Saint Paul

This research aims to evaluate community health actions focused on women aged 30 to 65 who are living in vulnerable situations in the outer areas of Reunion Island. The study is designed to assess the effectiveness of these actions in promoting cervical cancer screening by comparing self-screening methods to those performed by health professionals. The trial focuses on human papillomavirus HPV, a risk factor for anal cancer, in people living with HIV. Participants will engage in small group workshops to raise awareness about cervical cancer screening through discussion groups. Additionally, women who are not up to date with their cervical cancer screening will be offered an HPV self-test using a vaginal swab during an individual consultation. This randomized controlled crossover study compares the acceptability and concordance of self-screening versus professional screening. During the study, researchers will monitor how many women complete cervical cancer screening within three months after the community health intervention. Participants will attend awareness sessions and may perform self-testing. The study will track screening completion rates to measure the impact of the interventions. The trial is expected to run until March 2028, with participants followed for at least three months after intervention.

Researchers are investigating the use of Trastuzumab deruxtecan T-DXd in adults with unresectable or metastatic HER2-low and HER2-ultralow breast cancer. This includes patients who have previously received chemotherapy for metastatic breast cancer or have hormone receptor-positive disease treated with endocrine therapy but are unsuitable for further endocrine treatment. The study aims to understand treatment effectiveness, patient characteristics, and experiences in a real-world setting through a non-interventional approach. Participants will be observed while receiving either T-DXd or conventional chemotherapy as part of their routine care, without any drug administration by the study itself. The study includes two groups one with patients having HER2-low breast cancer treated with T-DXd after prior chemotherapy, and another with hormone receptor-positive, HER2-low or HER2-ultralow breast cancer patients treated with either T-DXd or conventional chemotherapy but not prior chemotherapy for metastatic disease. Data will be collected on treatments, side effects, and management of adverse drug reactions. During the study, participants demographic and clinical data, treatment patterns, tolerability, and quality of life will be monitored over approximately 37 months. Assessments include the time to next treatment, treatment discontinuation, physician-reported safety events, patient-reported tolerability, quality of life questionnaires, and symptom diaries. This long-term observation will help evaluate real-world outcomes and patient experiences with T-DXd and conventional chemotherapy in this population.

Large hiatal hernia LHH affects about half of laparoscopic antireflux surgeries and often recurs after repair, with up to 30% recurrence reported within two years. Researchers are studying whether adding a biosynthetic absorbable mesh to the standard suture repair reduces the chance of hernia coming back, without increasing complications. This phase III trial compares mesh reinforcement to no mesh in patients with symptomatic LHH to better understand which approach offers improved outcomes. Participants will undergo laparoscopic hiatal hernia repair either with or without the use of a biosynthetic absorbable mesh patch. This randomized, parallel-group study evaluates two groups one receiving mesh reinforcement and the other receiving standard suture repair alone. The trial lasts at least two years, focusing on the rate of hernia recurrence and other health outcomes following surgery. During the study, participants will have regular assessments including imaging to detect hernia recurrence at 24 months. Quality of life will be measured using questionnaires GIQLI, SF36, EQ-5D-5L, EQ-VAS at multiple time points from the day of surgery through two years. Researchers will also monitor complications, fever, weight, and blood pressure to track safety and overall health. This comprehensive follow-up aims to evaluate both the effectiveness and cost-effectiveness of mesh use in LHH repair.