BJMO - volume 15, issue 4, june 2021
L. Dirix MD
Deoxyribonucleic acid (DNA) recombination between homologous chromosomes is essential in the process of meiosis as it drives genetic diversity and assures accurate segregation. In somatic cells, a substantial machinery is involved in DNA damage repair (DDR). Failure to repair DNA damage has many consequences, including cancer predisposition. Insights in DDR mechanisms and the prevalence of defects in DDR in tumours has resulted in the fundamental insight of the presence of DDR defects as a chemosensitising biomarker for alkylating agents in high-grade serous ovarian cancer, non-small-cell lung cancer and glioblastoma. Increasing the DDR defect by PARP inhibition in this context of pre-existing DDR impairment, can result in catastrophic DNA damage and cancer cell death. In patients with mCRPC and demonstrated intratumoural DDR defect, PARP inhibition represents a valuable new treatment option.
(BELG J MED ONCOL 2021;15(4):164-9)
Read moreBJMO - volume 15, issue 4, june 2021
Ir A. Hébrant PhD, H. Antoine-Poirel MD, PhD, K.B.M. Claes PhD, F. Dedeurwaerdere MD, J. Van der Meulen MD, F. Lambert MD, J. Van Huysse MD, G. Martens MD, PhD, N. D’Haene MD, PhD, K. Geboes MD, P. Pauwels MD, PhD, A. Jouret-Mourin MD, PhD, P. Peeters MD, M. van den Eynde MD, PhD, R. Salgado MD, PhD, P-J. Van Dam MD, P. Lefesvre MD, PhD, X. Sagaert MD, PhD, S. Metsu PhD, A. Demols MD, PhD, J-L. van Laethem MD, PhD
Pancreatobiliary cancers (PBC) group pancreatic and biliary tract cancers and are among the cancers with the lowest survival rate. Emerging data suggest that novel biomarker-specific targeted therapies can be proposed for selected populations with survival benefit. This review summarises the scientific evidence to test for these biomarkers in order to optimise the management of pancreatobiliary cancers, within the context of the Belgian NGS convention.
(BELG J MED ONCOL 2021;15(4):170-6)
Read moreBJMO - volume 15, issue 3, may 2021
A. Iabkriman MD, J. Collignon MD, F.P. Duhoux MD, PhD
The phosphatidylinositol-3-kinases (PI3Ks) play a critical role in cellular metabolism and proliferation, as well as in the development of cancer. Several mutations in the genes coding for PI3Ks have been identified in a large proportion of tumours at different rates, depending on the tumour type. Therapies targeting PI3Ks have been developed in the last years and initially used in hematological malignancies. In medical oncology, a number of trials have tried to prove the efficacy of these compounds, but most of them have been confronted with very important toxicities and only a modest benefit in progression-free survival. Recent trials using more selective treatments have shown good efficacy with an acceptable toxicity profile. The aim of this article is to review the current knowledge about PI3K inhibitors, their potential use in medical oncology and their toxicities.
(BELG J MED ONCOL 2021;15(3):96-103)
Read moreBJMO - volume 15, issue 3, may 2021
M. De Praeter MD
Although prognosis of non-small cell lung carcinoma (NSCLC) patients with brain metastases (BMs) has improved over the last years, the overall survival remains poor. Indications for surgical resection of a single BM have been well defined in the literature: Limited and or controlled systemic disease, Karnofsky performance scale ≥70, solitary lesion larger than 3 cm, non-eloquent area of the brain and unclear pathological diagnosis. However, recent advances in surgical technique and intraoperative technologies have facilitated surgery, including surgery for multiple lesions and lesions in eloquent brain areas.1–4 With the advance of molecularly targeted therapy, selection of patients who qualify for surgery of their BMs has become even more complex.5 The purpose of this review is to determine the indications and timing of surgery for brain metastases in NSCLC.
BELG J MED ONCOL 2021;15(3):104-11
Read moreBJMO - volume 15, issue 2, march 2021
S. Bulteel BSc, T. Muilwijk MD
Intravesical BCG is the standard of care in the treatment of high-risk non-muscle invasive bladder cancer as it decreases the risk of recurrence and progression. Although it has been used for more than 40 years, it is currently still superior over chemotherapy and other immunotherapies. The worldwide shortage of BCG stresses the need for alternatives of BCG, for which the only curative treatment option outside clinical studies is an early radical cystectomy.
(BELG J MED ONCOL 2021;15(2):57-62)
Read moreBJMO - volume 15, issue 2, march 2021
S. Dumont MD, T. Van Gorp MD, PhD, I. Vergote MD, PhD, D. Timmerman MD, PhD
Human drug research, and cancer drug research in particular, heavily relies on traditional tumour models such as 2D cell cultures and xenografts to develop and test novel therapeutics. Organoids are a novel 3D cell platform derived from stem cells, allowing to faithfully replicate human tissue in an in vitro environment, bridging the ease of use of 2D cell cultures and the biological relevance of xenografts. In this manuscript, we introduce organoids to the oncological community and demonstrate the major advantages and challenges of this exciting new technology. Cancer organoids could be the next major step in tumour research and drug development, ultimately leading to highly precise personalised medicine.
(BELG J MED ONCOL 2021;15(2):63-8)
Read moreBJMO - volume 15, issue 1, january 2021
T. van Deun MD, H. Prenen MD, PhD
Pancreatic cancer is one of the deadliest cancer types. Incidence rates are on the rise in the Western world, transforming it into one of the most common causes of cancer-related death. Pancreatic adenocarcinoma is the most frequently encountered type and diagnosis often occurs in an advanced stage, hence when curative treatment is no longer an option. Current management strategies are based on the tumour stage and resectability as well as patient characteristics, and should be discussed by a multidisciplinary tumour board. In patients with resectable disease, surgery followed by adjuvant therapy is the golden standard. Neoadjuvant strategies are currently gaining popularity, especially for borderline resectable disease. In the advanced setting, treatment with combination chemotherapy has only modestly improved overall survival. The field of personalised medicine is rapidly evolving and slowly trying to find its way into the classically defined treatment paradigm of pancreatic cancer. In this article, we aim to provide an overview of the current treatment options and highlight future developments.
(BELG J MED ONCOL 2021;15(1):11-9)
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