BJMO - volume 19, issue 1, january 2025
C. Van De Wyngaert MD, A. Werion MD, J. Mesland MD, C. van Marcke MD, PhD
The proportion of cancer patients considered for admission in intensive care units (ICU) gradually increased over the last decades. In this situation, it is important to avoid inappropriate management, whether through refusal of admission that could be beneficial, or through futile therapeutic escalation. In this review, we describe the factors that medical oncologists and intensive carers should discuss when considering ICU admission for cancer patients and propose a framework for decision-making based on four important concepts. Among cancer patients, data strongly suggest that the short-term prognosis is more linked to the acute pathology than to the underlying active tumour. More specifically, the impairment of more than two vital organs and the requirement of organ support are the most important factors predictive of mortality. ECOG performance status furthermore remains a crucial prognostic factor to consider. Open discussions with patients and close relatives at cancer diagnosis and during treatment are mandatory for informed decision making during an acute event.
(BELG J MED ONCOL 2025;19(1): 4–10)
Read moreBJMO - volume 19, issue 1, january 2025
L. Seynaeve MD
Neurological diseases occur more frequently in patients with active tumours and/or undergoing treatment for oncological disease. Malignancy-associated changes in cell signalling and biological processes occur, as well as “naturally occurring” and treatment-induced immune-related adverse events that can be both cell- or antibody-mediated. Prompt evaluation, timely accurate treatment, and interdisciplinary care are of paramount importance to prevent or diminish long-term neurological sequelae and mortality.
(BELG J MED ONCOL 2025;19(1):11–14)
Read moreBJMO - volume 18, issue 7, november 2024
L. Decoster MD, PhD, K. Vekens MD
The introduction of targeted therapies has dramatically changed the outcome for patients with oncogenedriven non-small cell lung cancer. Recent advances have led to the introduction of targeted therapies in early-stage non-small cell lung cancer, as well as the development of new strategies to overcome resistance. The current manuscript gives an update on targeted therapies in oncogene-driven non-small cell lung cancer.
(BELG J MED ONCOL 2024;18(7):253–257)
Read moreBJMO - volume 18, issue 7, november 2024
C. Artigas MD, PhD, A.M. Bergman MD, PhD, M. Gizzi MD, I.J. de Jong MD, PhD, D.E. Oprea-Lager MD, PhD, W.J.G. Oyen MD, PhD, M. Strijbos MD, PhD
The life expectancy and quality of life of patients with metastatic castration-resistant prostate cancer (mCRPC) continue to improve with the registration of new therapies. However, for individual patients, the appropriateness and optimal sequence of taxanes, radium-223, androgen receptor pathway inhibitors and lutetium-177-prostate-specific membrane antigen (PSMA) remains to be determined. To assess the current positioning of radium-223 and lutetium-177-PSMA as treatments for mCRPC, a consensus meeting with a multidisciplinary panel of experts from the Netherlands and Belgium was held. This article summarises the panel’s guidance on preferred sequences and the discussions of that meeting.
(BELG J MED ONCOL 2024;18(7):258–267)
Read moreBJMO - volume 18, issue 7, november 2024
D. Schrijvers MD, PhD
The need for organs for transplantation is growing, as is the incidence of people affected by cancer. Many cancer patients will be cured of their disease and might be eligible for organ transplantation. There is always a possibility for donor-transmitted cancer, and this is a potentially lethal condition. In this review, the factors that determine the eligibility of cancer patients as organ donors are discussed.
(BELG J MED ONCOL 2024;18(7):268–270)
Read moreBJMO - volume 18, issue 6, october 2024
G. Desimpel MD, E. Seront MD, PhD
The year 2023 marked a significant revolution in urothelial cancer, introducing novel anticancer strategies. The synergy between antibody-drug conjugates and immune checkpoint inhibitors has led to a drastic improvement in patient outcomes. Using this combination in first-line metastatic urothelial carcinoma has achieved a median overall survival exceeding 30 months, a milestone in the field. This breakthrough not only paves the way for a deeper comprehension of the disease’s pathogenesis but also underscores the pivotal role of combinations in urothelial carcinoma, applicable not only in advanced stages but also in the localised setting. This review serves as a reminder of the novel mechanism of action of these drugs, alongside highlighting their safety profile. Additionally, we emphasise the critical importance of refining patient selection criteria, particularly in the context of immune checkpoint inhibitors and bladder sparing strategies.
(BELG J MED ONCOL 2024;18(6):227-234)
Read moreBJMO - 2024, issue 4, june 2024
S. Lobo-Martins MD, L. Arecco MD, E. Agostinetto MD, E. de Azambuja MD, PhD
Five years used to be the standard duration for adjuvant endocrine therapy (ET) for hormone receptor-positive early breast cancers, but the benefit of extending treatment duration beyond this period to reduce the risk of disease recurrence has been investigated in several randomised trials, mostly including postmenopausal patients and investigating the extension of aromatase inhibitors as part of the ET. Premenopausal patients represent, to date, a small proportion of the population in a few trials, and the options for extending adjuvant ET, especially in those patients receiving ovarian function suppression (OFS), are underexplored yet. For post-menopausal women, numerous sequences and durations have been proposed, but the optimal duration of extended adjuvant ET remains controversial. Distinct aspects influence this choice, such as the patient’s menopausal status, risk of recurrence, toxicity profile and patient’s preference. Furthermore, the introduction of new targeted agents into the adjuvant setting has brought new uncertainty regarding the ideal length of ET.
(BELG J MED ONCOL 2024;18(4):124–31)
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