Articles

Highlights in genitourinary cancers

BJMO - volume 15, issue 8, december 2021

T. Vermassen PhD, S. Rottey MD, PhD, D. De Maeseneer MD

ESMO 2021 again provided a variety of innovations in the management of genitourinary cancers. In prostate cancer (PCa), results of STAMPEDE suggest that early intensification of adjuvant therapy with ADT and abiraterone could become a new standard in high-risk non-metastatic PCa (currently off-label). Studies in metastatic castration-resistant PCa (mCRPC) indicated promising activity of 77Lu-PSMA-617 plus pembrolizumab and of cabozantinib plus atezolizumab. In the field of kidney cancer, patient-reported outcome data of KEYNOTE-564 further support adjuvant pembrolizumab as a new standard of care. Other studies in renal cell cancer (RCC) showed that treatment breaks during tyrosine kinase inhibitor therapy may be highly cost-effective without an effect on patient survival, that antibiotics can severely compromise survival outcomes in nivolumab-treated metastatic RCC patients and that therapeutic targeting of HIF-2α and VEGF may be effective in patients with metastatic clear cell RCC. In addition, cabozantinib proved to be safe and effective in patients with metastatic collecting ducts carcinoma. In urothelial cancer, dose-dense MVAC was identified as a safe and effective neoadjuvant treatment option for patients with muscle-invasive bladder cancer (MIBC). In metastatic urothelial cancer the addition of cetrelimab to erdafitinib seemed to increase treatment effects, while the EphrinB2-blocking agent sEphB4-HAS was found to have synergistic activity with pembrolizumab. Finally, an exploratory analysis of the pivotal IMvigor 130 trial found that cisplatin but not carboplatin seems to enhance anti-tumour immunity.

(BELG J MED ONCOL 2021;15(8):398–405)

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Highlights in genitourinary cancers

BJMO - volume 15, issue 5, september 2021

T. Vermassen PhD, S. Rottey MD, PhD, D. De Maeseneer MD

The 2021 ASCO Annual Meeting offered a variety of advancements in the treatment and detection of genitourinary cancers. For prostate cancer (PCa), matched tumour-normal tissue sequencing was shown to be the ideal standard of care (SOC) in de novo high-risk PCa patients. The addition of immune checkpoint inhibitors (ICI) to the SOC was found to be highly effective in muscle-invasive bladder cancer, with enfor-tumab vedotin (EV) continuing to show efficacy in urothelial carcinoma in a post-ICI advanced/ metastatic setting. Finally, the combination of ICI and tyrosine kinase inhibitors (TKIs) as first-line therapy for both non-clear cell and clear cell renal cell carcinoma (non-cc/ccRCC) displays a clear survival benefit, with this efficacy extending into the second-line treatment of patients with metastatic non-ccRCC who have previously received ICIs. The most important headline presentations relating to genitourinary cancers will be discussed in this congress highlights article.

(BELG J MED ONCOL 2021;15(5):256-63)

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Highlights in genitourinary cancers

BJMO - volume 14, issue 8, december 2020

T. Vermassen PhD, S. Rottey MD, PhD, D. De Maeseneer MD

Over the past years, many interesting studies in the field of prostate, urothelial and renal cell carcinoma have been initiated. In this overview, practice changing data from the latest virtual ESMO meeting are presented.

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Highlights in urologic cancer

BJMO - volume 13, issue 8, december 2019

D. De Maeseneer MD, E. Werbrouck MD, S. De Keukeleire MSc, S. Rottey MD, PhD

In recent years, innovations in renal, bladder and prostate cancer treatments have been introduced at a rapid pace. Every year, oncological societies had to update treatment guidelines according to new insights and results of large phase III trials. This article focuses on practice changing data from the 2019 ESMO congress in Barcelona, Spain.

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Introducing a Castrate Resistant Prostate Cancer (CRPC) Model Care Pathway in Belgian Hospitals – towards national standardisation?

BJMO - volume 13, issue 6, october 2019

T. Vermassen PhD, T. Roumeguère MD, PhD, Y. Neybuch MD, L. Hoekx MD, I. Fele , B. Sautois MD, PhD, W. Everaerts MD, PhD, D. De Maeseneer MD, F. Lecouvet MD, PhD, N. Lumen MD, PhD, P. Ost MD, PhD, S. Rorive MD, PhD, S. Stroobants MD, PhD, P. Dirix MD, PhD, S. Rottey MD, PhD

SUMMARY

Castrate-resistant prostate cancer (CRPC) is characterised by complex strategies for therapy and follow-up. In order to standardise CRPC cancer care on a national basis, an integrated care pathway was devised, based on clinical governance principles and acknowledged best practice, in order to reduce length of hospital stay, reduce costs of patient care, improve patient outcomes (e.g. Quality-of-Life, complications), etc. Therefore, a steering group of Belgian experts, consisting of medical oncologist, urologists, radiation oncologists, oncology nurses, pathologists and nuclear medicines, was assembled to discuss the need for an integrated care pathway for CRPC in Belgium. This was made possible through the financial support of Astellas Belgium. An extensive integrated care pathway was discussed with various stages, depending on the disease status of the patient. Belgian implementation could lead towards further standardisation of cancer care for CRPC patients although several important matters still have to be discussed or adapted. Further assessment and inter-hospital deliberation seems required to ensure a national implementation of the CRPC integrated care pathway.

(BELG J MED ONCOL 2019;13(6): 219–226)

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Congress highlights 2018

BJMO - , issue ,

D. De Maeseneer MD, F.X. Otte MD, S. Albisinni MD

ASCO GU represents one of the yearly highlights in the field of genitourinary cancer. During BMUC 2018 the key data presented at this meeting were summarized.

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Emerging concepts in urothelial cancer

BJMO - volume 12, issue 5, september 2018

D. De Maeseneer MD, K. Decaestecker PhD, S. Rottey MD, PhD

Treatment for urothelial cancer has undergone rapid change. Cisplatin based chemotherapy should be given in the neo-adjuvant setting in muscle invasive bladder cancer and could play a role in trimodality therapy when combined with surgery and radiotherapy. Genetic profiling has differentiated several subtypes of urothelial cancer, mimicking progress seen in breast cancer. Of these subtypes, p53 like tumours are less likely to respond to neo-adjuvant chemotherapy. In metastatic urothelial cancer, systemic immunotherapy (checkpoint inhibitors) has shown promising results in first line and second line patients. In a phase III trial, pembrolizumab, an anti-PD1 (programmed cell death 1) antibody, showed a survival benefit in second line metastatic urothelial cancer and should be the new standard of care. In patients who are cisplatin ineligible checkpoint can be used in first line, but no phase III data are available.

(BELG J MED ONCOL 2018;12(5):212–217)

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