L. Decoster MD, PhD

The value of population-based databases to evaluate long-term patient outcomes: A multicentric research project in older patients with cancer

SUMMARY

The use of population-based data is a relatively accessible and cost-effective approach to study long-term outcomes in oncology. Also in older patients with cancer, longer-term outcome studies are limited and population-based data could help address this gap. Under the lead of UZ Leuven and the Belgian Cancer Registry (BCR), a national study was initiated to explore the association between the general health status of older patients with cancer as assessed by geriatric screening and assessment, and long-term outcomes as captured by population-based data. To this extent, data previously gathered within the context of a multicentre clinical study will be linked with three population-based databases: cancer registration data from BCR, healthcare reimbursement data from InterMutualistic Agency and hospital discharge data from Technical Cell. The major advantage of these population-based data is their longitudinal nature, which allows to follow a (sub)population across several years. The downside is their lack of clinical information. One way to partially overcome this limitation is to supplement population-based data with primary study data to investigate more clinically relevant outcomes. Although often scientifically interesting and appealing, coupling with population-based data demands intensive administrative efforts including an authorisation demand at the Information Security Committee. During the whole process, special attention should be given to privacyrelated aspects of the use and linkage of these data to ensure confidentiality.

BELG J MED ONCOL 2021;15(7):362-6)

MET: another therapeutic target in non-small cell lung cancer

SUMMARY

The identification of clinically relevant driver mutations has reshaped the therapeutic landscape of non-small cell lung cancer (NSCLC). In the past year, the activation of the mesenchymal-to-epithelial transition (MET) pathway has gained importance because of the recent development of selective and effective MET inhibitors. In NSCLC, MET dysregulation may be caused either by mutation or amplification and is associated with poor prognosis. In addition, the optimal first-line treatment is currently undetermined since data from different trials suggest limited activity of immune checkpoint inhibitors, indicating a high medical need. In phase II trials, MET inhibitors have shown promising response rates (41–65%) and duration of response in MET exon 14 mutated NSCLC. First-line trials are currently ongoing. In de novo MET amplified NSCLC, the activity of these inhibitors seems limited to tumours with a high level amplification. As in other oncogene driven NSCLC, resistance mechanisms do appear ultimately and future research should focus on this in order to optimise treatment options for MET dysregulated NSCLC.

(BELG J MED ONCOL 2021;15(6):278-82)

Highlights in geriatric oncology

Summary

Cancer is primarily a disease of older adults, and as a result improving the care for older patients with cancer is becoming increasingly important. In this respect, the 2020 virtual ASCO meeting featured a fascinating and very important session entitled “You’re only old once: improving outcomes for older adults with cancer.” In this session, positive results were presented of four randomised controlled trials evaluating whether or not geriatric assessment has the potential to improve treatment outcomes in older patients with cancer. Three of these trials focused on the geriatric management of patients receiving chemotherapy or other cytotoxic agents, while a fourth study evaluated to what extent perioperative oncogeriatric management could improve the outcome of patients undergoing surgery for gastrointestinal cancer. Overall, all these studies indicate that an integrated geriatric oncology assessment provides an important clinical benefit to older cancer patients.

(BELG J MED ONCOL 2020;14(5):218-21)

Geriatric oncology: targeting older patients with cancer

SUMMARY

As the cancer population ages, treatment decisions in the older patients should not only be guided by the tumour characteristics but also by patient characteristics. The performance of a comprehensive geriatric assessment as well as a health related quality of life evaluation are important in order to deliver the optimal personalised care in older patients with cancer. The current PhD thesis focused on the use of screening tools, geriatric assessment and interventions as well as on health-related quality of life in older patients with cancer.

(BELG J MED ONCOL 2020;14(3):106–8)

Geriatric oncology: Integrative Oncology – Leaving no one behind

SUMMARY

The 2019 annual conference of the International Society of Geriatric Oncology took place in Geneva, Switzerland from November 14–16^th. This year, the International Society of Geriatric Oncology and the International Federation on Ageing also jointly hosted a meeting at the United Nations on the development and preparation of health care professionals for the ageing population with cancer.

(BELG J MED ONCOL 2020;14(3):114–5)

Geriatric oncology: becoming mainstream cancer care

SUMMARY

The 2018 annual conference of the International Society of Geriatric Oncology took place in Amsterdam, the Netherlands from November 16–18th. More than 500 delegates from 41 countries with a special interest in the care for older patients with cancer attended this conference. The meeting provided an overview of current advances in geriatric oncology.

(BELG J MED ONCOL 2019;13(2):60–62)

Geriatric oncology: From research to practice: Incorporating geriatric oncology into patient care

The 2017 annual conference of the International Society of Geriatric Oncology took place in Warsaw, Poland from November 9–11^th. More than 300 delegates from 42 countries with a special interest in the care for older patients with cancer attended this conference. The meeting provided an overview of current advances in geriatric oncology.

(BELG J MED ONCOL 2018:12(3):142–144)