "spectrum" of toxicity. We propose a review of the data available in the literature concerning the toxicity of ICIs on the upper digestive tract, illustrated by a few cases from our center.

Prostate cancer mainly affects older men and is treated with hormone therapy, often in combination with other treatments. Particular attention must be paid to the side effects of treatments that impact patients' quality of life. Comprehensive care and regular monitoring by a multidisciplinary team supported by supportive oncology care, coordinated by an advanced practice nurse or coordinating nurse, ensure optimal and safe care.

As the number of cancer treatments increases, new specific toxicities are emerging, requiring early and specialized treatment. The Gustave-Roussy center in Villejuif, near Paris, has set up a multidisciplinary toxicity pathway (ImmunoTox multidisciplinary consultation meeting, day hospital, mobile team). This includes an advanced practice nurse to optimize the management of undesirable effects, improve quality of life and mobilize all related skills.

Oral adjuvant hormone therapy for early breast cancer, despite its proven importance in terms of survival and prevention of recurrence, does not fall within the scope of clinical pharmacy programs set up for oral anticancer drugs, even though issues of therapeutic adherence have been clearly identified. The aim of our study was to explore the perception of healthcare professionals regarding the prescription and dispensing of this hormone therapy, in order to identify the risks for these patients and determine the clinical pharmacy actions that could address these risks.

Therapeutics used in cancer treatment can cause vestibular ototoxicity, which is particularly challenging to detect due to the frequent occurrence of nausea and vomiting in patients experiencing significant fatigue and stress. An appropriate diagnosis enables optimal symptom correction, reduces the risk of falls, and improves quality of life.

Cancer remains a significant public health concern globally, with increasing incidence in developing countries like India. While chemotherapy has improved survival rates, the quality of life and psychological well-being of cancer patients frequently deteriorate due to treatment-related toxicities, including electrolyte disturbances and psychological effects. This study aimed to examine the differential impact of platinum-based chemotherapy versus other regimens on Health-related Quality of Life (HRQoL) and Hospital Anxiety and Depression Scale (HADS) scores in cancer patients.

Immune checkpoint inhibitors (ICI) have revolutionized the treatment of solid tumors. However, they can induce immune-related adverse effects (irAEs) that can affect any organ. These irAEs are different from the side effects of traditional oncological treatments and require specific management. Given the increasing use of ICI, first-line care will increasingly need to manage these irAEs. This article aims to assist in the implementation of the guidelines for managing irAEs, with a particular focus on aspects related to first-line care.

Drug-induced immune thrombocytopenia (DIIT) is a rare cause of immune thrombocytopenia, characterized by the formation of drug-dependent antiplatelet antibodies. DIIT can lead to life-threatening hemorrhage. The diagnosis is difficult, relying on the detection of antiplatelet antibodies in patient's serum exclusively in the presence of the implicated drug. The gold standard test is the monoclonal antibody immobilization of platelet antigens (MAIPA), although other techniques (flow cytometry and Luminex®) can be used.

Lyme borreliosis is suspected when there are compatible symptoms associated with tick exposure. The diagnosis, except for erythema migrans, is based on serology. However, in some cases, serology may be erroneous.