Articles

Long-term outcomes in older patients with cancer and the association with geriatric screening and assessment results

BJMO - volume 18, issue 4, june

V. Depoorter PhD, K. Vanschoenbeek PhD, L. Decoster MD, PhD, C. Kenis RN, PhD, F. Verdoodt PhD, H. Wildiers MD, PhD

SUMMARY

Oncology care is tumour-centric by tradition, but especially in older patients, a more holistic approach is needed that takes into account each aspect of the patient’s health status and not just the tumour. Identifying areas of vulnerability with geriatric screening (GS) and/or geriatric assessment (GA) is crucial in providing patient-oriented and multidisciplinary care that is tailored to the patient’s general health status. The results of GS/GA allow the treating physician to apply clinical judgment based on an estimate of biological age to optimise cancer treatment decisions. The use of GS/GA is, however, not yet widespread in Belgian oncology practice so further evidence on what GS/GA results can contribute, particularly regarding long-term outcomes, was needed to further stimulate the systematic implementation. This study specifically aimed to explore the association between the GS (with Geriatric 8 or G8) / GA and long-term outcomes using linked clinical and population-based data from a cohort of older patients with cancer. It was demonstrated that older patients with an abnormal G8 score at cancer diagnosis had a significantly lower 10-year overall survival compared to patients with a normal G8 score. Furthermore, patients with an abnormal baseline G8 score displayed higher healthcare utilisation across primary care, hospital care, and residential care in the three years after cancer diagnosis. In deceased patients with an abnormal baseline G8 score, functional and cognitive impairment identified with GA at cancer diagnosis was associated with less specialised palliative care use in the last three months of life.

(BELG J MED ONCOL 2024;18(4):160–3)

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SIOG 2023: Highlights from the International Society of Geriatric Oncology annual conference

BJMO - volume 18, issue 2, march 2024

L. Decoster MD, PhD, C. Kenis RN, PhD

SUMMARY

The annual meeting of the International Society of Geriatric Oncology (SIOG) unites each year different health care workers involved in the treatment of older patients with cancer with the goal of improving personalised care. This year, recent advances in the field of geriatric oncology were discussed, including randomised controlled trials and ASCO guidelines for the implementation of comprehensive geriatric assessment.

(Belg J Med Oncol 2024;18(2):68–70)

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Highlights in lung cancer

BJMO - volume 17, issue 8, december 2023

L. Decoster MD, PhD

SUMMARY

Lung cancer was a hot topic at ESMO 2023 accounting for seven abstracts in the three presidential sessions.

(Belg J Med Oncol 2023;17(8):292–5)

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Highlights in lung cancer

BJMO - volume 17, issue 5, september 2023

L. Decoster MD, PhD, T. Feys MBA, MSc

SUMMARY

The most important lung cancer news at ASCO 2023 came from the ADAURA trial, showing a significant overall survival (OS) benefit from adjuvant osimertinib in patients with early-stage EGFR-mutant non-small cell lung cancer (NSCLC). Also in the early-stage setting, three different studies showed the clinical potential of using immunotherapy in the (neo)adjuvant treatment of non-oncogene-driven NSCLC patients. In the advanced setting, KEYNOTE-789 did not show a benefit with the addition of pembrolizumab to chemotherapy in EGFR-mutant advanced NSCLC patients progressing on first-line anti-EGFR TKI therapy. In the same setting, two new EGFR TKIs (BLU-945 and sunvozertinib) yielded promising results. Finally, retrospective data brought further insights into the optimal treatment duration of immunotherapy and on the use of chemoimmunotherapy in older NSCLC patients.

(Belg J Med Oncol 2023;17(5):183–6)

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Highlights in lung cancer

BJMO - volume 16, issue 8, december 2022

A. Enguita PhD, L. Decoster MD, PhD, T. Feys MBA, MSc

The 2022 annual ESMO meeting again featured a long list of interesting lung cancer-related abstracts, ranging from long-term updates of pivotal studies to preliminary data of studies assessing novel treatment strategies for lung cancer. This article will give an overview of the key highlights in lung cancer presented during this meeting. We are grateful to Prof. Lore Decoster, from the University Hospital Brussels, for helping us I selecting the abstracts for this overview and for providing her expert opinion on the different studies.

(Belg J Med Oncol 2022;16(8):395–403)

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The value of population-based databases to evaluate long-term patient outcomes: A multicentric research project in older patients with cancer

BJMO - volume 15, issue 7, november 2021

V. Depoorter PhD, K. Vanschoenbeek PhD, C. Kenis RN, PhD, H. De Schutter MD, PhD, L. Decoster MD, PhD, H. Wildiers MD, PhD, F. Verdoodt PhD

SUMMARY

The use of population-based data is a relatively accessible and cost-effective approach to study long-term outcomes in oncology. Also in older patients with cancer, longer-term outcome studies are limited and population-based data could help address this gap. Under the lead of UZ Leuven and the Belgian Cancer Registry (BCR), a national study was initiated to explore the association between the general health status of older patients with cancer as assessed by geriatric screening and assessment, and long-term outcomes as captured by population-based data. To this extent, data previously gathered within the context of a multicentre clinical study will be linked with three population-based databases: cancer registration data from BCR, healthcare reimbursement data from InterMutualistic Agency and hospital discharge data from Technical Cell. The major advantage of these population-based data is their longitudinal nature, which allows to follow a (sub)population across several years. The downside is their lack of clinical information. One way to partially overcome this limitation is to supplement population-based data with primary study data to investigate more clinically relevant outcomes. Although often scientifically interesting and appealing, coupling with population-based data demands intensive administrative efforts including an authorisation demand at the Information Security Committee. During the whole process, special attention should be given to privacyrelated aspects of the use and linkage of these data to ensure confidentiality.

BELG J MED ONCOL 2021;15(7):362-6)

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MET: another therapeutic target in non-small cell lung cancer

BJMO - volume 15, issue 6, october 2021

L. Decoster MD, PhD

SUMMARY

The identification of clinically relevant driver mutations has reshaped the therapeutic landscape of non-small cell lung cancer (NSCLC). In the past year, the activation of the mesenchymal-to-epithelial transition (MET) pathway has gained importance because of the recent development of selective and effective MET inhibitors. In NSCLC, MET dysregulation may be caused either by mutation or amplification and is associated with poor prognosis. In addition, the optimal first-line treatment is currently undetermined since data from different trials suggest limited activity of immune checkpoint inhibitors, indicating a high medical need. In phase II trials, MET inhibitors have shown promising response rates (41–65%) and duration of response in MET exon 14 mutated NSCLC. First-line trials are currently ongoing. In de novo MET amplified NSCLC, the activity of these inhibitors seems limited to tumours with a high level amplification. As in other oncogene driven NSCLC, resistance mechanisms do appear ultimately and future research should focus on this in order to optimise treatment options for MET dysregulated NSCLC.

(BELG J MED ONCOL 2021;15(6):278-82)

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