Articles

Molecular test algorithms for digestive tumours

BJMO - volume 13, issue 1, february 2019

A. Hébrant PhD, Ir , A. Jouret-Mourin MD, PhD, G. Froyen PhD, J. Van der Meulen PhD, M. De Man MD, R. Salgado MD, PhD, M. van den Eynde , N. D’Haene MD, PhD, G. Martens MD, PhD, E. van Cutsem , H.A. Poirel MD, PhD, S. Tejpar MD, PhD, J.L. van Laethem MD, PhD, K. Geboes MD, PhD, P. Pauwels MD, PhD, F. Dedeurwaerdere MD, B. Maes MD, PhD, J. De Grève MD, PhD, J. Vanhuysse , P. Peeters MD, L. Vanacker MD, M. Gomez-Galdon , M. Chintinne MD, PhD, A. Hendlisz MD, PhD, G. de Hertogh , X. Sagaert MD, PhD, M. Peeters MD, PhD, P. Vannuffel , P. Lefesvre MD, PhD, J. Vermeij , M. Simoens , T. Van den Mooter MD, N. van Damme , M. Van den Bulcke PhD

The Belgian Commission of Personalized Medicine has been created to advise the federal government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests. Here, we propose the Belgian strategy for molecular testing in the digestive tumours within a scientific-based framework. For each tested biomarker, a clinical test level is attached, which is key to establish the relevance of the test and to define the reimbursement. For each digestive tumour type, the different molecular tests are represented as decision trees with its test utility, test level and a brief technical test description.

(BELG J MED ONCOL 2019;13(1):4–10)

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PD-L1 Testing for Non-Small Cell Lung Cancer: Belgian Guidelines

BJMO - volume 12, issue 5, september 2018

P. Pauwels MD, PhD, M. Remmelink MD, PhD, D. Hoton MD, J. van Dorpe MD, PhD, K. Dhaene MD, PhD, F. Dome MD, A. Jouret-Mourin MD, PhD, B. Weynand MD, PhD, N. D’Haene

In recent years, the outcome of patients with non-small cell lung cancer (NSCLC) has improved thanks to the development of targeted therapies. Currently, the introduction of immunotherapy for lung cancer patients offers new treatment opportunities. The pathologist is now asked to provide the most accurate possible diagnosis in association with theranostic information in order to provide the best therapeutic option. For immunotherapy, programmed death receptor ligand 1 (PD-L1) status is, at the present, the required biomarker for patient stratification, at least in first line treatment. Different international societies have already underlined the importance of guidelines for managing samples of non-small cell lung cancer NSCLC. With the goal of adapting these international recommendations to the Belgian landscape, Belgian guidelines were published in 2016. This update integrates immunotherapy into the previously published guidelines.

(BELG J MED ONCOL 2018;12(5):233–238)

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Opportunities and challenges in oncology and molecular testing: the Belgian strategy

BJMO - volume 12, issue 2, march 2018

A. Hébrant PhD, E. Van Valckenborgh PhD, R. Salgado MD, PhD, G. Froyen PhD, F. Hulstaert , D. Roberfroid , S. Tejpar MD, PhD, A. Jouret-Mourin MD, PhD, M. Van den Bulcke PhD, A. Waeytens PhD

Summary

Molecular diagnostics in cancer aiming at improving diagnosis, prognosis and treatment are constantly exposed to new opportunities and challenges. The Belgian Commission of Personalised Medicine (ComPer-Med) has been created to advise the Federal Government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests. Here, we propose the Belgian strategy for molecular testing within a scientific based framework and its implementation in the Belgian healthcare system. For each tested biomarker a clinical test level is attached, which is key to establish the relevance of the test and to define the reimbursement.

(BELG J MED ONCOL 2018;12(2):46–50)

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Pathological diagnosis and molecular testing in non-small cell lung cancer: Belgian guidelines

BJMO - volume 10, issue 4, july 2016

P. Pauwels MD, PhD, M. Remmelink MD, PhD, D. Hoton MD, J. van Dorpe MD, PhD, K. Dhaene MD, PhD, F. Dome MD, A. Jouret-Mourin MD, PhD, B. Weynand MD, PhD, N. D’Haene MD, PhD

Summary

In recent years, the management of patients with non-small cell lung cancer has been modified thanks to the development of targeted therapies. The pathologist is now asked to give the most accurate possible diagnosis in association with theranostic information in order to provide the best therapeutic option.
Different international societies have already underlined the importance of guidelines for managing samples of non-small cell lung cancer. These Belgian guidelines have the goal of adapting these international recommendations to the Belgian landscape.

(BELG J MED ONCOL 2016;10(4):123–131)

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RAS-testing in colorectal cancer: Belgian guidelines

BJMO - volume 9, issue 5, september 2015

A. Jouret-Mourin MD, PhD, C. Cuvelier MD, PhD, P. Demetter MD, PhD, N. D’Haene MD, PhD, A. Driessen MD, PhD, A. Hoorens MD, PhD, N. Nagy MD, X. Sagaert MD, PhD, P. Pauwels MD, PhD, On behalf of the Working Group of Digestive Pathology and the Belgian Society of Pathology.

There is an urgent need for predictive biomarkers in several cancers. In colorectal cancers, KRAS exon 2 mutation analyses were mandatory when considering anti-epidermal growth factor antibody therapy with agents such as cetuximab or panitumumab. However, since the introduction of this testing, a cohort of patients still did not appear to benefit from this therapy. Recently, additional testing for KRAS exon 3 and 4, and NRAS considerably improved the predictive power for therapy success. Therefore, an update of the Belgian guidelines for RAS testing was urgently needed.

(BELG J MED ONCOL 2015;9(5):183–90)

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