À partir d’un travail associant l’analyse de sources d’archives, de sources imprimées et de sources orales, cette contribution se propose de mettre au jour, dans les années 1980 et 1990, l’extension ...du domaine managérial au secteur de l’Inspection pédagogique en charge de l’éducation physique et sportive (EPS). Sous l’influence conjointe du rattachement de cette discipline d’enseignement à l’Éducation nationale et du développement du Nouveau Management Public, la professionnalité de ces acteurs et de ces actrices de l’EPS évolue en réponse aux nouvelles exigences d’évaluation et de performance du système éducatif français. Le modèle de l’inspecteur ou de l’inspectrice de terrain, sanctionnant les actes pédagogiques des enseignants et des enseignantes d’EPS, est délaissé au profit du modèle de l’expert gestionnaire et multi-tâches sommé de maitriser de nouvelles techniques d’audit, d’évaluation et de contrôle.
À partir d’un travail associant l’analyse de sources d’archives, de sources imprimées et de sources orales, cette contribution se propose de mettre au jour, dans les années 1980 et 1990, l’extension ...du domaine managérial au secteur de l’Inspection pédagogique en charge de l’éducation physique et sportive (EPS). Sous l’influence conjointe du rattachement de cette discipline d’enseignement à l’Éducation nationale et du développement du Nouveau Management Public, la professionnalité de ces acteurs et de ces actrices de l’EPS évolue en réponse aux nouvelles exigences d’évaluation et de performance du système éducatif français. Le modèle de l’inspecteur ou de l’inspectrice de terrain, sanctionnant les actes pédagogiques des enseignants et des enseignantes d’EPS, est délaissé au profit du modèle de l’expert gestionnaire et multi-tâches sommé de maitriser de nouvelles techniques d’audit, d’évaluation et de contrôle.
Based on an analysis of archival sources, printed sources and oral sources, this contribution aims to bring to light the extension of the managerial domain to the sector of the pedagogical Inspection in charge of physical education (PE) in the 1980s and 1990s. Under the joint influence of the attachment of this teaching discipline to the National Education and the development of the New Public Management, the professionalism of these PE actors evolved in response to the new evaluation and performance requirements of the French education system. The model of the inspector in the field, sanctioning the pedagogical acts of PE teachers, is being abandoned in favor of the model of the expert manager and multi-tasker who is required to master new audit, evaluation and control techniques.
Cette contribution se propose de mettre au jour la conquête, au début des années 1960, d’une citadelle masculine : l’inspection Jeunesse et Sports (en 1964) puis l’Inspection pédagogique en charge de ...l’éducation physique et sportive (en 1976). D’origine populaire et professeure d’EPS de la ville de Paris, Lilyane Forestier présente un parcours a priori peu probable et pourtant… En se créant et en saisissant des opportunités, tout en développant des « stratégies de genre », elle parvient à gravir les échelons et à défendre une conception de l’EPS qui, présentée parfois comme à contre-courant, contribue d’une certaine façon à prolonger une vision différentialiste des individus. En ayant conquis une bonne partie de la citadelle masculine de l’inspection, elle a acquis un niveau de liberté vécue par l’inspectrice comme une grande autonomie. Mais cette apparente autonomie constitue aussi une forme de pouvoir qui, au final, permet d’exercer une forme de domination, notamment en matière de hiérarchie entre les sexes. Figure de l’inspection admise à la retraite en 1991, elle reste aux portes d’une Inspection Générale dont Yvonne Surrel, première femme nommée en son sein en 1961, s’est retirée en 1977, pour partir à la retraite.
In a society where the politics of life is geared toward maximizing the physical and psychological dimensions of human capital to ensure economic growth, France’s Inspectorate for Youth and Sports ...played a key role in disseminating a new mode of governance of bodies and youth—a form of self-governance based on the rising neoliberal values that emerged during the period of the Trente Glorieuses. Representing a tiny minority in an essentially male bastion, a small number of women, cherry-picked for their expertise and effectiveness as inspectors, came to play a vital role in a new mode of youth governance aimed, against a backdrop of social control, at encouraging young people to assume greater self-responsibility and to take ownership of their physical education and activities. Guided by research in the human and social sciences as a basis for rethinking how physical education is taught in schools, women may be seen as key contributors to the emergence of a new ethos designed to develop the ability of French youth to adapt to the social and economic transformation of capitalist society by appealing to the psyche (superego) and self-regulation. Despite promoting a “differentialist feminism”.
Based on an analysis of archival sources, printed sources and oral sources, this contribution aims to bring to light the extension of the managerial domain to the sector of the pedagogical Inspection ...in charge of physical education (PE) in the 1980s and 1990s. Under the joint influence of the attachment of this teaching discipline to the National Education and the development of the New Public Management, the professionalism of these PE actors evolved in response to the new evaluation and performance requirements of the French education system. The model of the inspector in the field, sanctioning the pedagogical acts of PE teachers, is being abandoned in favor of the model of the expert manager and multi-tasker who is required to master new audit, evaluation and control techniques.
•In our study, the vast majority of grade ≥ 2 adverse events (AEs) occurred in patients receiving sequential anti-PD-(L)1 and sotorasib therapy and are mostly represented by hepatotoxicity.•Dose ...reduction is generally insufficient to allow treatment continuation in case of grade ≥ 2 hepatotoxicity.•As corticosteroids impact on hepatotoxicity is unclear, liver biopsy can help discriminate candidates for corticosteroids in grade 3 or 4 hepatotoxicity.•Nausea and diarrhea are usually manageable with symptomatic treatment and do not lead to sotorasib discontinuation.•We propose practical guidance for sotorasib-related AEs prevention and hepatotoxicity management based on our experience and other available data that may be also useful for the new KRASG12C inhibitors in development.
Sotorasib is a first-in-class KRASG12C inhibitor that showed significant clinical activity in KRASG12C-mutated non-small cell lung cancer (NSCLC). The most frequent grade 3 or 4 sotorasib-related adverse events (AEs) were diarrhea (4–12 %) and hepatotoxicity (10.1–15.1 %). Data is lacking about the management of these AEs, especially in patients receiving sequential anti-PD-(L)1 and sotorasib therapy. Our aim was to report the management of grade ≥ 2 sotorasib-related AEs in real-world setting and to propose practical guidance for the management of grade ≥ 2 sotorasib-related AEs and more generally KRASG12C inhibitors-related AEs.
Records from all consecutive patients who initiated sotorasib through expanded access program in two French anti-cancer centers from January 1st 2021 to April 1st 2023 were reviewed to identify and grade sotorasib-related AEs, according to NCI-CTCAE v5.0., and to collect AEs management data. Patients were included in the analysis if they presented a grade ≥ 2 sotorasib-related AE.
From 57 patients identified, 21 met inclusion criteria including eighteen (86 %) who received sequential anti-PD-(L)1 and sotorasib therapy. Hepatotoxicity (76 %) and diarrhea (24 %) were the most common grade ≥ 2 sotorasib-related AEs. Among the 16 patients with a grade ≥ 2 hepatotoxicity, 12 (75 %) definitely discontinued sotorasib, among which 9 (56 %) after dose reductions and rechallenge, and five (32 %) received corticosteroids, allowing only one patient to resume sotorasib. Diarrhea and nausea were usually manageable and not associated with sotorasib discontinuation. We propose a step-by-step management practical guidance for sotorasib-related hepatotoxicity based on dose-reduction and careful monitoring. Liver biopsy is strongly encouraged for grade 3 and 4 hepatotoxicity to assess candidates for corticosteroids.
The experience with sotorasib might help better prevent, screen and manage sotorasib-related and other KRASG12C inhibitors-related AEs, particularly hepatotoxicity.
Sequential anti–programmed cell death protein 1 (PD-1) or anti–programmed death-ligand 1 (PD-L1) followed by small targeted therapy use is associated with increased prevalence of adverse events (AEs) ...in NSCLC. KRASG12C inhibitor sotorasib may trigger severe immune-mediated hepatotoxicity when used in sequence or in combination with anti–PD-(L)1. This study was designed to address whether sequential anti–PD-(L)1 and sotorasib therapy increases the risk of hepatotoxicity and other AEs.
This is a multicenter, retrospective study of consecutive advanced KRASG12C-mutant NSCLC treated with sotorasib outside clinical trials in 16 French medical centers. Patient records were reviewed to identify sotorasib-related AEs (National Cancer Institute Common Classification Criteria for Adverse Events—Version 5.0). Grade 3 and higher AE was considered as severe. Sequence group was defined as patients who received an anti–PD-(L)1 as last line of treatment before sotorasib initiation and control group as patients who did not receive an anti–PD-(L)1 as last line of treatment before sotorasib initiation.
We identified 102 patients who received sotorasib, including 48 (47%) in the sequence group and 54 (53%) in the control group. Patients in the control group received an anti–PD-(L)1 followed by at least one treatment regimen before sotorasib in 87% of the cases or did not receive an anti–PD-(L)1 at any time before sotorasib in 13% of the cases. Severe sotorasib-related AEs were significantly more frequent in the sequence group compared with those in the control group (50% versus 13%, p < 0.001). Severe sotorasib-related AEs occurred in 24 patients (24 of 48, 50%) in the sequence group, and among them 16 (67%) experienced a severe sotorasib-related hepatotoxicity. Severe sotorasib-related hepatotoxicity was threefold more frequent in the sequence group compared with that in the control group (33% versus 11%, p = 0.006). No fatal sotorasib-related hepatotoxicity was reported. Non-liver severe sotorasib-related AEs were significantly more frequent in the sequence group (27% versus 4%, p < 0.001). Severe sotorasib-related AEs typically occurred in patients who received last anti–PD-(L)1 infusion within 30 days before sotorasib initiation.
Sequential anti–PD-(L)1 and sotorasib therapy are associated with a significantly increased risk of severe sotorasib-related hepatotoxicity and severe non-liver AEs. We suggest avoiding starting sotorasib within 30 days from the last anti–PD-(L)1 infusion.
Sequential anti-programmed cell death protein 1 (PD-1) or anti-programmed death-ligand 1 (PD-L1) followed by small targeted therapy use is associated with increased prevalence of adverse events (AEs) ...in NSCLC. KRASG12C inhibitor sotorasib may trigger severe immune-mediated hepatotoxicity when used in sequence or in combination with anti-PD-(L)1. This study was designed to address whether sequential anti-PD-(L)1 and sotorasib therapy increases the risk of hepatotoxicity and other AEs.
This is a multicenter, retrospective study of consecutive advanced KRAS
-mutant NSCLC treated with sotorasib outside clinical trials in 16 French medical centers. Patient records were reviewed to identify sotorasib-related AEs (National Cancer Institute Common Classification Criteria for Adverse Events-Version 5.0). Grade 3 and higher AE was considered as severe. Sequence group was defined as patients who received an anti-PD-(L)1 as last line of treatment before sotorasib initiation and control group as patients who did not receive an anti-PD-(L)1 as last line of treatment before sotorasib initiation.
We identified 102 patients who received sotorasib, including 48 (47%) in the sequence group and 54 (53%) in the control group. Patients in the control group received an anti-PD-(L)1 followed by at least one treatment regimen before sotorasib in 87% of the cases or did not receive an anti-PD-(L)1 at any time before sotorasib in 13% of the cases. Severe sotorasib-related AEs were significantly more frequent in the sequence group compared with those in the control group (50% versus 13%, p < 0.001). Severe sotorasib-related AEs occurred in 24 patients (24 of 48, 50%) in the sequence group, and among them 16 (67%) experienced a severe sotorasib-related hepatotoxicity. Severe sotorasib-related hepatotoxicity was threefold more frequent in the sequence group compared with that in the control group (33% versus 11%, p = 0.006). No fatal sotorasib-related hepatotoxicity was reported. Non-liver severe sotorasib-related AEs were significantly more frequent in the sequence group (27% versus 4%, p < 0.001). Severe sotorasib-related AEs typically occurred in patients who received last anti-PD-(L)1 infusion within 30 days before sotorasib initiation.
Sequential anti-PD-(L)1 and sotorasib therapy are associated with a significantly increased risk of severe sotorasib-related hepatotoxicity and severe non-liver AEs. We suggest avoiding starting sotorasib within 30 days from the last anti-PD-(L)1 infusion.
