BJMO - volume 18, issue 5, september 2024
C. Gennigens MD, PhD, A. Lebeau PhD
In the field of gynaecologic oncology, numerous studies were presented at the 2024 ASCO Annual Meeting. Several therapeutic de-escalation strategies were discussed, including the lack of benefits from lymphadenectomy in advanced ovarian cancer and from adjuvant chemotherapy in early high-risk cervical cancer. Neoadjuvant combined with adjuvant PARP inhibitors for patients with resectable recurrent ovarian tumours is a promising approach to avoid chemotherapy and enhance quality of life. Among the new treatments, mirvetuximab soravtansine for platinum-resistant ovarian cancers and selinexor for advanced or recurrent TP53 wild-type endometrial tumours are particularly promising. Additionally, several trials have explored the impact of obesity and its management in gynaecological cancers.
(Belg J Med Oncol 2024;18(5):211–5)
Read moreBJMO - volume 18, issue 2, march 2024
C. Gennigens MD, PhD, S. Altintas MD, PhD, J-F. Baurain MD, PhD, H. Denys MD, PhD, S. Henry MD, I. Vergote MD, PhD, T. Van Gorp MD, PhD
Over the past decade, immune checkpoint inhibitors (ICI) emerged as a new therapeutic pillar across a broad range of cancer types. An important characteristic of patients responding to ICI-based therapy consists of a high mutational burden in the tumours. In line with this, patients with microsatellite instability-high or mismatch repair-deficient (MSI-H/dMMR) endometrial cancer (EC) proved to be particularly sensitive to ICI, leading to the approval of anti-PD-1 antibodies for patients with MSI-H/dMMR ≥2nd line recurrent setting. Responses to single-agent ICI have also been reported in a small proportion of patients with microsatellite stable (MSS) EC. However, a high unmet need remains for these patients. More recently, several phase III randomised controlled trials showed that adding an ICI to standard chemotherapy significantly delays the disease progression in patients with primary advanced or recurrent MSI-H/dMMR EC, but also, to a lesser extent, in MMR proficient (p)/MSS EC. This article will briefly review the available clinical trial data with ICI-based therapies in EC and will assess how this treatment modality could be integrated into the Belgian treatment paradigm for these patients.
(BELG J MED ONCOL 2024;18(2):49–59)
Read moreBJMO - volume 17, issue 8, december 2023
C. Gennigens MD, PhD, A. Enguita PhD, T. Feys MBA, MSc
The 2023 annual ESMO meeting featured several presentations with the potential to reshape the standard of care in gynaecological cancers. New approaches emerged as promising treatments in cervical cancer, such as chemoradiotherapy combined with induction chemotherapy or pembrolizumab in patients with newly diagnosed locally advanced cervical cancer, or the antibody-drug conjugate tisotumab vedotin in the recurrent or metastatic setting. In addition, several trials further solidified the efficacy and safety of combining immunotherapy (durvalumab, atezolizumab, dostarlimab or pembrolizumab) with chemotherapy, in the treatment of advanced or recurrent mismatch repair deficient (MMRd) endometrial cancer. In contrast, the combination of atezolizumab plus chemotherapy followed by niraparib maintenance failed to demonstrate clinical benefits in patients with recurrent ovarian cancer.
(Belg J Med Oncol 2023;17(8):298–303)
Read moreBJMO - volume 17, issue 4, june 2023
A. Verbiest MD, PhD, M. Baldewijns MD, PhD, B. Beuselinck MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, PhD, G. Pelgrims MD, T. Roumeguère MD, PhD, E. Seront MD, PhD, N. Sundahl MD, PhD, S. Rottey MD, PhD
The management of renal cell carcinoma is evolving rapidly. Here, the BSMO expert panel discusses recent advances focusing on systemic therapies, and provides guidelines adapted to the Belgian context.
(BELG J MED ONCOL 2023;17(4):118–27)
Read moreBJMO - volume 17, issue 2, march 2023
C. Gennigens MD, PhD, H. Denys MD, PhD, S. Altintas MD, PhD, J. Kerger MD, J-F. Baurain MD, PhD, V. Bours MD, PhD, S. Henry MD, K. Van de Vijver MD, PhD, D. Lambrechts PhD, I. Vergote MD, PhD
Epithelial ovarian cancer (EOC) is the most frequent form of OC, a disease with a poor prognosis and high lethality, as most patients are diagnosed at advanced stages. To successfully battle EOC, it is crucial to identify reliable biomarkers and use personalised therapies in patient subgroups. A common feature of high-grade serous and endometrioid OC is homologous recombination repair deficiency (HRD), which frequently stems from the inactivation of the breast cancer susceptibility (BRCA) genes. Poly-(adenosine diphosphate [ADP])-ribose polymerase inhibitors (PARPi) were, therefore, developed for their lethality against HRD tumour cells. While patients with non-HRD tumours may also benefit from PARPi therapy in the recurrent EOC setting, recent phase III trials on newly diagnosed advanced-stage EOC have shown that PARPi treatment benefit is greater in patients with HRD tumours. These findings open new avenues for the use of PARPi as maintenance therapy in HRD-positive patients who had received first-line chemotherapy. This manuscript provides recommendations for Belgian physicians on how to approach HRD testing and incorporate it into treatment decisions of patients with newly diagnosed advanced-stage EOC.
(BELG J MED ONCOL 2023;17(2):38–45)
Read moreBJMO - volume 15, issue 6, october 2021
I. Vergote MD, PhD, H. Denys MD, PhD, J. De Grève MD, PhD, C. Gennigens MD, PhD, K. Van de Vijver MD, PhD, J. Kerger MD, P. Vuylsteke MD, J-F. Baurain MD, PhD
Ovarian cancer is often diagnosed at an advanced stage, which is associated with worse survival outcomes and more limited therapeutic options. Over the last years, knowledge regarding the molecular features of ovarian cancer has advanced considerably, enabling the development of several options for diagnosis and treatment in a patient-tailored approach. Identification of homologous recombination deficiency (such as mutations of the BRCA1 and BRCA2 genes, or genomic instability) affecting DNA repair, has become essential in guiding treatment decisions, especially after the development of targeted agents. Therapeutic decisions take into consideration the cancer subtype, its molecular features and disease stage. Fundamental principles of good treatment for women with ovarian cancer include debulking surgery (to reduce the tumour to no residual disease whenever possible), along with appropriate systemic treatment (chemotherapy and targeted agents). To aid Belgian physicians in developing the best individual medical strategies for patients with primary and recurrent ovarian cancer, we present here standard of care applicable in Belgium, that also includes recently developed targeted agents and currently applicable reimbursement criteria.
(BELG J MED ONCOL 2021;15(6):286-91)
Read moreBJMO - volume 14, issue 2, march 2020
B. Delafontaine MD, C. De Backer MD, B. Beuselinck MD, PhD, P. Debruyne MD, PhD, L. D’Hondt MD, PhD, C. Gennigens MD, PhD, T. Gil MD, C. Vulsteke MD, PhD, N. Martínez Chanzá MD, A. Verbiest MD, PhD, M. Strijbos MD, PhD, G. Van Lancker MD, G. Pelgrims MD, S. Rottey MD, PhD, On behalf of the BSMO Uro-Oncology Task Force Group
The management of recurrent or metastatic renal cell carcinoma is evolving fast, with new therapeutic options becoming available that may improve the outcome of patients. In this paper, recent evolutions are discussed and recommendations are made regarding the management of renal cell carcinoma in a Belgian context.
(BELG J MED ONCOL 2020;14(2):56–70)
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