Articles

New oncology reimbursements in Belgium

BJMO - volume 16, issue 5, september 2022

T. Feys MSc, MBA

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2022;16(5):257)

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Highlights in breast cancer

BJMO - volume 16, issue 5, september 2022

T. Feys MSc, MBA

SUMMARY

ASCO 2022 featured a couple of breast cancer-related presentations with the potential to shake up the clinical practice. First and foremost, results of the DESTINY-Breast 04 study demonstrated a significant progression-free (PFS) and overall survival (OS) benefit with trastuzumab deruxtecan in the treatment of HER2-low metastatic breast cancer (mBC) patients who received 1–2 prior lines of therapy. By effectively creating a new category of breast cancer, this trial will redefine the classical breast cancer classification and will significantly expand the population of patients who can benefit from HER2-targeted therapy. In TROpICS-02, sacituzumab govitecan, an antibody-drug conjugate directed against TROP-2, was found to delay the disease progression of patients with heavily pre-treated HR+/HER2- advanced breast cancer. Also in HR+/HER2- advanced breast cancer, the MAINTAIN study demonstrated a significant PFS benefit with the continued use of a CDK4/6 inhibitor with a switch in endocrine therapy partner in women who progressed while being treated with a CDK4/6 inhibitor. Finally, ASCO 2022 also showed that the significant PFS benefit obtained from adding the CDK4/6 inhibitor palbociclib to letrozole in the first-line treatment of postmenopausal women with HR+ advanced breast cancer did not translate into a significant OS benefit.

(Belg J Med Oncol 2022;16(5):251–6)

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Highlights in thoracic oncology

BJMO - volume 16, issue 5, september 2022

J. Blokken PhD, PharmD, T. Feys MSc, MBA

SUMMARY

In the field of thoracic oncology, many refinements and longer follow-up results of previously reported trials were presented during the annual ASCO 2022 meeting. Although there were no presentations of new, truly practice-changing trials, several exciting and promising data are worthwhile to mention in this highlights in thoracic oncology overview.

(Belg J Med Oncol 2022;16(5):229–35)

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New oncology reimbursements in Belgium

BJMO - volume 16, issue 4, june 2022

T. Feys MSc, MBA

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2022;16(4):209)

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Immune checkpoint inhibition in oncogene addicted non-small cell lung cancer

BJMO - 2022, issue Special, may 2022

T. Feys MSc, MBA

Immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) dramatically changed the therapeutic algorithm for patients with advanced non-small cell lung cancer (NSCLC). Pivotal trials investigating ICIs in advanced NSCLC have usually excluded patients with oncogenic drivers, hence the outcome of these agents in this population is poorly characterized. The available data are scarce but point towards limited efficacy of ICI in NSCLC patients harboring oncogenic driver mutations. As such, the evidence to date supports the exhaustion of all TKI options prior to immunotherapy or chemotherapy in oncogene addicted tumors.

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Targeting MET exon 14 skipping mutations in non-small cell lung cancer

BJMO - 2022, issue Special, may 2022

T. Feys MSc, MBA

MET exon 14 skipping mutation (MET∆ex14) is present in about 3% of non-small cell lung cancers (NSCLCs). Recently, two MET-tyrosine kinase inhibitors (capmatinib and tepotinib) demonstrated their clinical potential in the treatment of this subgroup of NSCLC patients resulting in their FDA approval (EMA approval pending). In their respective pivotal trials, these agents have yielded a promising median progression-free survival (PFS) of 8-12 months. Unfortunately, however, it has also been reported that a third to half of patients show inherent resistance to MET-TKIs. Furthermore, the emergence of acquired resistance to MET-TKIs is inevitable. This article will summarize the clinical trial data generated with capmatinib and tepotinib in this setting after which some insights into the inherent and acquired resistance mechanisms to MET-TKIs will be addressed.

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Targeting BRAF-mutations in non-small cell lung cancer: state of the art and future perspectives

BJMO - 2022, issue Special, may 2022

T. Feys MSc, MBA

The increased use of next generation sequencing has allowed for a detailed interrogation of the molecular landscape of non-small cell lung cancer (NSCLC), identifying different patient subgroups with therapeutically targetable genetic alterations. In this respect, BRAF-mutant NSCLC represent a small, but non-negligible subgroup of NSCLC patients. Data from a pivotal phase II trial have demonstrated that dual BRAF (dabrafenib) and MEK (trametinib) inhibition has durable antitumor activity in patients with a BRAFV600E mutation, making screening for this specific BRAF alteration a mandatory requirement in the diagnostic work-up of metastatic NSCLC. Unfortunately, however, V600E mutations make up only half of all BRAF mutations in NSCLC and the non-V600 patients currently remain orphan of targeted approaches. This article will provide an overview of the clinical trial data obtained with BRAF inhibitors in BRAF-mutant NSCLC after which some of the remaining clinical challenges will be addressed.

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