BJMO - volume 18, issue 7, november 2024
L. Smets MSc, K. Haustermans MD, PhD, A. Wolthuis MD, PhD, G. Bislenghi MD, PhD, E. van Cutsem MD, PhD, L. Debrun BSc, G. de Hertogh MD, PhD, A. D’Hoore MD, PhD, R. Dresen MD, PhD, G. Rasschaert MD, X. Sagaert MD, PhD, S. Tejpar MD, PhD, F. van Herpe MD, J. Dekervel MD, PhD
The multidisciplinary management of rectal cancer is an evolving field, and these guidelines seek to offer direction for treating this condition. A tailored treatment approach should be based on a multi-disciplinary tumour board discussion taking into account tumour staging, patient performance status, and expectations. Patients with node-negative T1 rectal cancer can be managed by a local excision. In patients with early rectal cancer, primary surgery is the standard-of-care. In some of these patients, an organ-sparing approach by long-course chemoradiotherapy can be an alternative. A total neoadjuvant therapy (TNT)-approach consisting of a combination of (chemo)radiotherapy and chemotherapy is preferred for locally advanced disease.
(BELG J MED ONCOL 2024;18(7):271–278)
Read moreBJMO - volume 18, issue 6, october 2024
I. Kindts MD, PhD, A. Baten MD, B. Bussels MD, A. De Caluwé MD, L. Donnay MD, L. Goethals MD, PhD, M. Machiels MD, PhD, V. Remouchamps MD, PhD, L. Veldeman MD, PhD, C. Weltens MD, PhD, P. Poortmans MD, PhD
Primary treatment of preference for a local or locoregional breast cancer is breast-conserving therapy (this is breast-conserving surgery followed by radiation therapy). When a breast cancer recurs, or in case of a second ipsilateral breast cancer, the optimal treatment strategy is less well defined than in the primary setting. Standard of care is salvage mastectomy. However, avoidance of mastectomy, if oncologically safe, has proven to be associated with improved patient satisfaction in terms of cosmetic outcome and quality of life apart from cost and resource implications for healthcare providers. With this manuscript, the Belgian Breast Group of the BeSTRO sets up some basic principles regarding repeat breast-conserving therapy awaiting international guidelines.
(BELG J MED ONCOL 2024;18(6):235-238)
Read moreBJMO - volume 18, issue 1, february 2024
L. van Zuylen MD, PhD, J. van Esch MD, PhD, S. Kobes , I. van Voorthuizen , W. van der Geugten MSc, M. Slager MSc, L. de Jong MSc, L. Tulner MD, A. Rothengatter-Ophof MD, T. Efthymiou MD, M. Tenk MD, M.S. Vos MD, PhD, I. Rietkerk MSc, I. van Trigt MSc, E. Lemmens-Sauter , A. de Graeff MD, PhD
The guideline ‘Care in the dying phase’ of 2010 has been revised by a committee consisting of members mandated by several scientific, professional and patient organisations. For every module, the literature search (up to 2014) of the guideline ‘Care of dying adults in the last days of life’ from the National Institute for Health and Care Excellence (NICE) has been used. Based on a bottleneck analysis, several scientific questions were formulated with regard to marking the dying phase, the use of opioids for dyspnoea or pain, prevention and treatment of death rattle, and artificial hydration. Other parts of the guidelines were revised consensus-based. In this paper, a summary of the most important recommendations of the guideline is given.
(BELG J MED ONCOL 2024;18(1):17–23)
Read moreBJMO - volume 17, issue 4, june 2023
A. Verbiest MD, PhD, M. Baldewijns MD, PhD, B. Beuselinck MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, PhD, G. Pelgrims MD, T. Roumeguère MD, PhD, E. Seront MD, PhD, N. Sundahl MD, PhD, S. Rottey MD, PhD
The management of renal cell carcinoma is evolving rapidly. Here, the BSMO expert panel discusses recent advances focusing on systemic therapies, and provides guidelines adapted to the Belgian context.
(BELG J MED ONCOL 2023;17(4):118–27)
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No authors
The recent approval of the poly(ADP-ribose) polymerase (PARP) inhibitor olaparib for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) harbouring pathogenic variants of BRCA2 or BRCA1 marks the start of molecularly guided precision medicine in prostate cancer. In parallel with this approval comes the need to embed molecular diagnostics in the clinical management of patients with mCRPC. To date, however, there are no established protocols in Belgium for the use of mutation testing in this setting. This article will therefore provide practical guidance for sample preparation and handling, pre-analytic processing, and pathogenic variant analysis in mCRPC. Across the different phases of this process, a multidisciplinary approach involving urologists, oncologists, radiologists, pathologists, molecular biologists, technicians, nurses, and geneticists will be key to safeguard adequate sample selection to perform molecular analyses at the time of metastatic disease. It will also facilitate high-quality molecular testing with a minimal failure rate. Only by optimising this process will physicians be able to adequately select mCRPC patients that are most likely to benefit from PARP inhibition, or other future targeted therapies, allowing to use these agents in the correct patient groups.
(BELG J MED ONCOL 2022;16(7):343–54)
Read moreBJMO - volume 16, issue 7, november 2022
S. Verbeke MD, PhD, S. Verschuere MD, PhD, M-D. Martín-Martinez MD, B. Lelie MD, L. Libbrecht MD, PhD, M. Baldewijns MD, PhD, S. Rorive MD, PhD, G. Beniuga MD, J. Eben MD, M-A. van Caillie MD, N. D’Haene MD, PhD, C. Gabriel MD, F. Dedeurwaerdere MD, Ir A. Hébrant PhD, H.L. Gijs , K.B.M. Claes PhD, D. De Maeseneer MD, B. Tombal MD, PhD, P. Pauwels MD, PhD
The recent approval of the poly(ADP-ribose) polymerase (PARP) inhibitor olaparib for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) harbouring pathogenic variants of BRCA2 or BRCA1 marks the start of molecularly guided precision medicine in prostate cancer. In parallel with this approval comes the need to embed molecular diagnostics in the clinical management of patients with mCRPC. To date, however, there are no established protocols in Belgium for the use of mutation testing in this setting. This article will therefore provide practical guidance for sample preparation and handling, pre-analytic processing, and pathogenic variant analysis in mCRPC. Across the different phases of this process, a multidisciplinary approach involving urologists, oncologists, radiologists, pathologists, molecular biologists, technicians, nurses, and geneticists will be key to safeguard adequate sample selection to perform molecular analyses at the time of metastatic disease. It will also facilitate high-quality molecular testing with a minimal failure rate. Only by optimising this process will physicians be able to adequately select mCRPC patients that are most likely to benefit from PARP inhibition, or other future targeted therapies, allowing to use these agents in the correct patient groups.
(BELG J MED ONCOL 2022;16(7):343–54)
Read moreBJMO - volume 16, issue 6, october 2022
G. Nader-Marta MD, F.P. Duhoux MD, PhD, D. Taylor MD, T. Van den Mooter MD, H. Denys MD, PhD, J-L. Canon MD, J. Mebis MD, A. Awada MD, PhD, H. Wildiers MD, PhD, K. Punie MD, E. de Azambuja MD, PhD
HER2-targeted agents are the central component of HER2-positive metastatic breast cancer (MBC) treatment. The combination of trastuzumab, pertuzumab and a taxane is the preferred first-line regimen in most settings. For patients with disease relapse after adjuvant therapy, treatment decisions in the first-line are influenced by the treatment-free interval and the regimens used in the (neo)adjuvant setting. T-DXd has been recently established as the preferred second-line therapy. T-DM1, or the combination of tucatinib, trastuzumab and capecitabine, are reasonable third-line options, although efficacy and safety data of these regimens after prior exposure to T-DXd are lacking. In fourth and later lines, trastuzumab duocarmazine, neratinib plus capecitabine, margetuximab plus chemotherapy, lapatinib-based combinations or the continuation of trastuzumab with different chemotherapy partners are valid alternatives.
(BELG J MED ONCOL 2022;16(6): 287–92)
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