BJMO - volume 15, issue 4, june 2021
Ir A. Hébrant PhD, H. Antoine-Poirel MD, PhD, K.B.M. Claes PhD, F. Dedeurwaerdere MD, J. Van der Meulen MD, F. Lambert MD, J. Van Huysse MD, G. Martens MD, PhD, N. D’Haene MD, PhD, K. Geboes MD, P. Pauwels MD, PhD, A. Jouret-Mourin MD, PhD, P. Peeters MD, M. van den Eynde MD, PhD, R. Salgado MD, PhD, P-J. Van Dam MD, P. Lefesvre MD, PhD, X. Sagaert MD, PhD, S. Metsu PhD, A. Demols MD, PhD, J-L. van Laethem MD, PhD
Pancreatobiliary cancers (PBC) group pancreatic and biliary tract cancers and are among the cancers with the lowest survival rate. Emerging data suggest that novel biomarker-specific targeted therapies can be proposed for selected populations with survival benefit. This review summarises the scientific evidence to test for these biomarkers in order to optimise the management of pancreatobiliary cancers, within the context of the Belgian NGS convention.
(BELG J MED ONCOL 2021;15(4):170-6)
Read moreBJMO - volume 15, issue 2, march 2021
L. Mans MD, M. Pezzullo MD, M.A. Bali MD, PhD, L. Verset MD, PhD, J. Closset MD, C. Bouchart MD, J-L. van Laethem MD, PhD
Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death and its 5-year overall survival is poor. Surgery remains the only curative treatment but less than 20% of the patients are resectable at diagnosis. New treatment options for the management of metastatic disease have recently emerged, and with them the question of their use in preoperative strategy. Neoadjuvant sequence may increase the achievement of R0 resection margins in borderline resectable tumours but also the proportion of patients who will receive chemotherapy. We report a case of borderline resectable PDAC treated with duodenopancreatectomy after neoadjuvant treatment consisting of chemotherapy and SBRT.
(BELG J MED ONCOL 2021;15(2):79-82)
Read moreBJMO - volume 14, issue 6, october 2020
J-L. van Laethem MD, PhD, L. Mans MD, A. Demols MD, PhD
Pancreaticobiliary cancers remain challenging to be treated due to aggressive biology and heterogeneous molecular patterns. Chemotherapy remains the backbone therapy, with two lines available in each cancer. Using targeted therapies in unselected populations has led to complete failure while currently used immunotherapy with anti-PD1 can only be active in instable tumours (MSI-High), a rare condition in these cancers. As recently reported, targeting specific genes in pancreaticobiliary cancers may significantly improve tumour control and offer new ways to manage them, in addition to conventional chemotherapies usually proposed in front line. Consequently, it is now more and more recommended to perform genetic and genomic testing of these tumours, searching for new druggable targets. Dedicated trials focusing on such enriched populations are currently ongoing.
(BELG J MED ONCOL 2020;14(6):274-9)
Read moreBJMO - volume 13, issue 1, february 2019
Ir A. Hébrant PhD, Ir , A. Jouret-Mourin MD, PhD, G. Froyen PhD, J. Van der Meulen MD, M. De Man MD, R. Salgado MD, PhD, M. van den Eynde MD, PhD, N. D’Haene MD, PhD, G. Martens MD, PhD, E. van Cutsem MD, PhD, H.A. Poirel MD, PhD, S. Tejpar MD, PhD, J-L. van Laethem MD, PhD, K. Geboes MD, P. Pauwels MD, PhD, F. Dedeurwaerdere MD, B. Maes MD, PhD, J. De Grève MD, PhD, J. Vanhuysse , P. Peeters MD, L. Vanacker MD, M. Gomez-Galdon , M. Chintinne MD, PhD, A. Hendlisz MD, PhD, G. de Hertogh MD, PhD, X. Sagaert MD, PhD, M. Peeters MD, PhD, P. Vannuffel , P. Lefesvre MD, PhD, J. Vermeij , M. Simoens , T. Van den Mooter MD, N. van Damme PhD, M. Van den Bulcke PhD
The Belgian Commission of Personalized Medicine has been created to advise the federal government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests. Here, we propose the Belgian strategy for molecular testing in the digestive tumours within a scientific-based framework. For each tested biomarker, a clinical test level is attached, which is key to establish the relevance of the test and to define the reimbursement. For each digestive tumour type, the different molecular tests are represented as decision trees with its test utility, test level and a brief technical test description.
(BELG J MED ONCOL 2019;13(1):4–10)
Read moreBJMO - volume 12, issue 2, march 2018
J-L. van Laethem MD, PhD
Pancreatic cancer is one of the most lethal cancers and will become the second leading cause of cancer-death; despite some progress in management, median survival remains around 24 months in resected disease, fifteen months in locally advanced non resectable disease and twelve months in metastatic setting. Two backbone regimens, folfirinox and gemcitabine-abraxane are nowadays used in routine practice, mainly in metastatic disease but are now investigated in both adjuvant and neo-adjuvant therapy. Neoadjuvant therapy, although requiring robust proof of definite efficacy, is more frequently used for borderline resectable tumours with promising results; moreover, it offers a unique window to integrate care and research by assessing new drugs in translational platforms. Molecular biology (multiomics) and imaging (radionomics) will also permit and promote a more comprehensive use of new drugs, including immune-oncological ones and strategies and select the best patients for precision medicine, the ultimate goal being to improve this poor outcome. This review covers the current standard and best practice in the different sub-entities of pancreatic cancer and opens perspectives in new therapeutic challenges.
(BELG J MED ONCOL 2018;12(2):39–45)
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