T. Feys MBA, MSc

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2023;17(2):66)

Highlights in hormone-receptor-positive breast cancer

SABCS 2022 featured a plethora of interesting presentations in the field of hormone receptor-positive (HR+) breast cancer (BC). In the early disease setting, updated results were presented for the MonarchE trial, evaluating adjuvant abemaciclib + endocrine therapy (ET). Results were also presented for the SWOG S1207 study, assessing the addition of everolimus to adjuvant ET, together with 12-year results of TAILORx. A final early-stage study evaluated the Breast Cancer Index as a tool to select pre-menopausal patients for whom ovarian function suppression (OFS) will likely not be beneficial. In the advanced setting, the RIGHT Choice study assessed ribociclib plus ET in patients with aggressive forms of metastatic HR+ BC. Several novel treatment strategies were also evaluated in the metastatic HR+ setting. CAPItello-291 tested the AKT inhibitor capivasertib plus fulvestrant (CAPItello-291), while several other studies addressed the use of selective oestrogen receptor degraders (SERDs) in this setting. Finally, an analysis of the phase III TROPICS-2 study was presented evaluating the efficacy of Sacituzumab Govitecan in function of Trop-2 expression levels.

Highlights in HER2-positive breast cancer

For patients with early-stage Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast cancer (BC), the most important data presented at SABCS 2022 consisted of the final results of the phase III PEONY study. Results of this trial add to the existing body of evidence demonstrating the benefit of the pertuzumabtrastuzumab-docetaxel regimen in patients with HER2-positive early breast cancer (EBC). In the metastatic setting, trastuzumab deruxtecan (T-DXd) was once again the center of the attention with the presentation of data from the DESTINY-Breast02, DESTINY-Breast03 and ROSET-BM trials. Finally, several studies assessed the possibility of chemotherapy-free regimens for the treatment of HER2-positive, hormone receptor (HR)- positive metastatic BC.

Advances in local therapy for patients with early-stage breast cancer

During SABCS 2022, several abstracts were dedicated to advances in local therapy for patients with earlystage breast cancer (BC). A first trial assessed the impact of breast conserving therapy on local recurrence in patients with multiple ipsilateral BC. Next, the OPBC-04/EUBREAST-06/OMA study evaluated the oncological outcomes following sentinel lymph node biopsy or targeted axillary dissection after downstaging with neoadjuvant chemotherapy. In addition to this, POLAR was identified as a genomic classifier that is not only prognostic for locoregional recurrence but also predictive for a benefit of radiotherapy. Finally, hypofractionated regimens of radiotherapy were studied

Miscellaneous news from SABCS

This final article discussing highlights from SABCS 2022 summarizes some of the presentations that did not fit in the categories discussed earlier. This summary will address the results of three clinical trials evaluating neoadjuvant treatment strategies in HER2-negative early breast cancer together with the data from the POSITIVE trial, evaluating the safety of interrupting endocrine therapy to facilitate pregnancy panning in younger women with breast cancer.

Breast cancer task force

In line with the tradition, the 2023 annual BSMO meeting kicked off with a session from the Breast Cancer Task Force. Prof. Evandro de Azambuja (Institut Jules Bordet, Brussels) opened the session with a lecture on the extended use of adjuvant endocrine therapy and the impact of recent insights on clinical practice. Thereafter, Dr. Donatienne Taylor (Clinique Sainte-Elisabeth CHU UCL Namur, Namur) discussed the antibodydrug conjugate landscape in advanced breast cancer. Finally, Dr. Caroline Duhem (Centre Hospitalier de Luxembourg, Luxemburg) shared her knowledge and experiences with the emerging adjuvant treatment escalation options in early HR+/HER2- breast cancer

Political and economic issues in oncology

In the session on political and economic issues in oncology, Dr. Jeroen Mebis from the Jessa Hospital in Hasselt gave an overview on oncological nomenclature. In his talk, he discussed the relevant nomenclature numbers in daily clinical practice and shared his knowledge on hospital financing. Subsequently, Dr. Johan Kips (representative of the Minister of Social Affairs and Health Frank Vandenbroucke) discussed the legal and medical parameters for network formation in oncological treatment. Mattias Neyt (Senior health economist at the Belgian Health Care Knowledge Centre) closed the session with some insights into the new health technology assessment collaboration at a European level.