BJMO - 2021, issue Special, april 2021
A. Dekker MD, T. Feys MBA, MSc
The introduction of tyrosine kinase inhibitors (TKIs) targeting mutant epidermal growth factor receptor (EGFR) has revolutionized the treatment of patients with EGFR-mutant advanced NSCLC. In the recently published REVEAL trial, investigators assessed the current clinical practice for these patients in Belgium revealing some striking observations. In fact, one out of five EGFR-mutant advanced NSCLC patients in this study did not receive ESMO standard of care in first line. After progression on a first EGFR-TKI, Moreover, nearly 30% of patients were not tested for the presence of a T790M mutation after progression on first-line treatment with an EGFR TKI and a quarter of patients did not receive subsequent systemic treatment for NSCLC. These findings underscore the need for more diligent decision-making in the treatment of these patients in order to maximize the clinical potential of EGFR TKIs.
Read moreBJMO - 2021, issue SPECIAL, march 2021
S. Siva MD, PhD
Over the last decade, tyrosine kinase inhibitors and immune checkpoint inhibitors have revolutionized the treatment landscape for patients with metastatic renal cell carcinoma (mRCC). Currently, immunotherapy-based combination therapy (i.e. pembrolizumab-axitinib, avelumab-axitinib, nivolumab-ipilimumab) is the preferred first line treatment option for patients with mRCC. But even with these regimens the complete response rate is limited at approximately 8–9%. In this context, metastasis directed therapy (MDT) remains the only potentially curative treatment option for patients with mRCC. During the 2021 BMUC meeting, Prof. Shankar Siva (Peter McCallum Cancer Centre, Melbourne, Australia), discussed the current state of affairs with respect to MDT in the contemporary mRCC treatment landscape.
Read moreBJMO - 2021, issue SPECIAL, march 2021
D.E. Spratt MD
Currently, the main prognostic biomarkers used in the management of prostate cancer are molecularly defined, including prostate specific antigen (PSA), Gleason score, D’Amico risk group, National Comprehensive Cancer Network (NCCN) risk groups, etc. More recently, genomic classifiers have been developed to facilitate a better precision medicine in patients with prostate cancer. During his lecture at the 2021 BMUC meeting, Dr. Daniel E. Spratt gave an overview of the current biomarker landscape in patients with prostate cancer and made a case for the use of these novel genomic classifiers.
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R. de Putter MD
With the advent of next-generation sequencing (NGS) technologies together with large whole-exome and genome studies in prostate and other cancers, our understanding of the landscape of genomic alterations has dramatically been refined. Several studies found that germline or acquired DNA damage repair (DDR) defects affect a high percentage of castration resistant prostate cancer (CRPC) patients. Among DDR defects, BRCA mutations show relevant clinical implications. BRCA mutations are associated with adverse clinical features in primary tumors and with poor outcomes in patients with mCRPC. In addition, BRCA mutations predict a good response to poly-ADP ribose polymerase (PARP) inhibitors. However, concerns still remain on the role of extensive mutational testing in prostate cancer patients, given the implications for patients and for their progeny. During the 2021 annual BMUC meeting, these and other issues regarding NGS testing in prostate cancer were addressed by Dr. Robin de Putter.
Read moreBJMO - 2021, issue SPECIAL, march 2021
dr. A. Padhani
In the same way that molecularly targeted therapies have transformed decision making of many diseases, advances in nuclear medicine and molecular imaging are poised to re-invent the way in which we diagnose, stage, and monitor response to therapy in patients with prostate cancer. Several next-generation imaging (NGI) modalities facilitate an improved diagnostic accuracy for the staging of prostate cancer, especially at lower tumour burdens. In view of these new imaging modalities, the American Society of Clinical Oncology (ASCO) recently formulated recommendations on how to appropriately use these techniques in different prostate cancer subgroups. During BMUC 2021, Prof. Anwar Padhani talked us through the key take home messages of these guidelines.
Read moreBJMO - 2021, issue SPECIAL, march 2021
N. Sundahl MD, PhD, N. Martínez Chanzá MD, prof. J. Catto
During the 2021 Belgian Multidisciplinary meeting on Urological Cancers (BMUC) three presentations were given on the subject of bladder preservation in muscle invasive bladder cancer (MIBC). The first presentation by Dr. Nora Sundahl, from the department of radiation oncology, University of Gent, Belgium, addressed the question whether it is best to use radio-chemotherapy, radio-immunotherapy or a combination of all three in patients with muscle invasive bladder cancer (MIBC). Dr. Nieves Martinez-Chanza, from the Medical Oncology department at Jules Bordet Institute, Brussels, Belgium, aimed to answer the question whether neo-adjuvant immunotherapy is already good enough as a treatment option. Lastly Prof. James Catto, professor in Urological Surgery at the University of Sheffield and Urological Surgeon at Sheffield Teaching Hospital discussed four common clinical assumptions around radical cystectomy (RC) and the role of RC in current practice. Although there is some overlap in the discussed topics we will honour the presenters interpretations of the subject by discussing them separately.
Read moreBJMO - 2021, issue SPECIAL, march 2021
M. Gizzi MD
In recent years, we have witnessed a number of exciting therapeutic innovations for patients with metastatic urothelial cancer (mUC). During a lecture at the 2021 annual BMUC meeting Dr. Marco Gizzi provided an overview of these advances.
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