SPECIAL

Follow up of early testicular cancer: when and how long?

BJMO - 2021, issue SPECIAL, march 2021

R. Huddart PhD

Testicular germ cell tumours (TGCTs) are the most common cancer in men between the ages of 15 and 40 years. Luckily, the majority of these patients can expect to be cured. However, the optimal follow-up for patients after their initial management is still subject to debate. During a keynote lecture at the 2021 annual BMUC meeting, Prof Robert Huddart discussed some of the key aspects of this follow-up process.

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Highlights in HER2-positive breast cancer

BJMO - 2021, issue Special, december 2021

J. Blokken PhD, PharmD, T. Feys MBA, MSc

In the field of Human Epidermal Growth Factor Receptor 2 (HER2) positive early breast cancer, an interesting Subpopulation Treatment Effect Pattern Plot (STEPP) analysis of the APHINITY trial was presented at SABCS 2020. In addition, BluePrint RNA sequencing was used in an attempt to predict the benefit of adjuvant pertuzumab in this trial. Other interesting data in early HER2-positive breast cancer came from the use of neratinib as extended adjuvant therapy. In the metastatic setting, results of the PERTAIN study, the first randomised phase II trial to assess the addition of pertuzumab to trastuzumab and an aromatase inhibitor in the presence or absence of induction chemotherapy, were presented. Finally, a long list of abstracts featured results with novel HER2-directed therapies, including the antibody-drug conjugate trastuzumab deruxtecan, the tyrosine kinase inhibitor tucatinib and the investigational monoclonal antibody margetuximab.

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Highlights in luminal breast cancer

BJMO - 2021, issue Special, december 2021

T. Feys MBA, MSc, T. Rawson MSc

Among patients with early breast cancer (BC), approximately 75% present with a luminal tumour (HR+).1 In addition to being the most common BC subtype, luminal BC also causes most deaths.2 Interestingly, the deaths caused by this BC subtype occur over a longer period of time compared to what is seen with HER2-positive and triple negative breast cancer (TNBC).3,4 As such, it is safe to say that luminal BC continues to be an unmet clinical need. To address this need, a long list of clinical trials are looking into novel strategies to optimize the management of patents with luminal BC. SABCS 2020 featured a plethora of abstracts discussing updates of pivotal trials in luminal breast cancer in addition to studies generating promising results with novel therapeutic agents in patients with more advanced HR+ BC.

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Highlights in triple-negative breast cancer

BJMO - 2021, issue Special, december 2021

J. Blokken PhD, PharmD, T. Feys MBA, MSc

Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer that is prone to early recurrence. In recent years, however, promising data were generated with immunotherapy-based treatment regimens in both the neoadjuvant and metastatic setting. Several updates of these studies were presented at SABCS 2020. In addition, the meeting featured several interesting abstracts discussing potential biomarkers that would facilitate a better treatment selection. In addition to immunotherapy, several novel therapeutics, including antibody-drug conjugates and targeted therapies are emerging in the treatment for patients with metastatic TNBC.

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Highlights in radiotherapy

BJMO - 2021, issue Special, december 2021

J. Blokken PhD, PharmD, T. Feys MBA, MSc

SABCS 2020 featured several interesting presentations in the field of radiotherapy. The PRIME 2 study investigated the impact of omitting postoperative whole breast radiotherapy in older, low-risk women with early invasive breast cancer. Outcomes of the phase III BIG 3-07/TROG 07.01 trial were also reported providing improved insights into the optimal radiation dose and fractionation schedule for non-low risk ductal carcinoma in situ of the breast. Other interesting topics included the comparison of patient and physician reports of toxicity after breast radiotherapy and the finding that radiation therapy improves survival in early-stage HER2-positive breast cancer with a high-levels of tumour infiltrating lymphocytes. Finally, we report on the results of a retrospective analysis assessing the feasibility of radiation therapy de-escalation in patients with stage I, node-negative, HER2-positive breast cancer.

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Miscellaneous news from SABCS 2020

BJMO - 2021, issue Special, december 2021

A. Dekker MD, T. Feys MBA, MSc

We want you to be completely up to date on the results presented at SABCS 2020, hence this article will focus on three presentations that were not previously addressed in the congress highlights. A first presentation reported on the high rate of persistent controlled substance use following mastectomy with reconstruction surgery. Results of a large systematic review and meta-analysis provide solid evidence on the chance of pregnancy after breast cancer and underscores the importance of oncofertility counselling. A third interesting study performed a large, pooled analysis to further define and explore the role of circulating tumor cell count as a tool for early treatment monitoring in patients with metastatic breast cancer (MBC).

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PSMA PET/CT imaging for the primary staging of prostate cancer

BJMO - 2020, issue Special, october 2020

dr. Siska van Bruwaene , Prof, dr. Karolien Goffin

In recent years, PSMA PET/CT imaging has emerged as one of the hottest topics in prostate cancer. In this respect, results of the proPSMA trial that were published earlier this year have the potential to be a real gamechanger in the primary staging of prostate cancer. Nowadays, CT and bone scans are the preferred imaging tools in primary staging, but the results of this trial now indicate that PSMA PET/CT can potentially replace this standard of care. However, many questions remain to be answered: can we forego on CT and bone scan and routinely opt for a one-stop-shop with PSMA PET/CT? Are there specific pitfalls with this technique? What should be the conclusion after a positive/negative result on PSMA PET/CT? In a first session of the 2020 annual BMUC meeting, the results obtained with PSMA PET/CT in the context of primary prostate cancer were critically reviewed with a specific focus on some of these unanswered questions. During this session Dr. Siska van Bruwaene (AZ Groeninge, Kortrijk, Belgium) zoomed in on PSMA PET/CT in the context of lymph node staging after which Prof. Dr. Karolien Goffin (University Hospitals Leuven, Leuven, Belgium) turned the attention to distant disease staging with this imaging technique.

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