C. van Marcke Archives

Admission of patients with solid cancer in the Intensive Care Unit: Challenging situations

BJMO - volume 19, issue 1, january 2025

C. Van De Wyngaert MD, A. Werion MD, J. Mesland MD, C. van Marcke MD, PhD

SUMMARY

The proportion of cancer patients considered for admission in intensive care units (ICU) gradually increased over the last decades. In this situation, it is important to avoid inappropriate management, whether through refusal of admission that could be beneficial, or through futile therapeutic escalation. In this review, we describe the factors that medical oncologists and intensive carers should discuss when considering ICU admission for cancer patients and propose a framework for decision-making based on four important concepts. Among cancer patients, data strongly suggest that the short-term prognosis is more linked to the acute pathology than to the underlying active tumour. More specifically, the impairment of more than two vital organs and the requirement of organ support are the most important factors predictive of mortality. ECOG performance status furthermore remains a crucial prognostic factor to consider. Open discussions with patients and close relatives at cancer diagnosis and during treatment are mandatory for informed decision making during an acute event.

(BELG J MED ONCOL 2025;19(1): 4–10)

The impact of sarcopenia in oncology Patients

BJMO - volume 16, issue 6, october 2022

N. Baczewska MD, C. van Marcke MD, PhD, R. Poncin MD, L. Duck MD

SUMMARY

Sarcopenia is defined as the loss of muscle mass and strength and plays an increasingly important role in the management of oncology patients. Sarcopenia is frequently mislabelled as malnutrition or cachexia. Clinicians lack a consensus definition of easy-to-use, straightforward, reliable diagnostic tools to optimally recognise sarcopenia. This review will broadly go through the current literature in order to define sarcopenia, as well as to understand its mechanisms. Helpful diagnostic tools will be discussed, which can be used to optimise the management of patients suffering from a malignant disease. This review will also illustrate how sarcopenia is an independent negative predictive and prognostic factor regarding survival and quality of life, directly impacting toxicity and efficacy of oncological treatments.

(BELG J MED ONCOL 2022;16(6):274–8)

Acute cerebral toxicity during concurrent anti-HER2 therapy and radiotherapy for breast cancer brain metastases

BJMO - volume 12, issue 1, february 2018

C. van Marcke MD, PhD, L. Renard MD, F.P. Duhoux MD, PhD

Summary

Patients with HER2-positive advanced breast cancer frequently develop brain metastases. Dual anti-HER2 therapy significantly prolongs survival in previously untreated metastatic disease. However, no safety data exist on the concurrent use of pertuzumab, trastuzumab and brain radiotherapy. We describe two cases of previously untreated HER2-positive breast cancer and brain metastases, who developed acute cerebral toxicity during the concomitant administration of anti-HER2 therapy and whole-brain radiotherapy. Systematic clinical data is warranted to prove the safety of this association.

(BELG J MED ONCOL 2018;12(1):22–25)