J. Blokken PhD, PharmD

Political and economic issues in oncology

In the session on political and economic issues in oncology, Dr. Jeroen Mebis from the Jessa Hospital in Hasselt gave an overview on oncological nomenclature. In his talk, he discussed the relevant nomenclature numbers in daily clinical practice and shared his knowledge on hospital financing. Subsequently, Dr. Johan Kips (representative of the Minister of Social Affairs and Health Frank Vandenbroucke) discussed the legal and medical parameters for network formation in oncological treatment. Mattias Neyt (Senior health economist at the Belgian Health Care Knowledge Centre) closed the session with some insights into the new health technology assessment collaboration at a European level.

Supportive care task force

The second day of the 2023 annual BSMO meeting kicked off with a session from the supportive care task force. First, Dr. Fontaine (UZ Brussel, Brussels) and Prof. Klastersky (Institut Jules Bordet, Brussels) organised an interactive session on the proposal of a new multidisciplinary oncology consultation for supportive care. Thereafter, Dr. Fontaine presented the results of the Belgian pain survey. Finally, Dr. Gabry Kuijten presented the aim and achievements of the My Cancer Navigator initiative by the Anticancer Fund.

The KRAS oncogene: a long and winding road to druggability

The Kirsten rat sarcoma viral oncogene homolog (KRAS) is mutated in about a quarter of all human cancers and is at the centre of several pathways involved in tumorigenesis. As such, novel therapeutic strategies that can target this oncoprotein are potentially extremely valuable. However, since its discovery as on oncogene, almost four decades have gone by without any major breakthrough in the therapeutic targeting of mutant KRAS. In recent years, however, we are finally witnessing a paradigm shift with the discovery of druggable pockets on KRAS and the clinical activity of covalent KRAS^G12C inhibitors such as sotorasib and adagrasib.

Highlights in thoracic oncology

SUMMARY

In the field of thoracic oncology, many refinements and longer follow-up results of previously reported trials were presented during the annual ASCO 2022 meeting. Although there were no presentations of new, truly practice-changing trials, several exciting and promising data are worthwhile to mention in this highlights in thoracic oncology overview.

(Belg J Med Oncol 2022;16(5):229–35)

Congress highlights SABCS 2021

SUMMARY

The hybrid SABCS 2021 could only attract a few hundred life attendees, but like every year, several key abstracts were presented. In early stage, a meta-analysis on aromatase inhibitor versus tamoxifen in premenopausal ER+ patients showed lower recurrence with aromatase inhibitors, while the impact on overall survival remains unclear. An EBCTCG meta-analysis showed no benefit for an anthracycline-taxane adjuvant chemotherapy regimen compared to a taxane only regimen, if the taxane was given sequentially after the anthracycline, confirming the role of anthracycline-free chemotherapy regimens in a large proportion of patients with early breast cancer. In ER+ metastatic disease, the new SERD elacestrant was more potent than classical endocrine therapy after progression on first/second line endocrine therapy. Datopotamab deruxtecan is a promising new ADC targeting TROP2 with clear activity in triple negative disease. In HER2 positive disease, T-DXd displayed substantial antitumour effect on brain metastases, and pyrotinib can be added to the list of highly potent HER2 tyrosine kinase inhibitors. In patients with HER2 mutations, neratinib showed clear antitumour activity both in ER positive and triple negative metastatic breast cancer. In the surgery field, black and Hispanic women were shown to be at higher risk for breast cancer related lymphedema after axillary lymph node dissection. The Italian SINODAR-ONE trial built further on the Z0011 trial and confirmed that axillary surgery can be omitted in patients with breast cancer patients and one or two macro metastatic sentinel nodes.

(BELG J MED ONCOL 2022;16(2):79–87)

How to stage primary prostate cancer in 2022

Over the past years, next-generation imaging such as multiparametric whole body MRI and PSMA-PET/CT scans have been gaining momentum. Nonetheless, Prof. Padhani argues not to throw bone scintigraphy and CT scans (BS/ CT scans) out just yet. On the contrary, he puts BS/CT scans at the centre of patient care in men with locally advanced prostate cancer (LAPC). However, BS/ CT also comes with important limitations for which next-generation imaging (NGI) can serve as a problem solver after BS/CT scan assessments. During his talk at the BMUC 2022 meeting, Prof. Padhani emphasized the proven prognostic role of BS/CT scans, their predictive role in directing pelvic radiotherapy and for oncologic drug development. Finally, he argued that higher-quality evidence on the management and/or outcomes is needed before BS/CT scans can be substituted by NGI.¹

Radiation oncology for the medical oncologist

In the multidisciplinary oncology landscape, radiation oncology is becoming increasingly important in the treatment of many cancer patients. In this light, Prof. Dr. Liv Veldeman (University Hospital Ghent, Ghent, Belgium), president of the Belgian Society for Radiotherapy and Oncology (BeSTRO), discussed the most important steps in the radiotherapy process. In addition, she shared her experience with modern radiotherapy treatments and addressed how these innovative techniques may further
improve treatment outcomes.