K. Decaestecker PhD

Boosting anticancer immunity with radiotherapy

SUMMARY

Preclinical and early clinical data indicate that stereotactic body radiotherapy (SBRT) could work synergistically with checkpoint inhibitors and increase response rates. Given the potential synergistic effect between both treatments, the associated toxicity might also be increased. We conducted two phase I trials combining SBRT with ipilimumab (n=13) or pembrolizumab (n=18) in metastatic/inoperable melanoma and metastatic urothelial carcinoma respectively. To evaluate the effect of SBRT timing, patients were randomised to either sequential or concurrent SBRT in the latter trial. To assess early efficacy, a phase II trial of SBRT and nivolumab was conducted in metastatic/inoperable melanoma (n=20). Our data shows that SBRT combined with ipilimumab, nivolumab or pembrolizumab is safe and might increase efficacy in a subset of patients.

(BELG J MED ONCOL 2020;14(1):28–30)

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Emerging concepts in urothelial cancer

Treatment for urothelial cancer has undergone rapid change. Cisplatin based chemotherapy should be given in the neo-adjuvant setting in muscle invasive bladder cancer and could play a role in trimodality therapy when combined with surgery and radiotherapy. Genetic profiling has differentiated several subtypes of urothelial cancer, mimicking progress seen in breast cancer. Of these subtypes, p53 like tumours are less likely to respond to neo-adjuvant chemotherapy. In metastatic urothelial cancer, systemic immunotherapy (checkpoint inhibitors) has shown promising results in first line and second line patients. In a phase III trial, pembrolizumab, an anti-PD1 (programmed cell death 1) antibody, showed a survival benefit in second line metastatic urothelial cancer and should be the new standard of care. In patients who are cisplatin ineligible checkpoint can be used in first line, but no phase III data are available.

(BELG J MED ONCOL 2018;12(5):212–217)

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Highlights of Scientific Summits Meeting

Summary

Since last year a board of respectively three urologists and one radiation oncologist created the ‘Scientific Summits’. This is a scientifically independent Belgian congress for urologists, radiation oncologists, medical oncologists and radiologists with special interest in urology and more specifically in urologic oncology. The aim of Scientific Summits is providing up-to-date scientific information based on the highlights of the most recent international congresses. The 4^th edition took place in the charming city of Durbuy, Belgium.

The first day of the meeting focussed on the treatment and prevention of side effects of various anticancer treatments in urologic oncology. Experts in the field shared practical tips and tricks, based on interactive case discussions. They illustrated difficult situations and how to deal with them. On the second day of the meeting, interactive state-of-the-art lectures provided us with up-to-date information on how to evaluate and manage advanced and recurrent prostate cancer.

(BELG J MED ONCOL 2018;12(2):82–85)

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