BJMO - 2024, issue Special, june 2024
J. Blokken PhD, PharmD, T. Feys MBA, MSc
The percentage of brain metastases at initial diagnosis ranges from 10–30% in patients with non-small cell lung cancer (NSCLC), with increasing incidence throughout the disease course. These brain metastases can cause motor dysfunction, mental dysfunction, seizures, headaches, nausea and vomiting and can thus severely hamper the patient’s quality of life. Historically, the presence of brain metastasis is a poor prognostic factor, and its control may prolong the prognosis of the patient. Brain metastases can be addressed with local therapy (such as surgery and radiotherapy), or with systemic therapy using classical anticancer drugs. Unfortunately, one of the major limitations in defining the optimal initial treatment for NSCLC patients with brain metastases is that patients with untreated brain metastases were often excluded from randomised clinical trials evaluating systemic therapies.1 Furthermore, also a drug’s inability to penetrate the blood-brain barrier (BBB) can result in treatment resistance.2 The most suitable treatment should be determined during a multidisciplinary consult and should be based on histologic type, the general condition of the patient, and the size and number of brain metastases.2 This mini-review discusses the systemic management of patients with NSCLC and brain metastases, with a particular focus on patients with actionable genomic alterations.
Read moreBJMO - 2024, issue Special, march 2024
J. Blokken PhD, PharmD, T. Feys MBA, MSc
The second day of BMUC 2024 kicked off with the late-breaking session on uro-oncology. During this session, three recent clinical trials with important implications for daily clinical practice were discussed and critically interpreted. First, Prof. Piet Ost (University Hospital Ghent) walked us through the results of the GETUG-AFU18 trial. Thereafter, Dr. Marco Gizzi (Institut Roi Albert II Cliniques universitaires Saint-Luc) shared his insights on the potential caveats of the KEYNOTE-564 trial after which Dr. Alexander Giesen (University Hospitals Leuven) closed the session with a presentation on the PREVENT trial.
Read moreBJMO - 2024, issue Special, february 2024
J. Blokken PhD, PharmD
The second day of the 2024 annual BSMO meeting kicked off with a session from the supportive care task force. First, Dr. Gary Deng (Memorial Sloan Kettering Cancer Center, United States) gave a talk on integrative medicine and how it helps cancer supportive care. Thereafter, Dr. Antonietta Iasiello (Dr. Spinedi Clinic, Orselina, Switzerland), discussed health education according to the Charter of Ottawa.
Read moreBJMO - 2024, issue Special, february 2024
J. Blokken PhD, PharmD
In line with the tradition, the 2024 annual BSMO meeting kicked off with a session from the Breast Cancer Task Force. Dr. Françoise Derouane (University Hospitals Leuven, Leuven) opened the session with a lecture on candidates for neoadjuvant chemotherapy in luminal disease. Thereafter, Dr. Ines Nevelsteen (University Hospitals Leuven, Leuven) discussed targeted axillary dissection after neoadjuvant chemotherapy in cN+ disease. In a third lecture, Dr. Nuria Kotecki (Institut Jules Bordet, Brussels) addressed the current challenges in the approach of brain metastases in breast cancer. Finally, Dr. Kevin Punie (GZA Hospitals Sint-Augustinus, Wilrijk) shared his knowledge and experience on how to select the optimal adjuvant endocrine therapy in early HR+ breast cancer.
Read moreBJMO - 2023, issue Targeted Therapy Issue Special, november 2023
J. Blokken PhD, PharmD
Cholangiocarcinoma (CCA) is the second most common primary liver cancer and accounts for approximately 10–15% of all primary liver cancers. CCA is subdivided into intrahepatic CCA (iCCA), arising from bile ductules proximal to the second-order bile ducts; perihilar CCA (pCCA), arising in the right and/or left hepatic duct and/or at their junction; and distal CCA (dCCA), arising from the epithelium distal to the insertion of the cystic duct. pCCA and dCCA are collectively referred to extrahepatic CCA (eCCA). For patients with early-stage CCA, the treatment usually consists of a surgical resection followed by adjuvant chemotherapy, while systemic chemotherapy is the standard first-line treatment for patients with advanced stage disease. However, given the fact that nearly 40% of patients with biliary tract cancer harbour genetic alterations which are potential targets for precision medicine, molecular analysis should be carried out before or during firstline therapy to evaluate options for second and higher lines of treatment as early as possible in advanced disease.1 This review aims to discuss the most promising therapeutic molecular targets for CCA and the targeted agents that are available in this setting.
Read moreBJMO - 2023, issue Highlights in Immunotherapy Special, november 2023
J. Blokken PhD, PharmD, T. Feys MBA, MSc
Over the past years, immune checkpoint inhibitors (ICIs) against cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1) have drastically changed the treatment landscape for patients with non-small cell lung cancer (NSCLC). Despite their success, a considerable proportion of patients will eventually consider ICI discontinuation due to disease progression, immune-related adverse events (irAEs) or the completion of a fixed duration course of ICIs without disease progression. Against this background, evidence is mounting that ICI retreatment could be an option for some patients. To date, however, no guidelines have been published for ICI rechallenge in lung cancer and it is still unclear which patients could benefit from a second course of ICI. In this, one needs to make a distinction between restarting the ICI without any other cancer treatment in between (retreatment) or restarting ICI after another treatment was used between the two ICI regimens (rechallenge). This is an important distinction as additional treatments may influence the homeostasis of the patients’ immune system.1,2 This article describes some of the key elements that could influence treatment outcomes upon ICI retreatment or rechallenge and addresses potential strategies for ICI rechallenge and safety management.
Read moreBJMO - 2023, issue Highlights in Immunotherapy Special, november 2023
J. Blokken PhD, PharmD
Over the past decade, we have witnessed a paradigm shift in the first-line treatment of patients with advanced or metastatic clear cell renal cell carcinoma (RCC). Nowadays, the preferred first-line treatment for these patients consists of a combination of an immune checkpoint inhibitor (ICI) with a tyrosine kinase inhibitor, or dual ICI therapy. With a minimal follow-up of three years, the pivotal CheckMate 9ER trial demonstrated the superior survival and response benefits of combination therapy with cabozantinib and nivolumab over sunitinib as first-line therapy for advanced RCC patients. However, effective management strategies to deal with potential adverse events are key to maintain tolerability with cabozantinib and nivolumab treatment.
Read more
Top
To provide the best experiences, we and our partners use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us and our partners to process personal data such as browsing behavior or unique IDs on this site and show (non-) personalized ads. Not consenting or withdrawing consent, may adversely affect certain features and functions.
Click below to consent to the above or make granular choices. Your choices will be applied to this site only. You can change your settings at any time, including withdrawing your consent, by using the toggles on the Cookie Policy, or by clicking on the manage consent button at the bottom of the screen.
