Nicolas Guibert

University of Toulouse

Background and Objective Little is known about malignant central airway obstruction (MCAO) complicating the metastatic spread of non‐bronchogenic solid cancers (NBC) and their bronchoscopic management. This study aimed to describe the epidemiology of this population and determine prognostic factors before therapeutic bronchoscopy (TB). Methods In...

Background and Objective EpiGETIF is a web‐based, multicentre clinical database created in 2019 aiming for prospective collection of data regarding therapeutic rigid bronchoscopy (TB) for malignant central airway obstruction (MCAO). Methods Patients were enrolled into the registry from January 2019 to November 2022. Data were prospectively entered...

Introduction: The investigation of peripheral pulmonary lesions (PPLs) can be challenging. Several bronchoscopic modalities have been developed to reach and biopsy PPL but the level of adoption of these techniques by interventional pulmonologists (IPs) is unknown. This international survey was conducted to describe current practices in PPL investi...

Objectives This study describes data from bronchoscopy performed at the diagnosis of ANCA-associated vasculitis (AAV). Methods We conducted a retrospective study between 2004 and 2019 in patients older than 18 years old with a diagnosis of microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) who underwent bronchoscopy at onset...

Purpose: This review aimed to summarise evidence about the impact of pharmacological and non-pharmacological interventions on survival in COPD patients. Methods: We performed a narrative literature review on the effect of pharmacological and non-pharmacological interventions on survival in COPD patients. Results: Inhaled therapies are central...

Patients with chronic cough experience major alteration in their quality of life. Given its numerous etiologies and treatments, this disease is a complex entity. To help clinicians involved in patient management of patients, guidelines have been issued by a group of French experts. They address definitions of chronic cough and initial management of...

Macrophages are essential for HIV-1 pathogenesis and represent major viral reservoirs. Therefore, it is critical to understand macrophage infection, especially in tissue macrophages, which are widely infected in vivo, but poorly permissive to cell-free infection. Although cell-to-cell transmission of HIV-1 is a determinant mode of macrophage infect...

A novel 3D-engineered silicone stent was successfully used to treat a refractory bronchopleural fistula of the right lower lobe in a patient with an open-window thoracostomy who complained of severe dysphonia and recurrent infections https://bit.ly/3GrKs2p.

Background and objective: Dynamic hyperinflation (DH) is a major marker of exertional dyspnoea in severe emphysema. We hypothesized that bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBVs) decreases DH. Methods: In this prospective bi-centre study from both Toulouse and Limoges Hospitals, we assessed DH during an increme...

Patients with chronic cough experience a high alteration of quality of life. Moreover, chronic cough is a complex entity with numerous etiologies and treatments. In order to help clinicians involved in the management of patients with chronic cough, guidelines on chronic cough have been established by a group of French experts. These guidelines addr...

Background: Pectus excavatum (PE) is the most common congenital chest wall deformity, whose cardiopulmonary consequences are controversial. PE surgery is in our experience usually performed for aesthetic reasons. Objectives: The aim of this study was to evaluate the impact of PE on respiratory function and exercise capacity in patients with PE b...

The ideal airway stent is still not available. Indications for 3D stents currently are limited to rare cases. Therefore, further research is required to investigate whether personalised airway stents will perform better than conventional stents. https://bit.ly/3GLjPa4.

Up to 30% of lung cancer patients suffer from central airway obstruction, resulting in major deterioration in prognosis and quality of life. Interventional bronchoscopy combines a number of invasive techniques used during rigid bronchoscopy. It is designed to rapidly improve symptoms, primarily dyspnea. Applied according to very precise indications...

Kirsten rat sarcoma viral oncogene homolog (KRAS) gene encodes a GTPase that acts as a molecular switch for intracellular signal transduction, promoting cell growth and proliferation. Mutations in the KRAS gene represent important biomarkers for NSCLC targeted therapy. However, detection of KRAS mutations in tissues has shown some limitations. Duri...

Background: Although the endobronchial valves (EBV) were successfully developed as treatment for severe emphysema, its main complication, pneumothorax, remained an important concern. Objective: To assess whether the placement of Zephyr© endobronchial valves throughout 2 procedures instead of 1 minor the frequency of pneumothorax without lowering th...

Asthma is a multifactorial disease with complex pathophysiology. Knowledge of its immunopathology and inflammatory mechanisms is progressing and has led to the development over recent years of increasingly targeted therapeutic strategies. The objective of this review is to pinpoint the different predictive markers of asthma severity and therapeutic...

Background Approval of biologics has recently revolutionized T2 severe asthma management. However, predictive biomarkers remain highly needed to improve patient's selection. Objective This study aims to determine whether serum immunoglobulins (Igs) levels might be predictive biomarkers of response to anti-interleukin-5 (IL5)/IL5Rα therapies. Meth...

Bilateral endobronchial valves treatment can lead to additional significant benefits in patients who respond to the first procedure and have a clear target lobe on both lungs but increases the rate of complications https://bit.ly/3J0mZ8h.

Résumé La mise en place de prothèses permet de soulager les symptômes liés aux sténoses des voies aériennes centrales dans l’immense majorité des cas. Elles peuvent être curatives dans un certain nombre de situations non tumorales et offrent un pont vers les traitements locaux ou systémiques dans le contexte des obstructions malignes. Ces 30 derniè...

Introduction Subglottic stenosis (SGS) is a rare condition that results from progressive narrowing of the upper airways. Outcomes and treatment options depend on the benign or complex nature of the stenosis. Treatment options for SGS include surgery and endoscopic techniques. The main endoscopic techniques used are dilation and laser resection. Obs...

Isolated right middle lobe (RML) lung volume reduction using endobronchial valves can lead to significant improvements in appropriately selected patients, with highly hyperinflated RML and preserved upper and lower lobes https://bit.ly/3rICgTn.

Approximately 30% of patients with non-small-cell lung cancer (NSCLC) present with localized/non-metastatic disease and are eligible for surgical resection or other “treatment with curative intent”. Due to the high prevalence of recurrence after treatment, adjuvant therapy is standard care for most patients. The effect of adjuvant chemotherapy is,...

Objective: This review summarizes the current status of neoadjuvant therapy and discusses the choice of new clinical research endpoints for non-small cell lung cancer. Background: Neoadjuvant chemotherapy is a recognized practice in patients with resectable and locally advanced lung cancer. With the introduction of molecular targeted drugs and i...

Background Since successful development of endobronchial valves (EBV) as treatment for severe emphysema, its main complication, pneumothorax, remains an important concern. Objective We hypothesized that a two-step EBV implantation, during two distinct iterative procedures could lead to a more progressive target lobe volume reduction (TLVR) and thu...

Introduction Mini-invasive bronchoscopic techniques (such as radial endobronchial ultrasonography (rEBUS) and electromagnetic navigation (EMN)) have been developed to reach the peripheral lung but result in small samples. The feasibility of an adequate molecular testing from these specimens has been very little studied. Methods We retrospectively...

Confocal laser endomicroscopy imaging of lepidic adenocarcinomas is feasible. This technique should be further evaluated as a realtime guiding tool during virtual electromagnetic navigation bronchoscopy for ground-glass opacities https://bit.ly/3uzTcMU.

Pneumatocoele is a very rare complication of Zephyr EBV, probably due to chest tube insertion and suction of a trapped and emphysematous lung. Complete healing and functional improvements are possible without the need for valve removal. https://bit.ly/2K84Vjl.

SPLF) va fêter ses vingt ans d'existence. Au cours de ces années, le GELF, qui compte 187 membres dans 18 pays, a eu pour mission de rassembler tous les pneumologues franco-phones intéressés par l'endoscopie bronchique ou pleurale, diagnostique ou thérapeutique. Il s'est efforcé d'être une force de proposition, un lieu de réflexion et de dialogue,...

INTRODUCTION Patients with advanced-stage non-small cell lung cancer (NSCLC) whose tumors harbor an anaplastic lymphoma kinase (ALK) gene rearrangement benefit from treatment with multiple ALK inhibitors (ALKi). Approximately 30% of tumor biopsies contain insufficient tissue for successful ALK molecular characterization. This study evaluated the ad...

Résumé La thermoplastie bronchique a été développée au cours des quinze dernières années et constitue la première technique endoscopique approuvée dans la prise en charge de l’asthme sévère non contrôlé en impasse thérapeutique. L’utilisation d’ondes de radiofréquence appliquées sur la paroi des bronches lobaires, segmentaires et sous-segmentaires...

Liquid biopsy is a rapidly emerging field due to an increasing number of oncogenic drivers and a better understanding of resistance mechanisms to targeted therapies in non-small cell lung cancer (NSCLC). The sensitivity of the most widely used blood-based assays is, however, limited in particular in cases of low tumor volume where shed of tumor-der...

Background: As the endobronchial valves (EBV) were successfully developed as treatment for severe emphysema, its main complication, pneumothorax, remained an important concern (prevalence reported as 26% in a recent published meta-analysis). Objective: To assess whether the placement of Zephyr endobronchial valves throughout 2 procedures instead o...

Résumé Concept de science-fiction il y a peu, la biopsie liquide devient un outil du quotidien pour l’oncologue thoracique. Le terme « biopsie liquide » regroupe plusieurs concepts différents comme les cellules tumorales circulantes, l’ADN tumoral circulant ou les ARN tumoraux circulants, dont les intérêts et perspectives sont différents. Cette rev...

Background Lung cancer screening with low-dose chest CT (LDCT) reduces the mortality of eligible individuals. Blood signatures might act as a standalone screening tool, refine the selection of patients at risk, or help to classify undetermined nodules detected on LDCT. We previously showed that circulating tumour cells (CTCs) could be detected, usi...

Endobronchial localizations of inflammatory myofibroblastic tumors (IMT) are very unusual. We herein report the multimodal, bronchoscopic management of three cases, offering durable local control in all cases (including 2 patients who were definitively cured). Though surgery is usually considered the gold standard, therapeutic bronchoscopy should p...

Liquid biopsy refers to the analysis of any tumour-derived material circulating in the blood or any other body fluid. This concept is particularly relevant in lung cancer as the tumour is often difficult to reach and may need an invasive and potentially harmful procedure. Moreover, the multitude of anticancer drugs and their sequential use underlin...

AS offers rapid and sustained relief of symptoms in most patients treated for malignant or benign CAO and can also be curative in itself in cases of benign tracheobronchial stenosis. In the past 30 years, this field has seen significant progress, from the misuse of vascular non-covered metallic stents to the development of silicone airway stents wi...

The spatial and temporal genomic heterogeneity of various tumor types and advances in technology have stimulated the development of circulating tumor DNA (ctDNA) genotyping. ctDNA was developed as a non-invasive, cost-effective alternative to tumor biopsy when such biopsy is associated with significant risk, when tumor tissue is insufficient or ina...

Résumé Concept de science-fiction il y a peu, la biopsie liquide devient un outil du quotidien pour l’oncologue thoracique. Le terme « biopsie liquide » regroupe plusieurs concepts différents comme les cellules tumorales circulantes, l’ADN tumoral circulant ou les ARN tumoraux circulants, dont les intérêts et perspectives sont différents. Cette rev...

Objectives: Tumor mutational burden is an emerging biomarker of response to immune checkpoint inhibitors (ICI), whose clinical adoption is challenging. We hypothesized that targeting limited but relevant genetic alterations in plasma cell-free DNA along with early monitoring may non-invasively predict response to ICI in advanced non-small cell lun...

Opinion statement: Targeted therapies and more recently immune checkpoint inhibitors (ICI) have transformed the treatment landscape of advanced NSCLC. Clinical trials investigating immune checkpoint inhibitors (ICI) have usually excluded patients with oncogenic drivers, so that the outcome of these agents in this population is poorly known. In pat...

Résumé Introduction Le système nerveux central (SNC) (méningite carcinomateuse ou métastases solides cérébrales) est un site de récidive très fréquent des cancers bronchiques non à petites cellules (CBNPC) porteurs d’anomalies activatrices. Matériel et méthode Notre étude rétrospective consiste à décrire la population des patients présentant des...

Anatomically complex airway stenosis (ACAS) represents a challenging situation in which commercially available stents often result in migration or granulation tissue reaction due to poor congruence. This proof-of-concept clinical trial investigated the feasibility and safety of computer-assisted designed (CAD) and manufactured personalised three-di...

Introduction: The impact of fractional exhaled nitric oxide (FENO) on the management of chronic cough (CC) is still inconclusive. The aim of the present study was to assess whether FENO is a good tool to predict the response to inhaled corticosteroids (ICS) in patients with CC. Methods: Patients, referred for investigation of CC, had a FENO meas...

103 Background: Tumor mutational burden is an emerging biomarker of response to immune checkpoint inhibitors (ICI), whose clinical adoption is challenging, especially in liquid biopsies. We hypothesized that targeting limited but relevant genetic alterations in plasma cell-free DNA with next generation sequencing (NGS) along with early monitoring m...

Introduction Malgré les progrès réalisés dans la personnalisation des prothèses des voies aériennes, les sténoses d’anatomie complexe restent de prise en charge délicate. Les modèles de série sont souvent à l’origine de complications, directement liées au manque de congruence entre le dispositif et l’anatomie (migration et granulomes en particulier...

Antibodies targeting immune checkpoints were recently approved for metastatic melanoma. However, not all patients will respond to the treatment and some will experience grade III-IV immune-related adverse events. Therefore, early identification of non-responder patients would greatly aid clinical practice. Detection of circulating tumour DNA (ctDNA...

Objectives: The effect of anti-PD-1/PD-L1 inhibitors on lung adenocarcinomas (LADCs) with KRAS mutations is debatable. We examined the association between specific mutant KRAS proteins and the immune infiltrates with the outcome of patients with LADCs. Patients and methods: In 219 LADCs harboring either wild-type (WT) or mutated KRAS gene, we qu...

Background: Patient selection for PD-1 inhibitors in NSCLC is still based on imperfect screening biomarkers, including PD-L1 tumor expression and tumor mutational burden. We hypothesized that pretreatment molecular profile of ctDNA and its early kinetics during treatment could represent a reliable and non-invasive approach to determine response. Me...

Background: Inhibitors of the PD-1/PD-L1 immune checkpoint have become a standard of care in non-small cell lung cancer (NSCLC). Patient selection, currently based on PD-L1 expression on tumor tissue, is limited by its temporal and spatial heterogeneity. We hypothesized that liquid biopsy with PD-L1 analysis on circulating tumor cells (CTCs) might...

Background: Tumor genotyping is transforming lung cancer care but requires adequate tumor tissue. Advances in minimally invasive biopsy techniques have increased access to difficult-to-access lesions, but often result in smaller samples. With the advent of highly sensitive DNA genotyping methods used for plasma analysis, we hypothesized that these...

Purpose: Plasma cell-free DNA (cfDNA) genotyping is increasingly used in cancer care, but assay accuracy is debated. Because most cfDNA is derived from peripheral blood cells (PBC), we hypothesized that nonmalignant mutations harbored by hematopoietic cells (clonal hematopoiesis, CH) could be a cause of false positive plasma genotyping. Experiment...

147 Background: Inhibitors of the immune checkpoint PD-1/PD-L1 have become a standard of care in NSCLC. Patient selection, currently based on PD-L1 expression in tumor tissue, is limited by its temporal and spatial heterogeneity. We hypothesized that monitoring PD-L1 staining of circulating tumor cells (CTCs) could represent a valuable non-invasive...

145 Background: Inhibitors of immune checkpoint PD-1/PD-L1 (ICI) have become a care standard in non-small cell lung cancer (NSCLC). Despite promising results, some patients cannot take advantage of immunotherapy effects. Nowadays, neither predictive nor prognostic circulating biomarkers have been found in order to select patients or to predict resp...

Background: Genomic analysis of plasma cell-free DNA is transforming lung cancer care, however available assays are limited by cost, turnaround time, and imperfect accuracy. Here we study amplicon-based plasma next-generation sequencing (NGS), rather than hybrid-capture-based plasma NGS, hypothesizing this would allow sensitive detection and monit...

New 3D technologies are rapidly entering into the surgical landscape, including in interventional pulmonology. The transition of 2D restricted data into a physical model of pathological airways by three-dimensional printing (3DP) allows rapid prototyping and fabrication of complex and patient-specific shapes and can thus help the physician to plan...

Résumé Près de la moitié des hémoptysies sont actuellement considérées cryptogéniques. Les hémorragies provenant du système artériel pulmonaire sont rares, dues habituellement à des anévrismes ou pseudo-anévrismes dont le diagnostic radiologique est parfois difficile. Nous rapportons ici le cas d’un patient admis pour hémoptysie de grande abondance...