J. Blokken PhD, PharmD

Clinical cancer therapy in Belgium: What not to have missed in 2021

In this article selected studies influencing therapeutic guidelines in solid tumours, as well as highlights in breast cancer, lung cancer, digestive oncology, genitourinary cancer, biomarkers, and what’s new in rare tumours/histologies are discussed.

Consolidation immunotherapy for stage III non-small cell lung cancer in Belgian real-life practice

PACIFIC-R is a real-world international observational study evaluating patients with unresectable stage III non-small-cell-lung cancer treated with durvalumab following platinum-based chemoradiation. At the annual BSMO meeting, baseline characteristics and progression-free survival results for the Belgian cohort of this study were presented and contextualised with the PACIFIC-R global population and the durvalumab arm of the phase III PACIFIC trial.

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.

Breast cancer task force

The breast cancer task force session of the Belgian Society of Medical Oncology (BSMO) annual meeting reviewed the most important recent data on advanced HER2-positive breast cancer and triple negative breast cancer (TNBC). First, Dr. Eline Naert (University Hospital Ghent) discussed the treatment algorithm for advanced HER2-positive breast cancer anno 2022. Prof. Francois Duhoux (UCLouvain) subsequently addressed the current and emergent treatment options for patients with early or locoregional advanced triple-negative breast cancer. Finally, Prof. Christos Sotiriou (Institut Jules Bordet) closed the session by further dissecting the TNBC heterogeneity through molecular profiling and special transcriptomics.

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.