T. Feys MBA, MSc

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

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.

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS

(BELG J MED ONCOL 2022;16(3):154–7)

New oncology reimbursements in Belgium

OVERVIEW OF BELGIAN REIMBURSEMENT NEWS
(BELG J MED ONCOL 2022;16(2):97)

Congress highlights SABCS 2021

SUMMARY

The hybrid SABCS 2021 could only attract a few hundred life attendees, but like every year, several key abstracts were presented. In early stage, a meta-analysis on aromatase inhibitor versus tamoxifen in premenopausal ER+ patients showed lower recurrence with aromatase inhibitors, while the impact on overall survival remains unclear. An EBCTCG meta-analysis showed no benefit for an anthracycline-taxane adjuvant chemotherapy regimen compared to a taxane only regimen, if the taxane was given sequentially after the anthracycline, confirming the role of anthracycline-free chemotherapy regimens in a large proportion of patients with early breast cancer. In ER+ metastatic disease, the new SERD elacestrant was more potent than classical endocrine therapy after progression on first/second line endocrine therapy. Datopotamab deruxtecan is a promising new ADC targeting TROP2 with clear activity in triple negative disease. In HER2 positive disease, T-DXd displayed substantial antitumour effect on brain metastases, and pyrotinib can be added to the list of highly potent HER2 tyrosine kinase inhibitors. In patients with HER2 mutations, neratinib showed clear antitumour activity both in ER positive and triple negative metastatic breast cancer. In the surgery field, black and Hispanic women were shown to be at higher risk for breast cancer related lymphedema after axillary lymph node dissection. The Italian SINODAR-ONE trial built further on the Z0011 trial and confirmed that axillary surgery can be omitted in patients with breast cancer patients and one or two macro metastatic sentinel nodes.

(BELG J MED ONCOL 2022;16(2):79–87)

Highlights of the 15^th BSMO-Bordet symposium – The Integration of Molecular Biology Advances into Oncology Clinical practice

SUMMARY

In light of the ongoing global pandemic, the 15^th BSMO-Bordet symposium meeting went virtual in 2021. This did not detract from the engaging lineup of presentations, emphasising treatment breakthroughs in various cancers. In addition to this, several projects with a local impact on the Belgian oncology landscape were presented.

(BELG J MED ONCOL 2022;16(2):88–96)

Neoadjuvant and adjuvant systemic therapy in bladder cancer

In recent years, researchers have evaluated the integration of immunotherapy in the perioperative management of patients with muscle invasive bladder cancer (MIBC), with mixed results. During BMUC 2022, Professor Richard Cathomas (Division of Oncolgy, Cantonal Hospital Graubünden, Switzerland, and University of Zurich, Switzerland) provided an overview of these advances.

How to stage primary prostate cancer in 2022

Over the past years, next-generation imaging such as multiparametric whole body MRI and PSMA-PET/CT scans have been gaining momentum. Nonetheless, Prof. Padhani argues not to throw bone scintigraphy and CT scans (BS/ CT scans) out just yet. On the contrary, he puts BS/CT scans at the centre of patient care in men with locally advanced prostate cancer (LAPC). However, BS/ CT also comes with important limitations for which next-generation imaging (NGI) can serve as a problem solver after BS/CT scan assessments. During his talk at the BMUC 2022 meeting, Prof. Padhani emphasized the proven prognostic role of BS/CT scans, their predictive role in directing pelvic radiotherapy and for oncologic drug development. Finally, he argued that higher-quality evidence on the management and/or outcomes is needed before BS/CT scans can be substituted by NGI.¹