Articles

An update on the management of metastatic clear-cell renal cell carcinoma: the BSMO expert panel recommendations

BJMO - volume 14, issue 2, march 2020

B. Delafontaine MD, C. De Backer MD, B. Beuselinck MD, PhD, P. Debruyne MD, PhD, L. D’Hondt MD, PhD, C. Gennigens MD, T. Gil MD, C. Vulsteke MD, PhD, N. Martinez Chanza MD, A. Verbiest MD, M. Strijbos MD, PhD, G. Van Lancker MD, G. Pelgrims MD, S. Rottey MD, PhD, On behalf of the BSMO Uro-Oncology Task Force Group

SUMMARY

The management of recurrent or metastatic renal cell carcinoma is evolving fast, with new therapeutic options becoming available that may improve the outcome of patients. In this paper, recent evolutions are discussed and recommendations are made regarding the management of renal cell carcinoma in a Belgian context.

(BELG J MED ONCOL 2020;14(2):56–70)

Read more

State of the art in the treatment of soft tissue sarcomas

BJMO - volume 13, issue 6, october 2019

C. Gennigens MD, G. Jerusalem MD, PhD

SUMMARY

Soft tissue sarcomas represent 75% of all sarcomas and constitute a group of more than 50 different histological subtypes, with an even greater number of molecular subtypes. Localised STSs are generally treated by surgery followed, or preceded, by radiotherapy and according to criteria linked with the risk of local recurrence. Metastatic STSs are principally treated by systemic treatments such as chemotherapy and targeted drugs. The most important drugs used are doxorubicin, ifosfamide, dacarbazine, gemcitabine/docetaxel, eribulin and trabectedin; but also pazopanib. The place of localised treatments (surgery, radiotherapy, radiofrequency, etc.) in this setting is reserved for oligometastatic disease. A multidisciplinary approach is mandatory, with centralisation of all cases in reference centres, as early as at the time of clinical diagnosis of a suspected sarcoma. This ‘centralised’ approach, for this rare and complex disease, has an impact on the oncologic outcomes (quality of resection and overall survival) of patients.

(BELG J MED ONCOL 2019;13(6): 227–233)

Read more

Leptomeningeal carcinomatosis from solid tumours: a systematic review of the literature

BJMO - volume 11, issue 6, october 2017

P. Frères MD, C. Gennigens MD, D. Martin , G. Jerusalem MD, PhD

SUMMARY

Leptomeningeal carcinomatosis (LC), or neoplastic meningitis, is a disastrous complication of advanced cancer. This disease occurs in approximately 5% of patients with solid tumour and results from the dissemination of tumour cells from the cerebral spinal fluid (CSF) flow throughout the entire central nervous system (CNS). LC is characterized by multiple and fluctuant neurologic symptoms and signs. Useful tests for the diagnosis include magnetic resonance imaging (MRI) and CSF analysis. Unfortunately, the diagnosis remains challenging due to pleomorphic symptoms and false negative results of diagnostic procedures. For most patients, the aim of the treatment is to control symptoms, by using targeted radiotherapy and corticosteroids. More aggressive therapeutic approaches, such as intrathecal (IT) or systemic chemotherapy, should be restricted to highly selected and good-risk patients. Moreover, only few randomized clinical trials are available in the field and studies using more recent targeted therapies or immunotherapy should always be considered in these patients, as outcome with standard of care is disappointing.

(BELG J MED ONCOL 2017;11(6):259–264)

Read more

Management and systemic treatment of clear cell metastatic renal cell carcinoma: BSMO expert panel recommendations

BJMO - volume 9, issue 1, february 2015

Z. El Ali MD, PhD, D. Van Brummelen MD, P. Wolter MD, S. Rottey MD, PhD, S. Altintas MD, PhD, D. Schallier MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, F. Van Aelst MD, S. Sideris MD, T. Gil MD, N. Sirtaine MD, L. D’Hondt MD, PhD, D. Luyten MD, C. Focan MD, PhD, G. Matus MD, M. Rasschaert MD, G. Pelgrims MD, the BSMO Renal Cancer Task Force Group

Almost 30% of patients with renal cell cancer present initially with advanced stage IV disease. In the past decade, the management of the metastatic renal cell cancer has been revolutionised by the knowledge of its molecular biology and development of targets against vascular endothelial growth factor and mammalian target of rapamycin pathways. In this paper we present recommendations based on a thorough review of available guidelines and data from the phase III randomised controlled trials that evaluated new agents in patients with advanced metastatic renal cancer.
(BELG J MED ONCOL 2015;9(1):16–24)

Read more