Numerous studies have increasingly suggested that medical history and lifestyle factors could be involved in the increase of cancer risk in adults. The issue whether psychological factors can influence the development of cancer has been discussed for many years. In the field of brain cancer, psychological stress has not so far been investigated. We conducted a French case-control pilot study with 122 adult incident cases and 122 controls free of any cancer diagnosis, matched for age and gender, to investigate links between malignant primitive brain tumours (MPBT) and medical history, private habits and psychological stress. Data were collected through self-administered questionnaires, and person-to-person interviews. To complete the psychological stress assessment, 100-mm visual analog scales were used. After adjustment for confounders, we found no significant effect of head trauma, aspartame, tobacco or alcohol consumption, place (rural or urban) of residence, sociodemographic data, and experience of psychological stress at work/home. Our results showed a significant association between MPBT risk and major life events over the past 5 years before diagnosis (OR = 1.90, 95% CI 1.13-3.20), family histories of cancer (OR = 1.90, 95% CI 1.12-3.22), fresh vegetable and fruit intake (OR = 0.29, 95% CI 0.09-0.95), and skipped meals several times per week (OR = 0.35, 95% CI 0.16-0.77). The present study suggests the role of genetic factors in glioma risk, and also suggests that an acute and sudden psychological stress might influence MPBT appearance. Additional large clinical studies are needed to confirm these findings.

had similar and higher rates. The rate of frailty in men was higher than in women only in Afro-Caribbeans (Table 1).Weakness (96.3%), slow walking speed (85.9%), and exhaustion (72.5%) were the most common criteria for frailty in the whole group. African Americans, Afro-Caribbeans, and Hispanics were more likely to report exhaustion (P = .003) and have slow walking speed (P < .001) than European Americans. DISCUSSIONThe data presented add to a sparse literature on ethnic differences in frailty. In the multiethnic convenience sample studied, 15.6% were identified as frail (range 4.0-59.1%). 7 The ethnic differences in frailty reported here are consistent with the limited data available in the literature. 2-4 Because a convenience sample of participants who met specific entry criteria was used, the higher rates of frailty in the three ethnic groups studied than in European Americans should be further studied in other populations. Future research should also examine factors that may explain these differences, such as genetics, lower income and education level, dietary behavior and nutrition, physical activity level, prevalence of chronic diseases, and receipt of medical care. 2,8-10 The ethnic differences also suggest the need for further research into the underlying causes of and development of culturally sensitive interventions to prevent and treat frailty. The most-prevalent criteria for frailty (weakness, exhaustion, slow gait speed) reinforce the need for intervention studies that address these factors.

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During the acute phase of the COVID-19 pandemic, hospitals faced a challenge to manage patients, especially those with other comorbidities and medical needs, such as cancer patients. Here, we use Process Mining to analyze real-world therapeutic pathways in a cohort of 1182 cancer patients of the Lausanne University Hospital following COVID-19 infection. The algorithm builds trees representing sequences of coarse-grained events such as Home, Hospitalization, Intensive Care and Death. The same trees can also show probability of death or time-to-event statistics in each node. We introduce a new tool, called Differential Process Mining, which enables comparison of two patient strata in each node of the tree, in terms of hits and death rate, together with a statistical significance test. We thus compare management of COVID-19 patients with an active cancer in the first vs. second COVID-19 waves to quantify hospital adaptation to the pandemic. We also compare patients having undergone systemic therapy within 1 year to the rest of the cohort to understand the impact of an active cancer and/or its treatment on COVID-19 outcome. This study demonstrates the value of Process Mining to analyze complex event-based real-world data and generate hypotheses on hospital resource management or on clinical patient care.

Sous l'égide de la médecine hautement spécialisée, de la personna lisation des traitements et secondée par une recherche énergique, l'oncologie a connu en 2019 des avancées considérables. Cette année, de nombreux traitements ont consolidé leur importance et élargi leurs indications. L'annonce d'une pléthore de traite ments novateurs, en étude, est source d'espoir pour l'avenir. Des biomarqueurs simples ou composites, tels que l'expression PDL1, l'instabilité de microsatellite (MSI), la charge mutation nelle tumorale (TMB), les mutations des gènes BRCA1/2 ou un déficit du mécanisme de la recombinaison homologue des bases (HRD) permettent une meilleure sélection et personnalisation des traitements disponibles. Le but du présent article est de rassembler les avancées oncologiques de l'année.