BJMO - volume 11, issue 4, september 2017
T. Feys MBA, MSc, H. Wildiers MD, PhD
This report will discuss a selection of key studies related to breast cancer discussed during the 2017 annual meeting of the American Society of Clinical Oncology. ASCO 2017 featured important new data generated with CDK4/6 inhibitors in patients with advanced breast cancer and included several abstracts considering the potential of PD-L1 inhibition for breast cancer. In addition to this, updates of several large phase III studies, including MARIANNE, ALLTO and APHINITY were presented. For a more complete overview of breast cancer news presented at ASCO 2017, we refer to the ASCO annual meeting website (https://meetings.asco.org/am/register-submit-abstracts).
Read moreBJMO - 2017, issue 3, february 2017
L. Jongen , P. Neven MD, PhD, A. Lintermans , K. Van Asten MSc, C. Blomme , D. Lambrechts PhD, A. Poppe , H. Wildiers MD, PhD, A.S. Dieudonné , J. Decloedt , P. Berteloot , D. Verhoeven MD, PhD, M. Joerger , P. Vuylsteke MD, W. Wyendaele , M. Casteels , S. Van Huffel , W. Lybaert MD, J. Van Ginderachter , R. Paridaens , I. Vergote , V. Dezentjé , B. Van Calster PhD, H-J. Guchelaar
BJMO - 2017, issue 3, february 2017
L. Decoster MD, PhD, C. Kenis PhD, J. Flamaing , P.R. Debruyne , I. De Groof , C. Focan MD, PhD, F. Cornélis MD, V. Verschaeve , K. Vanoverbeke , Y. Libert , S. Luce , N. Nols , H. van den Bulck , J.C. Goeminne MD, K. Geboers , J.P. Lobelle , M. Lycke , K. Milisen , H. Wildiers MD, PhD, A. Baitar
BJMO - 2017, issue 3, february 2017
A. Coolbrandt , H. Wildiers MD, PhD, A. Laenen , B. Aertgeerts , B. Dierickx De Casterlé , T. Van Achterberg , K. Milisen
BJMO - volume 10, issue 8, december 2016
H. Wildiers MD, PhD, T. Feys MBA, MSc
(BELG J MED ONCOL 2016;10(8):308–13)
Read moreBJMO - volume 10, issue 4, july 2016
K. Van Asten MSc, P. Neven MD, PhD, G. Floris MD, PhD, R. Salgado MD, PhD, C. Sotiriou MD, PhD, H. Wildiers MD, PhD
Gene expression profiles provide strong prognostic information and can predict breast cancer outcome mainly in women with lymph node-negative, oestrogen receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. They are primarily designed to enable a more precise assessment on whether or not a patient needs adjuvant chemotherapy. However, the optimal use in clinical practice is still not established. The first set of data published from the TAILORx study and the results from the MINDACT study provide strong evidence for the clinical utility of gene expression profiles. Full disclosure of the results of prospective studies such as MINDACT and TAILORx on this topic is awaited in order to define their exact place in clinical decision-making. However, in several countries, these tests are already used in daily clinical practice, and are reimbursed. In addition, the use of gene expression profiles as a potential ancillary tool for treatment decisions is supported in several international treatment guidelines. Multiple studies have shown that there is a change in treatment decision based on gene expression profiles. In addition, different assays may provide different risk stratification at short-, middle- and long-term, so thoughtful use of these tests is recommended. Patients should be well informed about the benefits, risks, costs and uncertainties associated with these tests. Clinicians should also be educated on these matters. Furthermore, as gene expression profiles are expensive and not reimbursed in many countries, these tests are not accessible to all breast cancer patients. Patients’ preferences are important when making risk assessments and treatment decisions in those cases where there is doubt on the benefit of giving adjuvant chemotherapy. Taken together, gene expression profiles provide information that may be complementary to that provided by standard clinicopathological assessment in guiding decision of therapy in the adjuvant setting. These assays represent a step forward towards personalised medicine. We strongly propose to allow reimbursement of gene expression profiles in Belgium, but pragmatic and clear criteria for reimbursement should be developed with all stakeholders to avoid overconsumption.
(BELG J MED ONCOL 2016;10(4):114–122)
Read moreBJMO - 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
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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