BJMO - volume 13, issue 3, may 2019
G. El Hachem MD, Y. Jounblat MD, A. Awada MD, PhD, A. Gombos MD
Triple-negative breast cancer is a heterogeneous subtype of breast carcinoma lacking the expression of oestrogen, progesterone and human epidermal growth factor 2 receptors. For many decades, cytotoxic chemotherapy has been the standard of care offering only a short-living disease control. Knowing its poor outcome and aggressive behaviour, researchers are trying to find new therapeutic options hoping to improve the survival of this population. Many cytotoxic and targeted therapies were tested without major benefit. However, in the era of molecular and mutational classification of tumours, as well as the immune mediated mechanisms of proliferation and progression, the trials are currently oriented towards the identification of potential targets in the tumoral heterogenic environment. Here, we present a review of literature concerning the potential anti-neoplastic options and novel therapies for metastatic triple-negative breast cancers: new cytotoxic agents, new targeted therapies, anti-angiogenic agents, antibody-drug conjugates, poly-ADP ribose transferase inhibitors and immunotherapy. Many agents are promising, yet not powerful enough to get approvals for use into clinical practice.
(BELG J MED ONCOL 2019;13(3):84–92)
Read moreBJMO - volume 13, issue 2, march 2019
Ir A. Hébrant PhD, K. Punie MD, F.P. Duhoux MD, PhD, C. Colpaert MD, PhD, G. Floris MD, PhD, K. Lambein MD, PhD, P. Neven MD, PhD, M. Berlière MD, PhD, R. Salgado MD, PhD, M. Chintinne MD, PhD, K. Dahan MD, PhD, S. Dedeurwaerdere MD, J. De Grève MD, PhD, A. de Leener MD, PhD, H. Denys MD, PhD, R. de Putter MD, L. Desmyter PhD, M. Baldewijns MD, PhD, D. Feret MD, C. Fontaine MD, C. Galant MD, P. Hilbert PhD, J. Janssens MD, PhD, D. Larsimont MD, PhD, P. Lefesvre MD, PhD, T. Sticca PhD, M-D. Tkint de Roodenbeke MD, G. Van Den Eynden MD, PhD, I. Vanden Bempt MD, PhD, C. Van den Broecke MD, I. Vandernoot MD, C. Sotiriou MD, PhD, J. van Dorpe MD, PhD, H.A. Poirel MD, PhD, E. Van Valckenborgh PhD, G. Raicevic PhD, M. Van den Bulcke PhD, P. Aftimos MD
In order to advise the Federal Government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests, the Commission of Personalized Medicine (ComPerMed) has applied, for the breast tumours, the same methodology as previously applied for the digestive tumours. Meaning, the different molecular tests, represented in the shape of algorithms, are annotated with test levels — which aim to reflect their relevance based on current available data and to define the reimbursement — and are documented with recent literature, guidelines and a brief technical description.
(BELG J MED ONCOL 2019;13(2):40–45)
Read moreBJMO - volume 13, issue 1, february 2019
Ir A. Hébrant PhD, Ir , A. Jouret-Mourin MD, PhD, G. Froyen PhD, J. Van der Meulen MD, M. De Man MD, R. Salgado MD, PhD, M. van den Eynde MD, PhD, N. D’Haene MD, PhD, G. Martens MD, PhD, E. van Cutsem MD, PhD, H.A. Poirel MD, PhD, S. Tejpar MD, PhD, J-L. van Laethem MD, PhD, K. Geboes MD, P. Pauwels MD, PhD, F. Dedeurwaerdere MD, B. Maes MD, PhD, J. De Grève MD, PhD, J. Vanhuysse , P. Peeters MD, L. Vanacker MD, M. Gomez-Galdon , M. Chintinne MD, PhD, A. Hendlisz MD, PhD, G. de Hertogh MD, PhD, X. Sagaert MD, PhD, M. Peeters MD, PhD, P. Vannuffel , P. Lefesvre MD, PhD, J. Vermeij , M. Simoens , T. Van den Mooter MD, N. van Damme PhD, M. Van den Bulcke PhD
The Belgian Commission of Personalized Medicine has been created to advise the federal government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests. Here, we propose the Belgian strategy for molecular testing in the digestive tumours within a scientific-based framework. For each tested biomarker, a clinical test level is attached, which is key to establish the relevance of the test and to define the reimbursement. For each digestive tumour type, the different molecular tests are represented as decision trees with its test utility, test level and a brief technical test description.
(BELG J MED ONCOL 2019;13(1):4–10)
Read moreBJMO - volume 12, issue 7, november 2018
D. Schrijvers MD, PhD
Chemotherapy-induced anaemia is a well-known complication in cancer. With the venue of newer non-cytotoxic anti-cancer drugs, attention to anaemia and anaemia management has been shifted to the background. Nevertheless, anaemia is a frequent complication of some of these newer drugs. Mammalian target of rapamycin inhibitors, some of the antiangiogenic drugs, poly (ADP ribose) polymerases inhibitors and cyclin-dependent kinase inhibitors all can cause grade 3 or 4 anaemia. This review discusses the risks of anaemia development of anti-cancer drugs.
(BELG J MED ONCOL 2018;12(7):307–312)
Read moreBJMO - volume 12, issue 7, november 2018
C. Standaert MD, P.J.L. De Visschere , S. Rottey MD, PhD, S. Buelens , N. Sundahl MD, PhD, G.M. Villeirs
Serum prostate-specific antigen, digital rectal examination and transrectal ultrasound, supplemented with biopsy, are conventionally used for the screening, diagnosis, staging and surveillance of prostate cancer (PCa). However, their sensitivity and specificity are limited with diagnosis of clinically insignificant cancer and a potential risk of overtreatment as a result. Multiparametric MRI combines anatomical and functional pulse sequences, including diffusion-weighted imaging and dynamic contrast-enhanced MRI, and has evolved out of its limited role in PCa staging. The ability to visualise the prostate accurately and to detect or exclude clinically significant PCa makes multiparametric MRI a great tool to improve the diagnosis, staging, treatment planning and follow-up of patients with PCa. Multiparametric MRI can rule out clinically significant PCa and therefore has the potential to reduce the need for biopsies or to determine whether active surveillance or immediate treatment is appropriate.
(BELG J MED ONCOL 2018;12(7):313–318)
Read moreBJMO - volume 12, issue 7, november 2018
C. Maggen MD, V. Wolters MD, K. Van Calsteren , F. Amant MD, PhD
The association of cancer with pregnancy is rare, but a rising incidence is expected because of the increasing maternal age at first pregnancy. A cancer diagnosis during pregnancy reveals several medical and ethical dilemmas because diagnostic procedures and treatments may compromise foetal health. But on the other hand, delay in diagnosis and treatment should be prevented since this can adversely affect maternal outcome. There are no data suggesting that the termination of pregnancy improves the prognosis and the awareness of the feasibility of cancer treatment during pregnancy is growing. The oncological and obstetrical management of a patient that is diagnosed with cancer during pregnancy requires a multidisciplinary approach, taking the patient’s perspective into account. This review summarises the current knowledge on incidence, diagnosis, treatment, prognosis, obstetrical and neonatal outcome of cancer during pregnancy.
(BELG J MED ONCOL 2018;12(7):319–325)
Read moreBJMO - volume 12, issue 7, november 2018
A. Awada MD, PhD, J-F. Baurain MD, PhD, P. Clement MD, PhD, P. Hainaut MD, S. Holbrechts MD, PhD, K. Jochmans MD, V. Mathieux MD, J. Mebis MD, M. Strijbos MD, PhD, C. Vulsteke MD, PhD, T. Vanassche MD, P. Verhamme MD
Unprovoked venous thromboembolism (VTE) may be the earliest sign of malignancy, and as a result, screening for occult cancer in these patients has become routine practice. However, the elaborateness of this screening is subject to debate and varies between medical centres. This study’s expert panel, consisting of oncologists and thrombosis specialists, aimed to develop a practical Belgian guidance for adequate cancer screening in patients with unprovoked VTE. In summary, comprehensive non-invasive cancer screening consisting of a medical history assessment, physical examinations, basic blood tests and a chest X-ray is sufficient to pick up the vast majority of occult cancers. When specific abnormalities are picked up by the battery of tests in the comprehensive non-invasive cancer screening, more extensive screening using CT scans are recommended. Routine CT screening in all patients presenting with an unprovoked VTE does not provide a significant clinical benefit and should not be routinely performed. In the presence of specific risk factors (e.g., older age, smoking history, previous VTE), physicians are advised to be more vigilant. Finally, given the significant anxiety that cancer screening may cause to patients, accurate and clear patient communication is key. A complete list of guidance statements is provided at the end of the article.
(BELG J MED ONCOL 2018;12(7):326–329)
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