J-L. Canon Archives

Belgian clinical practice guidelines for the treatment of patients with HER2-positive advanced breast cancer

BJMO - volume 16, issue 6, october 2022

G. Nader-Marta MD, F.P. Duhoux MD, PhD, D. Taylor MD, T. Van den Mooter MD, H. Denys MD, PhD, J-L. Canon MD, J. Mebis MD, A. Awada MD, PhD, H. Wildiers MD, PhD, K. Punie MD, E. de Azambuja MD, PhD

SUMMARY

HER2-targeted agents are the central component of HER2-positive metastatic breast cancer (MBC) treatment. The combination of trastuzumab, pertuzumab and a taxane is the preferred first-line regimen in most settings. For patients with disease relapse after adjuvant therapy, treatment decisions in the first-line are influenced by the treatment-free interval and the regimens used in the (neo)adjuvant setting. T-DXd has been recently established as the preferred second-line therapy. T-DM1, or the combination of tucatinib, trastuzumab and capecitabine, are reasonable third-line options, although efficacy and safety data of these regimens after prior exposure to T-DXd are lacking. In fourth and later lines, trastuzumab duocarmazine, neratinib plus capecitabine, margetuximab plus chemotherapy, lapatinib-based combinations or the continuation of trastuzumab with different chemotherapy partners are valid alternatives.

(BELG J MED ONCOL 2022;16(6): 287–92)

Thrombo-embolic events in cancer patients with impaired renal function

BJMO - volume 9, issue 2, may 2015

I. Elalamy MD, PhD, J-L. Canon MD, A. Bols MD, PhD, W. Lybaert MD, L. Duck MD, K. Jochmans MD, L. Bosquée MD, PhD, M. Peeters MD, PhD, A. Awada MD, PhD, P. Clement MD, PhD, S. Holbrechts MD, PhD, J-F. Baurain MD, PhD, J. Mebis MD, J. Nortier MD, PhD

Venous thromboembolism is a frequent cause of mortality and morbidity in patients with malignancy. Thrombosis is one of the leading causes of death in patients with malignancy after cancer itself. As such, prompt recognition and treatment of venous thromboembolism are required in order to reduce the risk of venous thromboembolism-related mortality. This report reviews the interrelationship between cancer, renal insufficiency and venous thromboembolism. The working group behind this review article concludes that low molecular weight heparins decrease the risk of recurrent venous thrombosis in cancer patients without increasing major bleeding complications. Low molecular weight heparins are therefore recommended as first line antithrombotic treatment in cancer patients with a clear clinical benefit. In patients with renal dysfunction, who are at increased risk of bleeding and of thrombotic complications, preference should be given to unfractionated heparin or a low molecular weight heparin with a mean molecular weight such as tinzaparin, having less risk of plasma accumulation and offering the possibility to maintain full therapeutic dose.

(BELG J MED ONCOL 2015;9(2):53–60)