Articles

Algorithms for molecular testing in solid tumours

BJMO - volume 13, issue 7, november 2019

A. Hébrant PhD, M. Lammens MD, PhD, C. Van den Broecke MD, N. D’Haene MD, PhD, J. Van den Oord MD, PhD, A. Vanderstichele MD, PhD, A. Dendooven MD, PhD, P. Neven MD, PhD, K. Punie MD, PhD, G. Floris MD, PhD, J. Van der Meulen PhD, HA. Poirel MD, PhD, C. Dooms MD, PhD, S. Rottey MD, PhD, T. Boterberg MD, PhD, L. Brochez MD, PhD, M.C. Burlacu MD, G. Costante MD, D. Creytens MD, PhD, P. De Paepe MD, PhD, R. De Pauwn MD, B. Decallonne MD, PhD, F. Dedeurwaerdere MD, H. Denys MD, PhD, L. Ferdinande MD, PhD, R. Forsyth MD, PhD, M. Garmyn MD, PhD, T. Gevaert MD, PhD, J. De Grève MD, PhD, E. Govaerts MD, E. Hauben MD, PhD, J. Kerger MD, PhD, O. Kholmanskikh Van Criekingen MD, PhD, V. Kruse MD, PhD, Y. Lalami MD, L. Lapeire MD, PhD, P. Lefesvre MD, PhD, J.P. Machiels MD, PhD, B. Maes MD, PhD, G. Martens MD, PhD, M. Remmelink MD, PhD, I. Salmon MD, PhD, R. Sciot MD, PhD, S. Tejpar MD, PhD, K. Van de Vijver MD, PhD, L. Van de Voorde MD, I. Van den Berghe MD, A. Van den Bruel MD, K. Vandecasteele MD, PhD, L. Vanwalleghem MD, K. Vermaelen MD, PhD, R. Salgado MD, PhD, E. Wauters MD, B. Weynand MD, PhD, E. Van Valckenborgh PhD, G. Raicevic PhD, M. Van den Bulcke PhD, P. Pauwels MD, PhD

SUMMARY

In order to advise the Federal Government on the reimbursement of molecular tests related to Personalised Medicine in Oncology, the Commission of Personalised Medicine (ComPerMed), represented by Belgian experts, has developed a methodology to classify molecular testing in oncology. The different molecular tests per cancer type are represented in algorithms and are annotated with a test level reflecting their relevance based on current guidelines, drug approvals and clinical data. The molecular tests are documented with recent literature, guidelines and a brief technical description. This methodology was applied on different solid tumours for which molecular testing is a clear clinical need.

(BELG J MED ONCOL 2019;13(7):286–95)

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Molecular test algorithms for breast tumours

BJMO - volume 13, issue 2, march 2019

A. Hébrant PhD, K. Punie MD, PhD, F.P. Duhoux MD, PhD, C. Colpaert MD, PhD, G. Floris MD, PhD, K. Lambein MD, PhD, P. Neven MD, PhD, M. Berlière MD, PhD, R. Salgado MD, PhD, M. Chintinne MD, PhD, K. Dahan MD, PhD, S. Dedeurwaerdere MD, J. De Grève MD, PhD, A. de Leener MD, PhD, H. Denys MD, PhD, R. de Putter MD, PhD, L. Desmyter PhD, M. Baldewijns MD, PhD, D. Feret MD, C. Fontaine MD, C. Galant MD, PhD, P. Hilbert PhD, J. Janssens MD, PhD, D. Larsimont MD, PhD, P. Lefesvre MD, PhD, T. Sticca PhD, M-D. Tkint de Roodenbeke MD, G. Van Den Eynden MD, PhD, I. Vanden Bempt PhD, C. Van den Broecke MD, I. Vandernoot MD, C. Sotiriou MD, PhD, J. van Dorpe MD, PhD, H.A. Poirel MD, PhD, E. Van Valckenborgh PhD, G. Raicevic PhD, M. Van den Bulcke PhD, P. Aftimos MD

SUMMARY

In order to advise the Federal Government on all matters related to personalised medicine in oncology, including the reimbursement of molecular tests, the Commission of Personalized Medicine (ComPerMed) has applied, for the breast tumours, the same methodology as previously applied for the digestive tumours. Meaning, the different molecular tests, represented in the shape of algorithms, are annotated with test levels — which aim to reflect their relevance based on current available data and to define the reimbursement — and are documented with recent literature, guidelines and a brief technical description.

(BELG J MED ONCOL 2019;13(2):40–45)

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Four case reports of arterial thromboembolism and cisplatin administration

BJMO - volume 12, issue 3, may 2018

S. De Keukeleire MSc, T. De Beule , H. Denys MD, PhD, S. De Waele , W. Duthoy , V. Renard MD

Cisplatin is one of the frequently used chemotherapeutic agents. Common side effects such as vomiting, nephrotoxicity, ototoxicity and neurotoxicity are well known, though Cisplatin is also thought to activate destructive processes in blood vessels, including all types of arteries. Not only can it cause long-term cardiovascular complications (myocardial infarction, hypertension, and stroke), but also such complications during or shortly after its systemic administration. In a significant portion of patients, with up to 9% in some studies, thromboembolic events are encountered.1,2 In most of the cases, this concerns a venous thromboembolic event, though arterial thromboembolic events should not be neglected as it predicts a bad prognosis and significantly increased mortality risk, especially in cancer patients receiving other prothrombotic chemotherapies or when certain comorbidities are present that enhance the risk of thromboembolism.3 During a short period, we encountered four patients with arterial thromboembolic events while receiving Cisplatin-based therapy, of which three patients had a renal infarction. It should be noted that each patient had a different type of malignancy and Cisplatin was administered in combination with other therapeutic agents.

(BELG J MED ONCOL 2018:12(3):125–129)

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Extracellular vesicles to diagnose and treat cancer

BJMO - volume 11, issue 3, may 2017

J. Tulkens , L. Lippens , Eng , G. Vergauwen , S. Jeurissen MD, B. Dhondt MD, H. Denys MD, PhD, A. Hendrix PhD

SUMMARY

Extracellular vesicles transfer lipids, nucleic acids and membrane-associated as well as intraluminal proteins between cells to maintain homeostasis and regulate physiological functions. This communication system is hijacked in cancer. Tumour-derived extracellular vesicles enter the circulation and carry targeting motifs and unique messages for cell-type specific instruction of distant ecosystems to foster metastasis. In this review we focus on how extracellular vesicles provide new opportunities for the diagnosis and treatment of cancer. Quantification and characterisation of tumour-derived extracellular vesicles obtained by liquid biopsy may enable the diagnosis and prognosis of cancer patients. Interference with extracellular vesicle biogenesis and implementation of extracellular vesicles as cancer vaccines or drug delivery vehicles opens up therapeutic potential to treat cancer.

(BELG J MED ONCOL 2017;11(3):92–105)

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P.11 Outcome and relapse pattern between squamous cell and adenocarcinoma of the cervix

BJMO - 2017, issue 3, february 2017

K. Couvreur , K. Vandecasteele MD, PhD, P. Tummers , A. Makar , R. Van Den Broecke , H. Denys MD, PhD

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Adjuvant endocrine therapy in pre- and perimenopausal women with breast cancer: practice guidelines

BJMO - volume 10, issue 3, may 2016

F.P. Duhoux MD, PhD, P. Neven MD, PhD, A. Awada MD, PhD, M. Berlière MD, PhD, H. Wildiers MD, PhD, H. Denys MD, PhD

Summary

Oestrogen receptor positive early invasive breast cancer is a common disease in pre- and perimenopausal women. Adjuvant endocrine therapy is an essential part of its treatment. Until recently, premenopausal patients were uniformly treated with tamoxifen during five years. Given the recent publication of large clinical trials showing a benefit for other treatment regimens, the BSMO Breast Cancer Task Force met on the 6th of March, 2015, to propose common guidelines for adjuvant endocrine therapy for premenopausal patients. The members agreed that low-risk patients should be treated with five to ten years of tamoxifen, while the highest-risk patients should be treated with exemestane or tamoxifen plus ovarian function suppression. Special attention should be given to patients less than 35 years at diagnosis: in this subgroup, exemestane plus ovarian function suppression is preferred to tamoxifen plus ovarian function suppression.

(BELG J MED ONCOL 2016;10(3):92–96)

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Therapy-orienting testing of BRCA1 and BRCA2 germline mutations in women with ovarian cancer

BJMO - volume 9, issue 2, may 2015

K. Claes PhD, H. Denys MD, PhD, M. Huizing MD, PhD, I. Vergote , F. Kridelka MD, PhD, J. De Grève MD, PhD, V. Bours MD, PhD, On behalf of the BRCA Testing Working Group.

With the aim to optimally position poly-(adenosine diphosphate-ribose) polymerase inhibitors in the treatment of ovarian cancer, a panel of Belgian Experts came to a national multidisciplinary consensus: (i) germline BRCA1/2 testing should be indicated for all women with high-grade serous epithelial ovarian cancer, who are in good general condition (i.e. eligible for systemic treatment with low toxicity); BRCA1/2 mutation detection ratios being about 15–20% in this group; (ii) as the finding of a BRCA1/2 germline mutation has therapeutic implications in ovarian cancer patients, the request for therapy-orienting testing should be made as soon as possible during the course of first-line treatment. Pre-test genetic counselling is important because positive testing has implications for both the patients and their relatives, and the nature of the discussions depends on whether they take place in a therapeutic or familial context. The organisation of consultations should be coordinated in a collaborative effort between clinical geneticists, and gynaecological and medical oncologists, keeping in mind that ‘fast-track’ pre-test genetic counselling and short turnaround times are required for patients for whom the test results will have a therapeutic impact. Offering germline BRCA1/2 testing to all patients with high-grade serous epithelial ovarian cancer who are eligible for systemic treatment with low toxicity will lead to a limited increase in the number of patients eligible for this test in Belgium.

(BELG J MED ONCOL 2015;9(2):65–70)

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