BJMO - 2022, issue Special, may 2022
T. Feys MBA, MSc
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.
Read moreBJMO - 2022, issue Special, may 2022
T. Feys MBA, MSc
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.
Read moreBJMO - 2022, issue Special, may 2022
T. Feys MBA, MSc
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.
Read moreBJMO - 2022, issue Special, may 2022
A. Enguita PhD, T. Feys MBA, MSc
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.
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J. Blokken PhD, PharmD, T. Feys MBA, MSc
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
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A. Dekker MD, T. Feys MBA, MSc
About 15% of patients with localised prostate cancer (PCa) are identified as having a high risk for disease recurrence and these patients account for the vast majority of PCa deaths. To date, however, the optimal treatment for patients with high-risk, localized PCa remains controversial. While it is important to offer these patients an effective treatment, this treatment should not come with excessive side effects or impact the patient’s quality of life (QoL).1 During a session at the 2022 BMUC meeting, the different treatment options for these patients were discussed from the perspective of the surgeon, the medical oncologist and the radiation oncologist.
Read moreBJMO - 2022, issue Special, may 2022
A. Dekker MD, T. Feys MBA, MSc
What is the role of the patient in the management of prostate cancer? During BMUC 2022, André Deschamps, prostate cancer (PCa) patient and Chairman of Europa UOMO aimed to answer this question. In his lecture, he discussed the effect of PCa and its treatment on the daily life of patients and addressed some of the barriers and gaps that hamper a closer involvement of patients in the treatment decision process. 1
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