S. Rottey MD, PhD

The first Belgian multidisciplinary meeting on urological cancers

The Belgian multidisciplinary meeting on urological cancers was initiated as the first national multidisciplinary scientific meeting of medical oncologists (BSMO), urologists (BAU) and radiotherapists (ABRO-BVRO). It was a great opportunity to build bridges between these three important specialisations involved in the treatment of uro-oncology.

The steering committee of the meeting consisted of J. P. Machiels, G. Pelgrims, S. Rottey (BSMO); L. Hoekx, S. Joniau, T. Roumeguere (BAU); O. De Hertogh, G. De Meerleer and Y. Neybuch (ABRO-BVRO). The first meeting, held in Brussels on March 29th, 2014 was a great success with more than 150 attendees of the different specialisations involved.

(BELG J MED ONCOL 2014;8(5):224–7)

Attacking the androgen receptor pathway in prostate cancer

Summary

Since the 1940’s the androgen receptor has been the main target for systemic therapy in prostate cancer. Classic hormonal therapy aims at lowering serum testosterone levels or block the androgen receptor ligand-binding domain. Despite disease progression, castration-resistant prostate cancer remains predominantly androgen-driven as novel secondary hormonal therapy with abiraterone acetate or enzalutamide has demonstrated increased overall survival. Promising androgen synthesis inhibitors (orteronel, galeterone), androgen receptor inhibitors (ARN-509, EPI-001, AZD3514) and heat-shock protein modulators are under investigation. Given the upcoming arsenal of systemic therapies and the molecular heterogeneity of castration-resistant prostate cancer, patient-tailored therapy strategies are being explored.

(BELG J MED ONCOL 2013;7(3):111–8)

An update on the systemic treatment of renal cell cancer

Renal cell carcinoma is a common malignancy affecting men and women sporadically or as part of an inherited syndrome. Upregulation of VEGF and other growth factors due to accumulation of HIF in combination with an activation of the mTOR pathway are known to be important parts of the pathogenesis. These signaling pathways are therapeutic targets of monoclonal antibodies, small-molecules kinase inhibitors (TKI’s) and mTOR-pathway inhibitors and currently constitute the mainstay of metastatic RCC treatment. During the last decade, treatment options for patients with advanced renal cell carcinoma, a disease resistant to cytotoxic chemotherapy, have improved significantly with increasing survival rates. Several clinical trials are ongoing and new results are expected in the coming years. In Belgium, three TKI’s, two mTOR-inhibitors and one anti-VEGF monoclonal antibody in combination with IFN-α are reimbursed for the treatment of advanced renal cell carcinoma. Sunitinib can be administered in first line and everolimus from second line on to patients with low- or intermediate risk disease. Therapy with bevacizumab/IFN-α is an alternative first line option. Temsirolimus is an option in first line for patients with high risk disease. Sorafenib has shown positive results in patients pretreated with cytokines. Recently, pazopanib has become available as a first line treatment for patients with advanced renal cell carcinoma.

(BELG J MED ONCOL 2012;6:13–21)