Minimally invasive surgery now plays a central role in the management of gynecologic cancers, particularly endometrial and cervical cancers. Among these approaches, robot-assisted surgery has progressively developed due to its potential technical advantages, including improved ergonomics, three-dimensional visualization, and greater precision of surgical maneuvers. Despite the increasing adoption of this technology, its true role compared with conventional laparoscopy remains debated, particularly following concerns raised regarding the oncologic safety of minimally invasive surgery in early-stage cervical cancer. This narrative review analyzes the currently available evidence comparing robot-assisted surgery with conventional laparoscopy in endometrial and cervical cancers. Priority is given to studies with a high level of evidence, particularly randomized controlled trials, while also discussing the methodological limitations of the existing literature, which is characterized by heterogeneity in the studied populations, biases related to historical cohorts, and the major impact of the learning curve. Through the evaluation of perioperative, functional, and oncologic outcomes, this review provides a critical synthesis of the current literature and discusses the main challenges associated with the integration of robot-assisted surgery in gynecologic oncology. Particular attention is paid to the influence of surgical expertise, healthcare organization, and adherence to oncologic principles on the observed outcomes. Ongoing prospective trials are expected to provide additional data to better define the role of robot-assisted surgery in gynecologic oncology.

The pulmonary form of graft-versus-host disease (GvHD) manifests as fibrotic damage to the bronchi (bronchiolitis obliterans syndrome [BOS]) or parenchyma (interstitial lung disease). It affects between 5 and 10% of allogeneic transplant patients and its prognosis remains uncertain. During this sixteenth session of the workshops on harmonizing practices in allogeneic transplantation, we reviewed the definitions and diagnostic criteria for pulmonary GvHD, discussed the various treatments available and the role of lung transplantation. We emphasized the inadequacy of the currently recognized diagnostic criteria and the need to revise them for earlier detection of BOS. We reviewed the recommendations for functional follow-up after allogeneic transplantation. New treatments have been developed for GvHD: Janus kinase inhibitors (ruxolitinib), rhokinase inhibitors (belumosudil) and anti-CSF1R antibody (axatilimab). Their efficacy in pulmonary GvHD is difficult to determine due to a lack of studies focusing on respiratory function. We discussed their place in relation to inhaled treatments, systemic corticosteroids, and extracorporeal photopheresis. Lung transplantation is an option to consider in severe cases that are refractory to treatment. Allogeneic transplant recipients represent a small proportion of lung transplant patients, even though the results are the same as for other indications. We reviewed the conditions under which a patient with pulmonary GVHD should be referred to a center with expertise in lung transplantation.

The new registry of the European Society for Blood and Marrow Transplantation (EBMT) facilitates the collection of data from patients undergoing cellular therapy. The growing complexity of hematological diseases and their treatments have led to an exponential increase in data, resulting in challenges and heterogeneity in data entry. The objective of this workshop is to develop recommendations aimed at harmonizing data entry across all centers. The principal challenges related to data collection were identified within French-speaking centers and subsequently discussed. In accordance on the guidelines of the EBMT, we reviewed the data entry forms and selected representative disease pathologies (acute leukemias, myelodysplastic syndromes, myeloproliferative syndromes, overlap syndromes, and aplastic anemias). Four working groups were established, focusing respectively on diagnostics, transplant status, allogeneic transplantation, and follow-up at day 100 and annually. The entry of essential variables was delineated within the Core Dataset. Certain non-mandatory variables in the registry (Extended Dataset) are, however, indispensable for the conduct of future retrospective studies. The workshop highlighted the need for stronger collaboration between physicians, cytogeneticists, biologists, and data managers in order to better identify, define, and standardize the data to be collected. We emphasize that working tools are available within the guidelines. This workshop has highlighted several outstanding issues to be forwarded to the registry coordinators, as well as the need for practical training of data managers, complementing the existing e-learning modules.

In order to ensure safe outcomes for male and female patients with chronic myeloid leukemia (CML) and their children, the Fi-LMC group (France intergroupe de la LMC) discusses strategies regarding sexuality, contraception, fertility, procreation and breastfeeding. The working group underlines (1) the need for close collaboration between hematologists, andrologists, gynecologists/obstetricians and pharmacologists; (2) the importance of considering the thrombotic risk at diagnosis in case of marked hyperleucocytosis or thrombocytosis, as well as during pregnancy; (3) the need to discuss sperm banking or oocyte cryopreservation according to the individual risk of infertility; (4) personalized pregnancy management. Tyrosine kinase inhibitors (TKIs) administered during organogenesis are teratogenic, exposing to a risk of fetal loss, intrauterine growth restriction and congenital malformations. In cases of CML diagnosed during pregnancy, or unplanned pregnancy, continuation of pregnancy is generally possible without requiring systematic voluntary or medical termination. TKIs should be withheld during the entire first trimester, in favor of BCR::ABL1 monitoring or pegylated interferon-α depending on gestational age and hematologic presentation. For planned pregnancies, ideally in major or deep molecular response, several TKI withdrawal strategies are proposed, depending on their pharmacokinetics and on the patient's profile. From the second trimester onwards, imatinib or nilotinib can be reintroduced if needed. Dasatinib must be avoided throughout pregnancy. Data on bosutinib, ponatinib and asciminib remain insufficient. For patients wishing to breastfeed, TKIs must be discontinued sufficiently prior to delivery.

Transoral robotic surgery (TORS) for head and neck cancers has developed since 2005, following the pioneering work of the University of Pennsylvania team. Since then, numerous publications have demonstrated its clinical feasibility and safety, while several clinical trials have confirmed favorable oncologic and functional outcomes. Today, robotic surgery is routinely used as an alternative to conventional transoral approaches for tumors that are difficult to expose, as an alternative to external open approaches for tumors that are not amenable to transoral exposure, and as an alternative to non-surgical treatments when robotic surgery is expected to provide oncologic or quality-of-life benefits. The most common head and neck tumor sites treated with robotic surgery are HPV-positive oropharyngeal carcinomas, followed by HPV-negative oropharyngeal carcinomas, supraglottic laryngeal tumors, and other less frequent locations. In oropharyngeal carcinoma, published data have demonstrated oncologic outcomes at least equivalent to those achieved with other therapeutic and surgical strategies, while allowing de-escalation of adjuvant treatments in patients with low- or intermediate-risk disease. Evidence remains more limited for other tumor sites, particularly the larynx, hypopharynx, parapharyngeal spaces, and salvage surgery, where robotic surgery may be reserved for carefully selected indications and patients and performed by experienced teams. This article summarizes the current evidence regarding indications, oncologic and functional outcomes, and future perspectives of robotic surgery within the framework of personalized multimodal treatment strategies.

Glioblastomas, the most common and aggressive brain tumors in adults, present a significant therapeutic challenge. Despite the limited treatment options outlined by current guidelines, bevacizumab has emerged as a critical, yet controversial option. This study investigates the off-label use of bevacizumab in France, highlighting its therapeutic demand despite the absence of marketing authorization. Since the European Medicines Agency (EMA) rejected its application for glioblastoma treatment in 2009, it has not been re-evaluated at the European level. This research primarily aims to explore clinical practices surrounding bevacizumab's use and assess its relevance and potential benefits for patients with glioblastoma in real-world settings. A cross-sectional, observational epidemiological survey was conducted using data from ScanSanté® and feedback from hospitals in the Provence-Alpes-Côte d'Azur (PACA) and Corsica regions. These findings were then compared to literature data. In 2023, bevacizumab was used in 97.3% of hospital days related to malignant brain tumors treated off-label in France. Among off-label prescriptions for glioblastomas, 82.0% were for recurrent glioblastomas, 13.1% for newly diagnosed glioblastomas, and 4.9% had no precise diagnosis. Literature reviews indicate a favorable benefit-risk balance for certain patient profiles, particularly showing improved progression-free survival and quality of life when bevacizumab is employed. The significant off-label use of bevacizumab in glioblastoma treatment underscores an urgent therapeutic need in France. These findings were submitted to the French National Agency for the Safety of Medicines and Health Products (ANSM) to advocate for its regulated use in clinical practice.

Endocrine tumors arise from highly differentiated hormone-secreting cells and are characterized by strong hormone dependence, high metabolic activity, and marked phenotypic plasticity. During tumor progression and therapeutic intervention, endocrine tumor cells can adapt to adverse microenvironmental conditions and treatment pressure through remodeling of differentiation states, reprogramming of signaling pathways, and metabolic adaptation. Regulated cell death (RCD) is a key determinant of cell fate and an important mediator of anticancer treatment responses, while also being closely linked to tumor plasticity. In this review, we summarize the major forms of RCD in endocrine tumors and their crosstalk, with a focus on how hormone and metabolic signaling shape the RCD network and influence tumor plasticity. Current evidence suggests that endocrine signals, nutrient-sensing pathways, and organ-specific metabolic stress regulate multiple forms of RCD, including apoptosis, ferroptosis, autophagy-dependent cell death, and inflammatory cell death, thereby influencing the death threshold of tumor cells and contributing to therapy resistance, dedifferentiation, and invasive behavior. We also discuss emerging therapeutic strategies targeting RCD, as well as potential biomarkers and clinical stratification approaches. A better understanding of the interaction between RCD and endocrine tumor plasticity may help shift the current therapeutic concept from simply inducing tumor cell death to limiting maladaptive plasticity, thus offering new opportunities to overcome therapeutic resistance and dedifferentiation.