Auswahl der wissenschaftlichen Literatur zum Thema „Dysgueusia“

Tetrodotoxin is one of the most potent neurotoxins in the aquatic world. This review of published and unpublished reports aims to describe the poisoning cases that have occurred in mainland France and overseas territories. Six articles were included, with 13 poisoning events, individuals or collective (number (n) = 53 patients). Moreover, 13 unpublished poisoning events from toxicovigilance networks were found (n = 17). All cases happened in overseas territories: French Guyana (n = 7), New Caledonia (n = 11), Reunion (n = 35) and French Polynesia (n = 17). The median age was 36 years. The most frequent signs were neurological (81.8%), digestive (54.5%) and general (52.3%). Three cases of dysgueusia and nine cases of urogenital discomfort were observed in French Polynesia. Twelve severe cases were reported, including seven deaths. Only three events (11.5%) were documented by a tetrodotoxin assay. Two families of fish accounted for 91.6% of the poisonings: 33.3% due to the Diodontidae family and 58.3% to the Tetraodontidae family. Although rare, information and collection campaigns on tetrodotoxin poisoning are, therefore, essential.

e13604 Background: To limit SARS-Co-2 transmission in general population, French government had set up a first National containment from March 16, 2020 to June 2, 2020. Furthermore, General Direction of our hospital have implemented and organized physical distancing (telework, teleconsultation, virtual multi-disciplinary board), mask wearing, use of alcoholic ... to limit interpersonal contacts. To assess the impact of this policy, we have carried out a seroprevalence study and identified risk factors for SARS-Co-2 prevalence among HCP in May/June 2020. Methods: This is part of CORSER Study (“Etude séro-épidémiologique du virus SARS-CoV-2 en France d’une Cohorte CORSER-2d de personnels d’établissements de santé »), registered with ClinicalTrials.gov (NCT04325646). Two serological tests were applied in this cohort: S-Flow assay and Luciferase-linked immune-sorbent assay (LuLisa-N test). Results: Between 04 May to 26 June 2020, 392 Osar Lambret Cancer Center employees were included in the present study (about 40% of all staff). The most common jobs were: 92 nurses (23.4%), 80 radiology/radiotherapy manipulators (20.4%), 51 physicians (13.0%), 33 medical interns (8.4%) and 47 administrative staff members (11.9%). There were 98 men (25.0%) and 294 women (75.0%). The mean age was 38.7 (+/- 11.4). There were 7 seropositive cases; the seroprevalence was 1.8% (95%-CI: 0.7-3.6). Among the 7 positive cases, 5 were symptomatic (71.4%). In univariate analysis, factors associated with SARS-Co-2 seroprevalence: symptoms suggesting viral infection within 2 months (OR=5.33), dysgueusia (OR=37.00), anosmia (OR=66.29) and HCP exposed to COVID-19 patient outside work (OR=6.69). Gender, tobacco consumption, O blood group, HCP versus administrative staff, HCP working in different services, HCP providing care to suspected COVID-19 patients, HCP providing high-risk cares were not found to be associated with seropositivity. Of note, we have noticed that BMI≥ 24 kg/m² was associated with seroprevalence (OR=15.45), without biological rational. Conclusions: Our study suggests that strict implementation of protective measures was associated with low SARS-Cov-2 prevalence at the end of first National Containment, including among HCP treating COVID-19+ patients. HCPs seroprevalence seemed lower than seroprevalence of the general population at the same period (4-5%). Clinical trial information: NCT04325646.

5066 Background: Enzalutamide (ENZA) is a novel androgen receptor (AR) inhibitor that prolongs survival in men with metastatic castration-resistant prostate cancer (mCRPC) who had received prior docetaxel (DOC). DOC also prolongs survival in mCRPC and also appears to have anti-tumor effects mediated through the androgen-receptor axis, providing a compelling rationale for combining the two agents. CYP3A4 plays a role in DOC clearance and is induced by ENZA. We therefore conducted a phase I study to explore the PK and safety profiles of this combination. Methods: This study (NCT01565928) evaluated the safety and pharmacokinetics (PK) of DOC co-administered with ENZA in men with mCRPC on androgen deprivation therapy. Pts received DOC (75 mg/m2) by 1-h infusion every 3 weeks with corticosteroids. ENZA (160 mg/d) was started 24 h after the first DOC infusion. Plasma PK samples were collected for 24 h after Cycle (C) 1 and C2 DOC infusions to enable within-subject comparisons of DOC PK ± ENZA. A sample size of 18 pts able to receive ≥ 2 full doses of DOC was specified for PK analyses. Results: Twenty-two pts were enrolled, 4 did not receive 2 full doses of DOC. As of 21 Sept 2012, preliminary PK and C1 and C2 safety data were available from 15 pts. The median age was 65 (range 46-80 yrs); 11 had ECOG performance status 1 (vs 0). Prior primary therapy included surgery (n=2), radiation (n=4) or both (n=5); median PSA was 44.7ng/mL (1.9-585). ANC<1000/mm3 was reported in 14 pts (1 febrile neutropenia), other adverse events in ≥4 pts included fatigue (11), dyspnea (6), alopecia (5), peripheral neuropathy (5), anemia (4) and dysgueusia (4). No seizures were reported. Preliminary PK data (n=15) show similar DOC exposure (within 20%) for DOC in combination with ENZA vs. DOC alone.Final PK and updated tolerability and efficacy data beyond Cycle 2 will be presented. Conclusions: In mCRPC pts, ENZA does not appear to affect tolerability of DOC or have a clinically meaningful impact on DOC PK. Clinical trial information: NCT01565928.

63 Background: Enzalutamide (ENZA), a novel oral androgen receptor (AR) inhibitor, inhibits AR signaling via inhibition of androgen binding to the AR, AR nuclear translocation, and nuclear AR-DNA binding. ENZA demonstrated a survival benefit in men with metastatic castration-resistant prostate cancer (mCRPC) who had received prior docetaxel (Scher et al, NEJM 2012; 367:1187). A Phase III study in men with progressive chemotherapy-naïve disease (PREVAIL), is ongoing. Docetaxel (DOC) is the current standard first-line chemotherapy for mCRPC. CYP3A4, which plays a role in DOC clearance, is induced by ENZA. Patients (pts) eligible to receive DOC may benefit from continued AR inhibition with ENZA, provided the combination is well tolerated with no unacceptable drug-drug interactions. Methods: This study evaluated the safety and pharmacokinetics (PK) of DOC co-administered with ENZA in men with mCRPC on androgen deprivation therapy. Pts received DOC (75 mg/m2) by 1-h infusion every 3 weeks, with corticosteroids. ENZA (160 mg/d) was started 24 h after the first DOC infusion. Plasma PK samples were collected for 24 h after Cycle (C) 1 and C2 DOC infusions to enable within-subject comparisons of DOC PK ± ENZA. A sample size of 18 pts able to receive ≥ 2 full doses of DOC was specified for PK analyses. Results: As of 21 Sept. 2012, 22 pts have been enrolled, 3 did not complete both C1 and C2; PK and C1 and C2 safety data are currently available from 15 pts reported here. The median age was 65 (range 46-80 yrs); 11 had ECOG performance status 1 (vs 0). Prior primary therapy included surgery (n=2), radiation (n=4) or both (n=5); median PSA was 44.7ng/mL (1.9-585). ANC<1000mm3 was reported in 14 pts (1 febrile neutropenia), other adverse events in ≥4 pts included fatigue (11), dyspnea (6), alopecia (5), peripheral neuropathy (5), anemia (4) and dysgueusia (4). No seizures were reported. Preliminary PK data (n=15) show similar DOC exposure (within 20%) for DOC in combination with ENZA vs. DOC alone. Conclusions: This is the first evaluation of ENZA given in combination with DOC.In mCRPC pts ENZA does not appear to affect tolerability of DOC or have a clinically meaningful impact on DOC PK. Clinical trial information: NCT01565928.

Contexte : Le goût métallique est fréquemment rapporté par les patients au cours de leur traitement d’un cancer des voies aérodigestives supérieures. Très peu d’éléments sont connus sur ce symptôme : quelle est sa fréquence ? Ses cause(s) ?Nous avons mené une étude prospective observationnelle afin d’en déterminer l’incidence et la ou les causes, potentiellement possibles d’après la littérature. Deux hypothèses étaient possibles : une lipopéroxydation au niveau de la muqueuse orale et la levée d’inhibition du nerf facial sur le nerf glossopharyngien.Méthodes : 44 patients ont été suivis avant pendant et jusqu’à un an de la fin de leur traitement du cancer des voies aérodigestives supérieures. Des évaluations par questionnaires, prélèvements salivaires et tests supraliminaires d’intensité et de reconnaissance gustatifs ont été réalisés régulièrement, jusqu’à huit fois, durant un an.Un antidote potentiel, la lactoferrine en bain de bouche, a également été proposé en cas de goût métallique. Résultats : Le « goût » métallique a touché 27.2% des patients avec une intensité modérée à sévère chez 42.9% des personnes en souffrant. Il apparaissait surtout au milieu et à la fin de la radiothérapie ou de la radiochimiothérapie, avec un lien significatif avec la présence ou non d’une mucite orale. Ce goût métallique avait un impact significatif sur la qualité de vie liée au goût mais pas sur l’échelle visuelle analogique des ingestas ni sur le poids. Les hypothèses étiologiques de la lipopéroxidation et de la levée d’inhibition du nerf facial sur le nerf glossopharyngien n’étaient pas vérifiées. Enfin, le goût métallique pouvait être atténué par le bain de bouche de lactoferrine dans 63% des cas (de manière complète dans 16% et de manière partielle dans 47%).Conclusion : le goût métallique touche fréquemment et de manière intense les patients atteints d’un cancer des voies aérodigestives supérieures, surtout en cas de mucite. Les causes précises n’ont toujours pas été identifiées. La lactoferrine en bain de bouche semble atténuer ce symptôme
Background: Metallic taste is frequently reported by patients during treatment for head and neck. Very little is known about this symptom: What is its frequency? Its cause(s)?A prospective observational study was carried out to determine the incidence and cause(s), potentially possible according to the literature. Two hypotheses were put forward: lipoperoxidation of the oral mucosa, and release of facial nerve inhibition on the glossopharyngeal nerve.Methods: 44 patients were followed before, during and up to one year after completion of treatment for head and neck cancer. Evaluations by questionnaires, salivary sampling and supraliminal taste intensity and recognition tests were carried out regularly, up to eight times, for one year.A potential antidote, lactoferrin mouthwash, was also proposed in case of metallic taste. Results: The metallic “taste” affected 27.2% of patients, with moderate to severe intensity in 42.9% of sufferers. It appeared mainly in the middle and at the end of radiotherapy or radiochemotherapy, with a significant association with the presence or absence of oral mucositis. The metallic taste had a significant impact on taste-related quality of life, but not on the visual analog scale of ingestion or weight. The etiological hypotheses of lipoperoxidation and lifting of facial nerve inhibition on the glossopharyngeal nerve were not verified. Finally, the metallic taste could be alleviated by lactoferrin mouthwash in 63% of cases (completely in 16% and partially in 47%).Conclusion: metallic taste is a frequent and intense complaint in patients with head and neck cancer, especially in cases of mucositis. The precise causes have yet to be identified. Lactoferrin mouthwash seems to alleviate this symptom