D. Schallier Archives

Checkpoint inhibitors in the first-line treatment of non-small cell lung cancer

BJMO - volume 11, issue 8, december 2017

L. Decoster MD, PhD, K. Vekens MD, S. Mignon MD, D. Schallier MD, PhD, J. De Grève MD, PhD

SUMMARY

Antibodies against programmed cell death-1 (PD-1) and its ligand (PD-L1) have become standard-of-care in the second-line treatment for advanced non-small cell lung cancer after failure of first-line chemotherapy. The observed durable responses as well as the favourable toxicity profile have moved these agents to first-line studies for advanced non-small cell lung cancer. In tumours with high PD-L1 expression, pembrolizumab is registered as the preferred first-line treatment. Further studies are currently focusing on combination strategies. The major future challenge will be selecting the optimal treatment strategy for the patient.

(BELG J MED ONCOL 2017;11(8):380–385)

Management and systemic treatment of clear cell metastatic renal cell carcinoma: BSMO expert panel recommendations

BJMO - volume 9, issue 1, february 2015

Z. El Ali MD, PhD, D. Van Brummelen MD, P. Wolter MD, S. Rottey MD, PhD, S. Altintas MD, PhD, D. Schallier MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, PhD, F. Van Aelst MD, S. Sideris MD, T. Gil MD, N. Sirtaine MD, L. D’Hondt MD, PhD, D. Luyten MD, C. Focan MD, PhD, G. Matus MD, M. Rasschaert MD, PhD, G. Pelgrims MD, the BSMO Renal Cancer Task Force Group

Almost 30% of patients with renal cell cancer present initially with advanced stage IV disease. In the past decade, the management of the metastatic renal cell cancer has been revolutionised by the knowledge of its molecular biology and development of targets against vascular endothelial growth factor and mammalian target of rapamycin pathways. In this paper we present recommendations based on a thorough review of available guidelines and data from the phase III randomised controlled trials that evaluated new agents in patients with advanced metastatic renal cancer.
(BELG J MED ONCOL 2015;9(1):16–24)

Preferences of advanced lung cancer patients for information and participation in medical decision-making: a longitudinal multicentre study

BJMO - volume 6, issue 4, september 2012

K. Pardon , R. Deschepper , R. Vander Stichele , J.L. Bernheim , F. Mortier PhD, D. Schallier MD, PhD, L. Deliens MA, PhD, MSc

The main objective of this dissertation was to gain insight into the preferences of advanced lung cancer patients for receiving information and participating in decision-making concerning treatment options, health-care setting transfers and end-of-life decision-making (ELDs).

In the course of one year, physicians in thirteen hospitals in Flanders, Belgium, recruited patients with initial non-small-cell lung cancer, stage IIIb or IV. The patients were interviewed with a structured questionnaire every two months until the fourth interview and every four months until the sixth interview.

At inclusion, 128 patients were interviewed at least once; thirteen were interviewed six consecutive times. Nearly all patients wanted information about diagnosis, treatment and prognosis and a small majority wanted information about palliative care and ELDs. Preferences regarding participation varied according to the type of decision. Some preferences, more specifically the preferences for information about prognosis, palliative care and ELDs and the preferences for shared decision-making, were regularly not well met by the physician. Preferences were variable over time, at least when it concerned information preferences about palliative care, ELDs and participation preferences. Family was important in medical decision-making to 69% of the patients and to almost all patients in case of incompetence.

Doctors should ask their advanced lung cancer patients at the beginning of their illness how much information and participation they want, and should keep on asking because preferences do change over time in ways they might not expect. (BELG J MED ONCOL 2012;6:132–135)