Algorithms for molecular testing in solid tumours

BJMO - volume 13, issue 7, november 2019

Ir A. Hébrant PhD, M. Lammens MD, PhD, C. Van den Broecke MD, N. D’Haene MD, PhD, J. Van den Oord MD, PhD, A. Vanderstichele MD, PhD, A. Dendooven MD, PhD, P. Neven MD, PhD, K. Punie MD, G. Floris MD, PhD, J. Van der Meulen MD, HA. Poirel MD, PhD, C. Dooms MD, PhD, S. Rottey MD, PhD, T. Boterberg MD, PhD, L. Brochez MD, PhD, M.C. Burlacu MD, G. Costante MD, D. Creytens MD, PhD, P. De Paepe MD, PhD, R. De Pauwn MD, B. Decallonne MD, PhD, F. Dedeurwaerdere MD, H. Denys MD, PhD, L. Ferdinande MD, PhD, R. Forsyth MD, PhD, M. Garmyn MD, PhD, T. Gevaert MD, PhD, J. De Grève MD, PhD, E. Govaerts MD, E. Hauben MD, PhD, J. Kerger MD, O. Kholmanskikh Van Criekingen MD, PhD, V. Kruse MD, PhD, Y. Lalami MD, L. Lapeire MD, PhD, P. Lefesvre MD, PhD, J.P. Machiels MD, PhD, B. Maes MD, PhD, G. Martens MD, PhD, M. Remmelink MD, PhD, I. Salmon MD, PhD, R. Sciot MD, PhD, S. Tejpar MD, PhD, K. Van de Vijver MD, PhD, L. Van de Voorde MD, I. Van den Berghe MD, A. Van den Bruel MD, K. Vandecasteele MD, PhD, L. Vanwalleghem MD, K. Vermaelen MD, PhD, R. Salgado MD, PhD, E. Wauters MD, PhD, B. Weynand MD, PhD, E. Van Valckenborgh PhD, G. Raicevic PhD, M. Van den Bulcke PhD, P. Pauwels MD, PhD


In order to advise the Federal Government on the reimbursement of molecular tests related to Personalised Medicine in Oncology, the Commission of Personalised Medicine (ComPerMed), represented by Belgian experts, has developed a methodology to classify molecular testing in oncology. The different molecular tests per cancer type are represented in algorithms and are annotated with a test level reflecting their relevance based on current guidelines, drug approvals and clinical data. The molecular tests are documented with recent literature, guidelines and a brief technical description. This methodology was applied on different solid tumours for which molecular testing is a clear clinical need.

(BELG J MED ONCOL 2019;13(7):286–95)

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Belgian consensus guidelines for prostate core needle biopsy reporting

BJMO - volume 12, issue 6, october 2018

T. Gevaert MD, PhD, L. Libbrecht MD, PhD, E. Lerut MD, PhD, B. Weynand MD, PhD, M. Lammens MD, PhD, S. Verschuere MD, PhD, C. Mattelaer MD, B. Lelie MD, J. Eben MD, L. Martinez , M-A. van Caillie MD, S. Rorive MD, PhD, S. Verbeke MD, PhD, M. Baldewijns MD, PhD

The Belgian Working Group on Uropathology has agreed upon a dataset for prostate core needle biopsy reporting, based on existing international guidelines, recent scientific insights, national survey analysis and panel discussion, with the focus on a user- and receptor-friendly format. This dataset should encourage standardised structured reporting of prostate biopsies in the Belgian healthcare system, aiming to improve the quality of individual pathology reports and to provide real benefit for the clinical management of patients and secondary users. Therefore the Belgian Working Group on Uropathology recommends implementing this dataset in each Belgian pathology lab, in close consultation with the entire clinical team involved in the treatment of the prostate cancer patient.

(BELG J MED ONCOL 2018;12(6):279–286)

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The emerging role of stereotactic radiotherapy in oligometastatic cancer

BJMO - volume 10, issue 2, april 2016

D. Van Brummelen MD, R. Van den Begin MD, B. Engels MD, PhD, C. Collen MD, T. Gevaert MD, PhD, D. Verellen PhD, G. Storme MD, PhD, M. De Ridder MD, PhD


Most metastatic cancer patients pass through an oligometastatic disease phase. Management of oligometastatic cancer is changing due to the increasing application of local treatments, leading to longer disease control and, in some cases, even cure. This paper discusses stereotactic radiotherapy as a progressively more effective treatment of oligometastatic cancer due to technological developments enabling the specific delivery of higher radiation doses to the tumour itself, more insight in disease-related factors influencing its effectiveness, and its potential of synergy with immunotherapy.

(BELG J MED ONCOL 2016;10(2):58–62)

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Clinical implementation of frameless radiosurgery

BJMO - volume 7, issue 3, july 2013

T. Gevaert MD, PhD, D. Verellen PhD, B. Engels MD, PhD, J. D’Haens MD, PhD, M. De Ridder MD, PhD


Stereotactic radiosurgery is a treatment technique that uses a single high ablative dose of radiation to benign and malignant laesions while sparing healthy brain tissue. Several systems have been developed to perform this technique, and these differed in the way the irradiation was performed. An accurate positioning, immobilisation of the patient and a precise localisation of the laesion are essential. Traditionally, this was performed with a headring screwed onto the patient’s skull (frame-based technique). The positioning is achieved using a localiserbox, mounted on the invasive headring and stereotactic coordinates, obtained through the planning system. With recent developments in radiotherapy, this high precision positioning can nowadays also be performed without the invasive headring. This non-invasive approach, called frameless, improves patient comfort and uses a mask system to immobilise the patient and image-guidance to accurately position the patient on the basis of anatomy. The Novalis system (Brainlab AG) at the UZ Brussel can use both a frame-based and frameless approach. Frameless radiosurgery is carried out with a mask device and two stereoscopic x-ray images. This innovative frameless positioning technique showed equivalent positioning accuracy and immobilisation characteristics to the invasive frame-based technique.

(BELG J MED ONCOL 2013;7(3):93–97)

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Current perspectives on the use of the Gleason grading system for prostate cancer

BJMO - volume 6, issue 2, april 2012

T. Gevaert MD, PhD, H. Van Poppel MD, PhD, S. Joniau MD, PhD, D. De Ridder MD, PhD, E. Lerut MD, PhD

For more than four decades the Gleason score is the most widely accepted histopathological grading system for prostate cancer. It is a 5-tier grading system that correlates with tumour differentiation and is solely based on architectural patterns within the tumour. Although robust over time, revision of Gleason grading became unavoidable as diagnosis and treatment of prostate cancer also underwent an enormous evolution over time. In 2005 the International Society of Urological Pathology (ISUP) proposed several modifications to the Gleason system which should keep this grading system timely. This review compares the original system to the modified Gleason system and especially focuses on the prognostic relevance of the modifications. It further deals with the question if the Gleason system will be able to keep its prominent role in the diagnostic and prognostic algorithm for prostate carcinoma, especially in the nearby molecular era. (BELG J MED ONCOL 2012;6:45–51)

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