J. Blokken PhD, PharmD

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL. 2025;19(1):40)

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL. 2024;18(8):341)

Highlights in breast cancer

SUMMARY

At ESMO 2024, updated results of the KEYNOTE-522 study showed for the first time overall survival (OS) benefit when adding pembrolizumab to neoadjuvant chemotherapy in patients with early-stage triplenegative breast cancer (TNBC). In addition, real-world evidence indicated that oestrogen receptor (ER)-low human epidermal growth factor receptor 2 (HER2)-negative disease treated with the neoadjuvant KEYNOTE-522 regimen achieved very high pathological complete response (pCR) rates and should preferably be treated as TNBC. Updated results from the NATALEE trial further reinforced the efficacy of combining a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor with endocrine therapy in patients with early-stage hormone receptor (HR)-positive breast cancer at risk of recurrence. Furthermore, preliminary evidence showed promising activity in patients with luminal B-like breast cancer treated with preoperative radiotherapy (RT) plus immuno-chemotherapy. Additionally, the HypoG-01 trial supports the use of hypofractionated RT (40 Gy/15 fractions in three weeks) to irradiate loco-regional nodes in patients with early-stage breast cancer. In the metastatic setting, the addition of capivasertib to first-line paclitaxel did not significantly improve survival in patients with TNBC. In addition, first-line treatment with CDK4/6 inhibitors and endocrine therapy confirmed efficacy for patients with HR-positive HER2-negative breast cancer with aggressive disease criteria compared to upfront chemotherapy. Moreover, in patients with HR-positive breast cancer, a large proportion of patients currently categorised as having tumours with an immunohistochemical (IHC) score of 0 at local testing, are HER2-low (IHC 1 or 2+) or ultralow (IHC >0 and <1) at retesting and can also benefit from trastuzumab deruxtecan (T-DXd). Finally, substantial and durable intracranial clinical activity was seen in patients with HER2-positive breast cancer with stable and active brain metastases treated with T-DXd.

(BELG J MED ONCOL 2024;18(8):294–302)

Long-term data solidify nivolumab + cabozantinib as a standard first line treatment for patients with advanced renal cell carcinoma

Based on the results of several large, randomised phase III studies, combinations of an immune checkpoint inhibitor (ICI) and a tyrosine kinase inhibitor (TKI), or dual ICI therapy were established as the preferred first line treatment for patients with metastatic renal cell carcinoma (mRCC). During the 2024 ASCO GU conference, long-term data of the pivotal CheckMate 9ER study evaluating the combination of cabozantinib (CABO) and nivolumab (NIVO) in previously untreated mRCC patients were presented.¹ After a median follow-up of 55.6 months, CABO-NIVO continued to be associated with a significantly longer progressionfree (PFS) and overall survival (OS), and a significantly higher objective response rate (ORR) than sunitinib alone.¹ As such, these long-term data of the CheckMate 9ER study solidify the combination of CABO-NIVO as a preferred first line treatment choice for patients with mRCC.

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2024;18(6):287–288)

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2024;18(6):248)

Gut microbiota as a novel source of biomarkers for immunotherapy in NSCLC

There is growing interest for biomarkers that allow a better selection of non-small cell lung cancer (NSCLC) patients that are likely to benefit from immunotherapy. To date, several biomarkers are under investigation, including the PD1/PL-L1 axis, the tumour mutational burden, and the gut microbiota. The gut microbiota seems interesting due to its role in cancer, cancer treatment and treatment-related toxicities. Below we briefly summarize the conditions that might influence the composition of the gut microbiota and the subsequent effect on a response to immunotherapy, immune-related adverse events, and their management in NSCLC.¹