J. Blokken PhD, PharmD

Supportive care task force meeting

During the supportive care task force meeting, the BSMO supportive care task force introduced three clinical trials they would like to set up in the near future. In addition, new BSMO guidelines on extravasation and anaemia were presented after which the session was closed by Dr. Christel Fontaine (UZ Brussel) with a status update on the supportive care task force activities over the past year.

Immunotherapy for gastro-oesophageal cancers

Over the last decade, immunotherapy has become increasingly important as a treatment modality for various solid tumors. Unfortunately, the development of immunotherapy in the treatment of gastro-oesophageal malignancies has been lagging behind. More recently, however, impressive advancements have been made with immune checkpoint inhibitors in gastro-oesophageal cancers, with a long list of clinical trials yielding promising, and potentially practice changing results. This review provides an overview of the topline results of these studies.

Highlights in respiratory oncology

At this year’s ESMO meeting, much of the attention in the field of lung cancer went to early-stage nonsmall cell lung cancer (NSCLC) with interesting results from the Lung Art, COAST, GEMSTONE-301 and IMpower010 trials. For metastatic NSCLC, immunotherapy again walked away with much of the attention. In addition to this, several studies investigated the potential of combining anti-EGFR and anti-angiogenic agents, while others investigated novel targeted agents, including trastuzumab deruxtecan, poziotinib, plinabulin and datopotamab deruxtecan. Finally, we will highlight the most interesting results in other thoracic malignancies, including malignant pleural mesothelioma, extensive-stage small cell lung cancer, thymoma and thymic carcinoma.

(BELG J MED ONCOL 2021;15(8):406–14)

Targeted therapy making its move in early-stage EGFR-mutant NSCLC

Approximately 25% of patients with non-small cell lung cancer (NSCLC) are being diagnosed in an early stage of the disease. Even though these patients are eligible for radical surgery, the five-year survival rates for fully resected early-stage NSCLC remains disappointing. In fact, for patients who receive adjuvant chemotherapy after surgery, recurrence rates are high, with approximately half of patients suffering from disease relapse. The design of molecularly oriented studies and the availability of novel potent and less toxic targeted agents paved the way for the evaluation of these drugs in the (neo)adjuvant setting for patients with early-stage NSCLC harbouring oncogenic driver mutations. Here we summarise the results obtained with EGFR-targeted drugs in early-stage NSCLC.

Treatment sequencing in patients with advanced, BRAF-mutant melanoma

Over the last decade, the introduction of immune checkpoint inhibitors and targeted agents inhibiting BRAF, and MEK signal transduction pathways revolutionised the treatment paradigm for patients with metastatic melanoma. However, to date there is still no consensus on the optimal treatment sequence in BRAF-mutant metastatic melanoma. In the absence of prospective, randomised data, the treatment choice in clinical practice is mainly driven by patient characteristics. More recently, clinical trials are assessing the optimal treatment sequence of targeted therapy and immunotherapy, while other studies are looking into the potential of combining both treatment modalities in first-line.

Targeting RET-alterations in solid tumours

Over the past decade, researchers have tried to tackle RET-driven cancers with various multikinase inhibitors. However, their efficacy was only modest and came at the cost of significant toxicities, leading to high rates of treatment discontinuation. Therefore, the development of RET-specific inhibitors has become paramount. Recently, the highly selective RET tyrosine kinase inhibitors selpercatinib and pralsetinib have demonstrated high response rates in patients with RET-altered non-small cell lung cancer (NSCLC) and thyroid cancer. As brain metastases eventually occur in approximately 50% of patients with RET fusion-positive NSCLC, special attention should go to the intracranial activity of these drugs.

New oncology reimbursementsin Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2021;15(5):264-5)