Value of testing for homologous recombination repair deficiency in newly diagnosed advanced-stage epithelial ovarian cancer: Recommendations for Belgian physicians

BJMO - volume 17, issue 2, march 2023

C. Gennigens MD, PhD, H. Denys MD, PhD, S. Altintas MD, PhD, J. Kerger MD, J-F. Baurain MD, PhD, V. Bours MD, PhD, S. Henry MD, K. Van de Vijver MD, PhD, D. Lambrechts PhD, I. Vergote MD, PhD


Epithelial ovarian cancer (EOC) is the most frequent form of OC, a disease with a poor prognosis and high lethality, as most patients are diagnosed at advanced stages. To successfully battle EOC, it is crucial to identify reliable biomarkers and use personalised therapies in patient subgroups. A common feature of high-grade serous and endometrioid OC is homologous recombination repair deficiency (HRD), which frequently stems from the inactivation of the breast cancer susceptibility (BRCA) genes. Poly-(adenosine diphosphate [ADP])-ribose polymerase inhibitors (PARPi) were, therefore, developed for their lethality against HRD tumour cells. While patients with non-HRD tumours may also benefit from PARPi therapy in the recurrent EOC setting, recent phase III trials on newly diagnosed advanced-stage EOC have shown that PARPi treatment benefit is greater in patients with HRD tumours. These findings open new avenues for the use of PARPi as maintenance therapy in HRD-positive patients who had received first-line chemotherapy. This manuscript provides recommendations for Belgian physicians on how to approach HRD testing and incorporate it into treatment decisions of patients with newly diagnosed advanced-stage EOC.

(BELG J MED ONCOL 2023;17(2):38–45)

Read more

Breast cancer in a young woman with short stature: Which diagnosis not to miss

BJMO - volume 16, issue 4, june 2022

L. Depauw MD, J. Michielsen , K. Storm MSc, K. Forceville MD, N. Degrieck MD, S. Altintas MD, PhD, F. Lockefeer MD, J. van den Ende MD, K. Janssens MD


This article presents the case report of a 27-year old woman with a triple-negative ductal adenocarcinoma and distinct physical features, in whom Bloom syndrome was diagnosed. Bloom syndrome, a rare autosomal recessive genetic disorder caused by biallelic mutations in the BLM gene, is associated with a markedly increased risk of developing a variety of cancers at a young age (most commonly leukaemia, lymphomas and gastrointestinal tract tumours). Other clinical manifestations include proportional growth deficiency, microcephaly, a long narrow face, retro/micrognathia, photosensitive erythematous rash, endocrine disorders and fertility problems. The potentially life-threatening consequences of Bloom syndrome make early detection, diagnosis and thorough multidisciplinary follow-up of patients with this disease an essential matter.

(BELG J MED ONCOL 2022;16(4):191–5)

Read more

Breast cancer highlights from ASCO 2016

BJMO - volume 10, issue 5, august 2016

S. Altintas MD, PhD

(BELG J MED ONCOL 2016;10:190–196)

Read more

Management and systemic treatment of clear cell metastatic renal cell carcinoma: BSMO expert panel recommendations

BJMO - volume 9, issue 1, february 2015

Z. El Ali MD, PhD, D. Van Brummelen MD, P. Wolter MD, S. Rottey MD, PhD, S. Altintas MD, PhD, D. Schallier MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, PhD, F. Van Aelst MD, S. Sideris MD, T. Gil MD, N. Sirtaine MD, L. D’Hondt MD, PhD, D. Luyten MD, C. Focan MD, PhD, G. Matus MD, M. Rasschaert MD, G. Pelgrims MD, the BSMO Renal Cancer Task Force Group

Almost 30% of patients with renal cell cancer present initially with advanced stage IV disease. In the past decade, the management of the metastatic renal cell cancer has been revolutionised by the knowledge of its molecular biology and development of targets against vascular endothelial growth factor and mammalian target of rapamycin pathways. In this paper we present recommendations based on a thorough review of available guidelines and data from the phase III randomised controlled trials that evaluated new agents in patients with advanced metastatic renal cancer.
(BELG J MED ONCOL 2015;9(1):16–24)

Read more

Case report: squamous cell carcinoma of the breast, a rare cancer?

BJMO - volume 7, issue 3, july 2013

S. Vandamme , I. Geboers MD, J. Vervliet MD, C. Molderez MD, E. Van den Heuvel MD, J. Gaens MD, P. Meijnders MD, PhD, MD , PhD , W. Tjalma MD, PhD, S. Altintas MD, PhD


We present the case of a 56-year old patient with primary squamous cell carcinoma of the breast. She underwent a radical mastectomy with adjuvant chemotherapy, consisting of carboplatinum and gemcitabine, and consecutive radiotherapy. Twenty-seven months after her treatment she is still disease-free. Hormonal therapy was initiated for a small tubular carcinoma and is continuing. As yet, there is uncertainty about the correct management of this rare and aggressive type of cancer, but there is growing evidence that adjuvant platinum-based regimens, especially cisplatinum, might be effective in inducing long-term complete remission.

(BELG J MED ONCOL 2013;7(3):89–92)

Read more

Prognostic factors in ductal carcinoma in situ (DCIS)

BJMO - volume 6, issue 5, october 2012

S. Altintas MD, PhD, M. Huizing MD, PhD, W. Tjalma MD, PhD

Ductal carcinoma in situ of the breast (DCIS) is a clinical entity which is discovered as microcalcifications on screening mammography, it rarely represents a palpable disease. Asymptomatic women with DCIS receive treatments that are similar to women with invasive breast cancer and therefore experience substantial psychological distress despite the fact that they have an excellent prognosis and normal life-expectancy. It is also true that, in spite of aggressive treatment approaches, some patients do recur.

In analogue with invasive breast cancer, DCIS is a heterogeneous disease with different prognostic profiles. The high incidence of DCIS and variations in its treatment with different outcomes led to the introduction of the Van Nuys Prognostic index (VNPI) developed in 1996 by Silverstein. This index is a simple decision-making tool to improve or at least standardise DCIS care and had been incorporated in our daily practice since 1997. Data on that experience were analysed. We tried to obtain a better understanding of the molecular behaviour of DCIS laesions and looked for predictive and prognostic markers associated with disease-free survival (DFS). The next step was the use of micro-array analysis with the Genomic Grade Index (GGI), based on four proliferation genes, and the proliferation index Ki-67. These two indices, which are considered to be predictive for the behaviour of invasive breast cancer, were incorporated into the VNPI. Furthermore, we looked if the tumour microenvironment might play a crucial role in local relapse of DCIS and risk of subsequent invasive disease. (BELG J MED ONCOL 2012;6:164–168)

Read more