Articles

Geriatric oncology: targeting older patients with cancer

BJMO - volume 14, issue 3, may 2020

L. Decoster MD, PhD, C. Kenis PhD, MSc, H. Wildiers MD, PhD, J. De Grève MD, PhD

SUMMARY

As the cancer population ages, treatment decisions in the older patients should not only be guided by the tumour characteristics but also by patient characteristics. The performance of a comprehensive geriatric assessment as well as a health related quality of life evaluation are important in order to deliver the optimal personalised care in older patients with cancer. The current PhD thesis focused on the use of screening tools, geriatric assessment and interventions as well as on health-related quality of life in older patients with cancer.

(BELG J MED ONCOL 2020;14(3):106–8)

Read more

Immune checkpoint inhibition in triple negative breast cancer: targeting Achilles’ heel?

BJMO - , issue ,

V. Geldhof MD, PhD, K. Punie MD, H. Wildiers MD, PhD

Triple negative breast cancers pose an important challenge both for patients and their clinicians due to their aggressive disease course, poor long-term survival and lack of effective systemic treatment options. Recent scientific advances show that the adaptive immune system harbors the intrinsic capacity to eradicate cancer, generally through mechanisms that involve cytotoxic T-cells. Immune checkpoint inhibition boosts the host-anti-tumor response in many solid tumors, including breast cancer. However, cancer cells acquire ways to evade immunosurveillance and intra-tumoral T-cells are often functionally impaired, resulting in overt clinical cancer. Interestingly, the efficacy of immune checkpoint inhibition appears to correlate with tumor immunogenicity and the tumor mutational burden. Triple negative breast cancer has the highest tumor mutational burden of all breast cancer subtypes and therefore is believed to be the most immunogenic subtype. For this reason, clinical trials to date mainly focus on this specific subtype. Here, we review the accumulating evidence for immune checkpoint blockade in triple negative breast cancer.

Read more

Highlights in breast cancer

BJMO - volume 12, issue 8, december 2018

H. Wildiers MD, PhD, Tom Feys MBA, MSc, K. Punie MD

During ESMO 2018 an entire presidential session was dedicated to breast cancer. In addition to exciting immuno-oncology data in the treatment of triple negative breast cancer (TNBC), this session featured the presentation of the overall survival (OS) data of the phase III PALOMA-3 trial, evaluating the alpha-specific PI3K-inhibitor alpelisib in PI3KCA-mutant advanced breast cancer, and results of a clinical trial demonstrating improved outcomes when adding a histone deacetylase (HDAC) inhibitor to exemestane in hormone-receptor positive advanced breast cancer. In early breast cancer it was further demonstrated that non-compliance with adjuvant endocrine treatment is an under-appreciated and under-reported problem. In addition, the HOBOE-2 adds to the evidence that adjuvant bisphosphonates also improve the disease-free survival (DFS) in premenopausal luminal breast cancer patients who have received ovarian function suppression combined with an aromatase inhibitor. Finally, a subgroup analysis of the ShortHER trial suggests that for low- and intermediate risk cancer HER2-positive early breast cancer, 9 weeks of trastuzumab might be non-inferior to the standard 1-year treatment duration. However, the interpretation of this trial is challenging and as such, one year of trastuzumab should remain the standard for now.

Read more

Prevention of chemotherapy-induced nausea and vomiting: Belgian antiemetic treatment options anno 2018

BJMO - volume 12, issue 2, march 2018

W. Lybaert MD, P. Clement MD, PhD, K. Punie MD, J. Mebis MD, M. Renard MD, H. Wildiers MD, PhD

Summary

Chemotherapy-induced nausea and vomiting remains an important adverse effect of treatment in daily clinical practice. Recently, new data on combinations of antiemetic agents became available for the prevention of acute and delayed nausea/vomiting in patients receiving highly and moderately emetogenic chemotherapy. As a result, the leading international cancer societies updated their antiemesis guidelines. This text aims at providing guidance regarding these new regimens in the prophylaxis of chemotherapy-induced nausea and vomiting, with a particular focus on highly emetogenic chemotherapy.

(BELG J MED ONCOL 2018;12(2):51–60)

Read more

O.01 IDENTIFICATION, CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES OF SOMATIC HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2 (HER2) MUTATIONS IN METASTATIC BREAST CANCER PATIENTS

BJMO - volume 12, issue 3, february 2018

L. Jongen , Giuseppe Floris , D. Lambrechts PhD, Annouschka Laenen , Patrick Neven , Grace Mann , Richard Cutler Jr. , A. Lalani , H. Wildiers MD, PhD

Read more

Immune checkpoint inhibition in triple negative breast cancer: targeting Achilles’ heel?

BJMO - volume 12, issue 9, february 2018

V. Geldhof MD, PhD, K. Punie MD, H. Wildiers MD, PhD

Triple negative breast cancers pose an important challenge both for patients and their clinicians due to their aggressive disease course, poor long-term survival and lack of effective systemic treatment options. Recent scientific advances show that the adaptive immune system harbors the intrinsic capacity to eradicate cancer, generally through mechanisms that involve cytotoxic T-cells. Immune checkpoint inhibition boosts the host-anti-tumor response in many solid tumors, including breast cancer. However, cancer cells acquire ways to evade immunosurveillance and intra-tumoral T-cells are often functionally impaired, resulting in overt clinical cancer. Interestingly, the efficacy of immune checkpoint inhibition appears to correlate with tumor immunogenicity and the tumor mutational burden. Triple negative breast cancer has the highest tumor mutational burden of all breast cancer subtypes and therefore is believed to be the most immunogenic subtype. For this reason, clinical trials to date mainly focus on this specific subtype. Here, we review the accumulating evidence for immune checkpoint blockade in triple negative breast cancer.

Read more

Quality management for systemic treatment of breast cancer

BJMO - volume 12, issue 1, february 2018

D. Verhoeven MD, PhD, F.P. Duhoux MD, PhD, E. de Azambuja MD, PhD, H. Wildiers MD, PhD, P. Vuylsteke MD, A. Barbeaux MD, N. van Damme PhD, E. Van Eycken MD

Summary

Limited literature is available about quality management in systemic treatment of breast cancer patients. Professionals are the key players in the identification and interpretation of quality indicators. The Belgian Society of Medical Oncology takes the lead in the field of quality management of systemic treatment for cancer, especially breast cancer. A narrow collaboration with the Belgian Cancer Registry will allow benchmarking. The results will be presented and discussed between peers of the society. This should lead to better outcomes for all Belgian centres. All Belgian Society of Medical Oncology members are called for active participation

(BELG J MED ONCOL 2018;12(1):15–21)

Read more