REVIEW ONCOLOGY

Partial breast irradiation of early-stage breast cancer

SUMMARY

Whole-breast irradiation, as part of breast-conservation therapy (BCT), has been well-established the last decades. Nonetheless, most local recurrences found after BCT are within or close to the tumour bed. This led to the concept of partial breast irradiation (PBI), delivering the radiation dose to a decreased target volume, thereby lowering exposure to the organs at risk and hence potentially minimizing late adverse effects. This became increasingly important with growing survivorship of patients with early-stage breast cancer over the past decades and the consideration of late adverse effects is gaining more importance. In this review, we will present an overview of the current literature, techniques to deliver PBI and we try to establish whether there is a place for PBI in early-stage breast cancer treatment.

(BELG J MED ONCOL 2020;14(4):140–45)

The advanced practice nurse (APN) in oncology: an opportunity to meet the fast evolving needs in cancer care

SUMMARY

Cancer nursing is a profession in full development. In oncology, as well as in other domains, nursing roles have evolved substantially to better meet patients’ needs and expectations, the complexity of evidence-based (nursing) practice and to better fit needs related to quickly evolving oncology treatments and services. The recognition of advanced practice nurses (APN) in the Belgian legislation in 2019 may further stimulate the implementation of advanced practice nursing in interdisciplinary care, and in oncology in particular. APN have completed a master’s degree as well as additional education and training in a specific clinical domain, such as oncology. The core competencies of APN are clinical practice; expert coaching and guidance; consultation; collaboration; improvement of quality care and innovation; leadership; research and ethical decision-making. APN share a care-oriented focus and person-centred approach. Besides their role in direct clinical practice, APN create an added value in quality improvement, innovation and implementation of evidence-based nursing practice. Therefore, APN closely collaborate with nursing staff, medical staff, other healthcare professionals, management and stakeholders.

(BELG J MED ONCOL 2020;14(3):93–9)

Integration of oncology and palliative care: summary of the Lancet Oncology Commission paper

SUMMARY

An international collaboration between 30 experts in oncology, palliative care, public health and psycho-oncology provided opportunities and guidelines on how to achieve full integration based on current findings of palliative care research in a Lancet Oncology Commission paper. This review provides a summary of this commission paper in which an overview is given of the different levels of palliative care and which elements of patient-centred care are crucial in the provision of optimal integrated palliative care. Due to the increase in incidence and prevalence of patients living with advanced cancer and associated care needs, palliative care should be seen as an essential component of comprehensive care throughout the life course and disease trajectory. If cure is not achievable, a combined tumour-directed approach and patient-centred approach is needed. We need to rethink and reorganise the delivery of oncology and palliative care to improve treatment and promote collaboration at the appropriate levels of care. Palliative care needs to be implemented in cancer care plans and in clinical care pathways. To guide patients and their family through the healthcare system and improve their health care outcomes, a multidisciplinary team approach is needed in which primary, secondary and tertiary palliative care providers can collaborate and communicate and in which patients can be referred to tertiary palliative care if needed.

(BELG J MED ONCOL 2020;14(2):47–55)

Tumour mutational burden: a review

SUMMARY

Immunotherapeutics, like immune checkpoint blockade (ICB), have demonstrated therapeutic efficacy in a variety of human cancers. Even among the tumour types described as responsive, immunotherapy is only efficient in a minority of the patients. To maximise therapeutic benefits, a biomarker to identify ICB-responders is needed. Tumour mutational burden would correlate with the efficacy of immune checkpoint inhibitors. Clinical evidence for TMB as biomarker already exists in metastatic melanoma, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC). In this review an update about tumour mutational burden (TMB) is given.

(BELG J MED ONCOL 2020;14(1):4–7)

Adjuvant treatment of stage III melanoma: a tabulated review of randomised phase III trials

(BELG J MED ONCOL 2020;14(1):8–12)

Update in prostate cancer 2019

SUMMARY

The prostate cancer (PCa) landscape has changed dramatically over the past few years. New paradigm-shifting data are published nearly every month. This review aims to give a brief overview of the most important publications of 2018–2019. From the ever-lasting discussion about PSA screening, with the recent publication of the CAP trial, over diagnostics where multi-parametric MRI has caused a true revolution, to hypofractionation in radiotherapy and the dramatic treatment shifts in metastatic hormone sensitive and non-metastatic castrate resistant PCa. All exciting data that will change clinical practice.

(BELG J MED ONCOL 2020;14(1):13–21)

The hype of phase II trials

SUMMARY

Many of the new drugs are registered based on phase II data and surrogate endpoints. The medical oncologist should know the limitations and dangers of such an approach. The value of phase II trials and surrogate endpoints as well as clinical meaningful results are discussed.

(BELG J MED ONCOL 2019;13(7):273–6)