BJMO - volume 14, issue 1, january 2020
N. Sundahl PhD, V. Kruse MD, PhD, K. Decaestecker PhD, P. Ost MD, PhD
Preclinical and early clinical data indicate that stereotactic body radiotherapy (SBRT) could work synergistically with checkpoint inhibitors and increase response rates. Given the potential synergistic effect between both treatments, the associated toxicity might also be increased. We conducted two phase I trials combining SBRT with ipilimumab (n=13) or pembrolizumab (n=18) in metastatic/inoperable melanoma and metastatic urothelial carcinoma respectively. To evaluate the effect of SBRT timing, patients were randomised to either sequential or concurrent SBRT in the latter trial. To assess early efficacy, a phase II trial of SBRT and nivolumab was conducted in metastatic/inoperable melanoma (n=20). Our data shows that SBRT combined with ipilimumab, nivolumab or pembrolizumab is safe and might increase efficacy in a subset of patients.
(BELG J MED ONCOL 2020;14(1):28–30)
Read moreBJMO - volume 13, issue 6, october 2019
T. Vermassen PhD, T. Roumeguère MD, Y. Neybuch MD, L. Hoekx MD, I. Fele , B. Sautois MD, PhD, W. Everaerts MD, PhD, D. De Maeseneer MD, F. Lecouvet MD, PhD, N. Lumen MD, PhD, P. Ost MD, PhD, S. Rorive MD, PhD, S. Stroobants MD, PhD, P. Dirix MD, PhD, S. Rottey MD, PhD
Castrate-resistant prostate cancer (CRPC) is characterised by complex strategies for therapy and follow-up. In order to standardise CRPC cancer care on a national basis, an integrated care pathway was devised, based on clinical governance principles and acknowledged best practice, in order to reduce length of hospital stay, reduce costs of patient care, improve patient outcomes (e.g. Quality-of-Life, complications), etc. Therefore, a steering group of Belgian experts, consisting of medical oncologist, urologists, radiation oncologists, oncology nurses, pathologists and nuclear medicines, was assembled to discuss the need for an integrated care pathway for CRPC in Belgium. This was made possible through the financial support of Astellas Belgium. An extensive integrated care pathway was discussed with various stages, depending on the disease status of the patient. Belgian implementation could lead towards further standardisation of cancer care for CRPC patients although several important matters still have to be discussed or adapted. Further assessment and inter-hospital deliberation seems required to ensure a national implementation of the CRPC integrated care pathway.
(BELG J MED ONCOL 2019;13(6): 219–226)
Read moreBJMO - volume 13, issue 6, october 2019
P. Ost MD, PhD, D. Schrijvers MD, PhD, L. Duck MD, PhD, M. Gizzi MD, K. Goffin MD, PhD, S. Joniau MD, PhD, S. Rottey MD, PhD, T. Roumeguère MD, E. Seront MD, PhD, N. Withofs MD, PhD, B. Tombal MD, PhD
The treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) has changed dramatically with the approval of a variety of therapeutic agents including abiraterone acetate, cabazitaxel, docetaxel, enzalutamide and radium-223 dichloride and the introduction of docetaxel and abiraterone acetate in combination with androgen deprivation therapy in newly diagnosed metastatic prostate cancer. Evidence on the optimal sequence of these therapies is scarce. In practice, the most appropriate treatment (sequence) depends on patient and disease characteristics. This article summarises the recommendations of a multidisciplinary group of Belgian experts in sequencing treatments for patients with mCRPC, with a focus on radium-223 dichloride.
(BELG J MED ONCOL 2019;13(6): 240–250)
Read moreBJMO - 12, issue 3, february 2018
B. De Laere , M. Mayrhofer , T. Whitington , P-J. Van Dam , P. Van Oyen , C. Ghysel , J. Ampe , P. Ost MD, PhD, W. Demey MD, L. Hoekx MD, D. Schrijvers MD, PhD, B. Brouwers MD, PhD, W. Lybaert MD, E. Everaert , P. Van Kerckhove , D. De Maeseneer MD, M. Strijbos MD, PhD, A. Bols MD, PhD, K. Fransis , N. Beije , I. De Kruijff , S. Oeyen , A. Rutten MD, V. Van Dam , A. Brouwer , D. Goossens , L. Heyrman , G. Van Den Eynden MD, PhD, J. Vandebroek , J. Del-Favero , S. Sleijfer , A. Uhlen , J. Yachnin , S. Van Laere PhD, H. Grönberg , J. Lindberg , L. Dirix MD, PhD
BJMO - volume 11, issue 6, october 2017
V. Kruse MD, PhD, M. Schreuer , K. Vermaelen MD, PhD, P. Ost MD, PhD, T. Kerre , B. De Moerloose MD, PhD, L. Brochez MD, PhD
Checkpoint inhibitors targeting CTLA4, PD1 and PD-L1 have become a part of the daily clinical practice in the management of stage IV melanoma, renal cell carcinoma (RCC), non-small cell lung cancer (NSCLC) and Hodgkin-lymphoma patients. While these agents can elicit strong anti-tumour immune responses, they can also generate immune related adverse events, which can become life threatening if not detected and managed promptly. At the University Hospital Ghent, we created a working group of organ specialists with specific experience in dealing with immune related adverse events. This initiative is part of ION (Immuno-Oncology-Network) Ghent. In this paper we would like to share our institutional guidelines for the clinical care of patients treated with checkpoint-inhibitors with the Belgian Oncology Community.
(BELG J MED ONCOL 2017;11(6):265–276)
Read moreBJMO - 2017, issue 3, february 2017
B. De Laere , P. Van Oyen , C. Ghysel , P. Ost MD, PhD, W. Demey MD, L. Hoekx MD, D. Schrijvers MD, PhD, B. Brouwers MD, PhD, W. Lybaert MD, E. Everaert , J. Ampe , P. Van Kerckhove , D. De Maeseneer MD, M. Strijbos MD, PhD, A. Bols MD, PhD, K. Fransis , S. Oeyen , V. Van Dam , A. Brouwer , G. Van Den Eynden MD, PhD, A. Rutten MD, J. Vandebroek , S. Van Laere PhD, L. Dirix MD, PhD
BJMO - volume 10, issue 6, september 2016
V. Kruse MD, PhD, I. Chevolet MD, PhD, K. De Wolf MD, P. Ost MD, PhD, L. Brochez MD, PhD
The therapeutic landscape for the treatment of metastatic melanoma has been changing dramatically over the last years. Given the availability of several promising drugs, choosing the best sequence for the individual patient has become a challenge. Immunotherapy by means of checkpoint-inhibitors, such as the anti-CTLA4-antibody ipilimumab and the anti-PD1-antibodies nivolumab and pembrolizumab, has demonstrated unprecedented long-term survival rates. When prescribing an immunotherapeutic agent, the clinician should be aware that the patient is at risk of developing an immune-related adverse event, especially when anti-CTLA4 and anti-PD1 are administered together. A promising future strategy to increase response rates of the checkpoint-inhibitors is combining them with radiotherapy. Hereby an abscopal effect is induced, reducing both irradiated and non-irradiated tumour lesions. Another therapeutic strategy is based on the presence of a BRAF mutation among approximately 40–50% of melanoma patients. For those patients, combined therapy with a BRAF inhibitor and a MEK inhibitor is valued to be a convincing regimen, especially in case of a high disease burden, elevated LDH and a performance status of 1–2. In contrast, T-VEC is a valuable therapeutic option for patients with limited disease.
(BELG J MED ONCOL 2016;10(6):215–222)
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