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)
Read moreBJMO - volume 12, issue 7, november 2018
D. Schrijvers MD, PhD
Chemotherapy-induced anaemia is a well-known complication in cancer. With the venue of newer non-cytotoxic anti-cancer drugs, attention to anaemia and anaemia management has been shifted to the background. Nevertheless, anaemia is a frequent complication of some of these newer drugs. Mammalian target of rapamycin inhibitors, some of the antiangiogenic drugs, poly (ADP ribose) polymerases inhibitors and cyclin-dependent kinase inhibitors all can cause grade 3 or 4 anaemia. This review discusses the risks of anaemia development of anti-cancer drugs.
(BELG J MED ONCOL 2018;12(7):307–312)
Read moreBJMO - volume 12, issue 7, november 2018
C. Standaert MD, P.J.L. De Visschere , S. Rottey MD, PhD, S. Buelens , N. Sundahl PhD, G.M. Villeirs
Serum prostate-specific antigen, digital rectal examination and transrectal ultrasound, supplemented with biopsy, are conventionally used for the screening, diagnosis, staging and surveillance of prostate cancer (PCa). However, their sensitivity and specificity are limited with diagnosis of clinically insignificant cancer and a potential risk of overtreatment as a result. Multiparametric MRI combines anatomical and functional pulse sequences, including diffusion-weighted imaging and dynamic contrast-enhanced MRI, and has evolved out of its limited role in PCa staging. The ability to visualise the prostate accurately and to detect or exclude clinically significant PCa makes multiparametric MRI a great tool to improve the diagnosis, staging, treatment planning and follow-up of patients with PCa. Multiparametric MRI can rule out clinically significant PCa and therefore has the potential to reduce the need for biopsies or to determine whether active surveillance or immediate treatment is appropriate.
(BELG J MED ONCOL 2018;12(7):313–318)
Read moreBJMO - volume 12, issue 7, november 2018
C. Maggen MD, V. Wolters , K. Van Calsteren , F. Amant
The association of cancer with pregnancy is rare, but a rising incidence is expected because of the increasing maternal age at first pregnancy. A cancer diagnosis during pregnancy reveals several medical and ethical dilemmas because diagnostic procedures and treatments may compromise foetal health. But on the other hand, delay in diagnosis and treatment should be prevented since this can adversely affect maternal outcome. There are no data suggesting that the termination of pregnancy improves the prognosis and the awareness of the feasibility of cancer treatment during pregnancy is growing. The oncological and obstetrical management of a patient that is diagnosed with cancer during pregnancy requires a multidisciplinary approach, taking the patient’s perspective into account. This review summarises the current knowledge on incidence, diagnosis, treatment, prognosis, obstetrical and neonatal outcome of cancer during pregnancy.
(BELG J MED ONCOL 2018;12(7):319–325)
Read moreBJMO - volume 12, issue 7, november 2018
A. Awada MD, PhD, J.F. Baurain MD, PhD, P. Clement MD, PhD, P. Hainaut MD, PhD, S. Holbrechts MD, PhD, K. Jochmans MD, PhD, V. Mathieux MD, PhD, J. Mebis MD, PhD, M. Strijbos MD, PhD, C. Vulsteke MD, PhD, T. Vanassche MD, PhD, P. Verhamme MD, PhD
Unprovoked venous thromboembolism (VTE) may be the earliest sign of malignancy, and as a result, screening for occult cancer in these patients has become routine practice. However, the elaborateness of this screening is subject to debate and varies between medical centres. This study’s expert panel, consisting of oncologists and thrombosis specialists, aimed to develop a practical Belgian guidance for adequate cancer screening in patients with unprovoked VTE. In summary, comprehensive non-invasive cancer screening consisting of a medical history assessment, physical examinations, basic blood tests and a chest X-ray is sufficient to pick up the vast majority of occult cancers. When specific abnormalities are picked up by the battery of tests in the comprehensive non-invasive cancer screening, more extensive screening using CT scans are recommended. Routine CT screening in all patients presenting with an unprovoked VTE does not provide a significant clinical benefit and should not be routinely performed. In the presence of specific risk factors (e.g., older age, smoking history, previous VTE), physicians are advised to be more vigilant. Finally, given the significant anxiety that cancer screening may cause to patients, accurate and clear patient communication is key. A complete list of guidance statements is provided at the end of the article.
(BELG J MED ONCOL 2018;12(7):326–329)
Read moreBJMO - volume 12, issue 7, november 2018
C. Vulsteke MD, PhD, M. del Pilar Ortega Arevalo , Ir C. Mouton MBA, K. Stam , R. Goethals , F. Ameye , C. Populaire , M. Peeters MD, PhD, P. Verdonck
Keeping up with the rising amount of clinical data, guidelines and approvals of new antineoplastic drugs is a major challenge for every oncologist. Artificial intelligence promises to address this and to revolutionise health care and cancer treatment. What is the current state of artificial intelligence for the oncologist, and is it ready for prime time? In this article, the current, available tools of artificial intelligence are highlighted, which try to take a privileged role in the daily practice of the oncologist.
(BELG J MED ONCOL 2018;12(7)330–333)
Read moreBJMO - volume 12, issue 6, october 2018
V. de Weerdt , E. van Cutsem
Metastatic colorectal cancer is a heterogeneous disease. Tumours arising from different regions of the colon are clinically and molecularly distinct. The differing molecular characteristics translate into a differential clinical outcome with right-sided tumours displaying a worse prognosis compared to left-sided tumours. Besides the prognostic relevance of the primary tumour location, several retrospective analyses suggest that the primary tumour location may also be predictive of treatment benefit from targeted therapy with anti-EGFR and anti-VEGF directed agents in the first-line treatment of RAS wild-type metastatic colorectal cancer.
(BELG J MED ONCOL 2018;12(6):271–274)
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