Limiting exposure to environmental hazards during preconception and pregnancy is essential for preventing adverse pregnancy outcomes or developmental defects in offspring. However, the perception of environmental risk and the behavioral changes of women planning or having a pregnancy have rarely been investigated, except for a few risk factors. We thus performed a cross-sectional study of French postpartum women hospitalized in the Bordeaux University Hospital in 2017 by proposing a self-administrated survey. The main objective was to assess their level of awareness concerning a large panel of environmental hazards and modifications in their behavior during pregnancy in occupational and household environments. Among the 121 respondents, most identified the environment as a major factor for a healthy pregnancy but recognized a lack of knowledge regarding environmental risk factors. The internet, television, and magazines were their main sources of information. Most women modified some of their practices at work or home. These measures were rarely implemented in consultation with a health practitioner, which raises concerns about the relevance of the adjustments made. Our findings highlight the need to improve the quality of information available to women and to help them implement preventive measures in consultation with physicians.

Background:Metastatic colorectal cancer (mCRC) patients with mutant KRAS or NRAS are ineligible for anti-epidermal growth factor receptor (anti-EGFR) therapy, as RAS mutations activate downstream pathways independently of EGFR and induce primary resistance. However, even among RAS wild-type (WT) patients, only a fraction responds to anti-EGFR therapy, suggesting that other mechanisms of resistance exist. We hypothesise that different (epi)genetic alterations can lead to primary anti-EGFR resistance and that the crucial end point is the activation of protein signalling pathways.Methods:We analysed the expression and activation of proteins involved in cell signalling, using reverse phase protein arrays, on a multicentre French cohort of RAS WT mCRC treated with anti-EGFR treatment.Results:We identify activated EGFR and HER3 as protein biomarkers predictive for better overall survival. Active EGFR signalling and downstream PI3K, but not MAPK, pathway activation are associated with response to anti-EGFR treatment. Left-sided mCRC displays active ErbB2/3 and Wnt pathways and a better response to anti-EGFR therapy compared to right-sided mCRC.Conclusions:We identify active EGFR and PI3K signalling as a key factor for response to anti-EGFR treatment in mCRC and highlight the importance of developing these biomarkers in clinical practice for the selection of RAS WT mCRC patients that would benefit from anti-EGFR treatment.