BJMO - 2024, issue 4, june 2024
W. Lybaert MD, T. Vandamme MD, PhD, L. Mariën MSc, O. Islam MD, S. Chhajlani MD, C. De Weerdt MSc, I. Nietvelt MSc, M. Ulenaers MD, V. Casneuf MD, M. Maly MD, K. Geboes MD, PhD, D. Van Genechten , H. Leupe MD, C.M. Deroose MD, PhD
During the ENETS Conference, the NETTER-2 trial was again in the spotlight and is shifting [177Lu]Lu-DOTATATE PRRT to the first-line treatment setting of patients with advanced, well-differentiated grade 2 and grade 3 gastroenteropancreatic neuroendocrine tumours (NET). Nuclear medicine treatment for NET is now intensively focusing on alpha-emitting peptide receptor radionuclide therapy (PRRT). Adding immunotherapy to angiogenesis inhibition for NET is again a disappointing story, and all eyes are now set on the CAR T-cell technology to stimulate anti-tumour immune responses. Delta-like ligand 3 is an inhibitory Notch ligand selectively and highly expressed on the cell surface of small cell lung cancer and neuroendocrine carcinoma, and appears to be a promising target for bispecific T-cell engager therapy. In this report, the most important headlines will be discussed, with comments on the clinical relevance of the different studies.
(BELG J MED ONCOL 2024;18(4):164–75)
Read moreBJMO - volume 16, issue 3, may 2022
L. Crapé MD, K.P. Geboes MD, PhD, V. Casneuf MD, A.G. Verstraete MD, PhD, M. van den Eynde MD, PhD, I. Borbath MD, PhD, Y. Verheezen MD, W. Demey MD, J. Van der Meulen MD, V. Haufroid PhD
Fluoropyrimidines are frequently used as anti-cancer treatment for gastro-intestinal malignancies, breast, head and neck cancer and others. The enzyme dihydropyrimidine dehydrogenase (DPD) is crucial in the first and rate limiting enzyme step of 5-fluorouracil (5-FU) catabolism. Reduced or complete deficiency leads to severe and even fatal toxicity. The Belgian Group of Digestive Oncology (BGDO) has agreed upon a recommendation on screening for DPD deficiency before starting treatment, which was endorsed by the Belgian Society of Medical Oncology (BSMO), the College of Genetics (CG), and the Toxicological Society of Belgium and Luxembourg (BLT). This article focuses on the clinical flows and practical recommendations. Both targeted germline genotype testing and phenotyping are supported. It was suggested to use a stepwise approach, with a phenotype testing upfront because of higher sensitivity and lower societal cost. In patients with uracil levels above 14 ng/ mL, targeted germline genotype screening should follow. Fluoropyrimidines are contra-indicated in patients with complete DPD deficiency and starting dose recommendations have been validated for patients with partial deficiency.
(BELG J MED ONCOL 2022;16(3):119–24)
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