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Dekervel J, Casadei-Gardini A, Pinter M. Controversies in upper GI oncology: first-line systemic treatment in MASLD-associated HCC. ESMO Open 2024; 9:102245. [PMID: 38335903 PMCID: PMC10867617 DOI: 10.1016/j.esmoop.2024.102245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Affiliation(s)
- J Dekervel
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium.
| | - A Casadei-Gardini
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | - M Pinter
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
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Dekervel J, Laheru D, O'Reilly EM. Controversies in upper GI oncology: maintenance treatment in pancreatic cancer. ESMO Open 2024; 9:102244. [PMID: 38350337 PMCID: PMC10875330 DOI: 10.1016/j.esmoop.2024.102244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Affiliation(s)
- J Dekervel
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium.
| | - D Laheru
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore
| | - E M O'Reilly
- Memorial Sloan Kettering Cancer Center, New York, USA
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Alliet B, Severi C, Veekmans T, Cuypers J, Topal H, Deroose CM, Roskams T, Bex M, Dekervel J. Fulminant ectopic Cushing's syndrome caused by metastatic small intestine neuroendocrine tumour - a case report and review of the literature. Acta Gastroenterol Belg 2024; 87:48-51. [PMID: 38431792 DOI: 10.51821/87.1.11872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Cushing's syndrome (CS) secondary to adrenocorticotropic hormone (ACTH) producing tumours is a severe condition with a challenging diagnosis. Ectopic ACTH-secretion often involves neuroendocrine tumours (NET) in the respiratory tract. ACTH-secreting small intestine neuro-endocrine tumours (siNET) are extremely rare entities barely reported in literature. This review is illustrated by the case of a 75-year old woman with fulminant ectopic CS caused by a ACTH-secreting metastatic siNET. Severe hypokalemia, fluid retention and refractory hypertension were the presenting symptoms. Basal and dynamic laboratory studies were diagnostic for ACTH-dependent CS. Extensive imaging studies of the pituitary and thorax-abdomen areas were normal, while [68Ga]Ga-DOTATATE PET-CT revealed increased small intestine uptake in the left iliac fossa. The hypercortisolism was well controlled with somatostatin analogues, after which a debulking resection of the tumour was performed. Pathological investigation confirmed a well-differentiated NET with sporadic ACTH immunostaining and post-operative treatment with somatostatin analogues was continued with favourable disease control.
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Affiliation(s)
- B Alliet
- Department of Gastroenterology, UZ Leuven, Leuven, Belgium
| | - C Severi
- Department of Gastroenterology, ZOL, Genk, Belgium
| | - T Veekmans
- Department of Pathology, UZ Leuven, Leuven, Belgium
| | - J Cuypers
- Department of Endocrinology, AZ Turnhout, Turnhout, Belgium
| | - H Topal
- Department of Abdominal Surgery, UZ Leuven, Leuven, Belgium
| | - C M Deroose
- Department of Nuclear Medicine, UZ Leuven, Leuven, Belgium
| | - T Roskams
- Department of Pathology, UZ Leuven, Leuven, Belgium
| | - M Bex
- Department of Endocrinology, UZ Leuven, Leuven, Belgium
| | - J Dekervel
- Department of Gastroenterology - Digestive Oncology, UZ Leuven, Leuven, Belgium
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Coolbrandt A, Tobback H, Govaerts R, Vandezande L, Vinckx M, Laenen A, Wildiers H, Verslype C, Dekervel J, Van Herpe F, Van Cutsem E. A randomized controlled trial of hand/foot-cooling by hilotherapy to prevent oxaliplatin-related peripheral neuropathy in patients with malignancies of the digestive system. ESMO Open 2023; 8:101205. [PMID: 37018872 PMCID: PMC10163151 DOI: 10.1016/j.esmoop.2023.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Both acute and chronic symptoms of oxaliplatin-induced peripheral neuropathy (OIPN) affect patients' treatment dose and duration as well as quality-of-life. Hand/foot-cooling has been shown to reduce taxane-induced peripheral neuropathy but there is unclear evidence in the setting of oxaliplatin. PATIENTS AND METHODS In a monocentric, open-label phase II trial, patients with malignancies of the digestive system receiving oxaliplatin-based chemotherapy were randomly assigned to receive either continuous cooling of hands and feet using hilotherapy at 11°C during oxaliplatin infusion compared with usual care (no cooling). The primary endpoint was grade ≥2 neuropathy-free rate in 12 weeks after initiation of chemotherapy. Secondary endpoints included OIPN-related treatment alterations, acute OIPN symptoms and perceived comfort of the intervention. RESULTS The intention-to-treat population included 39 patients in the hilotherapy group and 38 in the control group. The grade ≥2 neuropathy-free rate at 12 weeks was 100% in the experimental group versus 80.5% in the control group (P = 0.006). This effect was persistent at 24 weeks (66.0% versus 49.2%, respectively) (P = 0.039). Next, treatment alterations-free rate at week 12 was 93.5% in the hilotherapy group compared with 83.3% in the control group (P = 0.131). Patients in the hilotherapy group experienced significantly less acute OIPN symptoms of numbness or tingling [odds ratio (OR) 0.05, 95% confidence interval (CI) 0.02-0.11, P < 0.0001], pain (OR 0.06, 95% CI 0.02-0.15, P < 0.0001) and/or cold sensitivity (OR 0.02, 95% CI 0.01-0.05, P < 0.0001) in fingers or toes as well as less pharyngeal cold sensitivity (OR 0.14, 95% CI 0.05-0.42, P = 0.0005). The majority of patients in the hilotherapy group rated the intervention as neutral, rather comfortable or very comfortable. CONCLUSIONS In this first study on hand/foot-cooling in oxaliplatin alone, hilotherapy significantly reduced the incidence of grade ≥2 OIPN at 12 and 24 weeks. Hilotherapy also reduced acute OIPN symptoms and was generally well tolerated.
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Affiliation(s)
- A Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - H Tobback
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium; Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - R Govaerts
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium; Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - L Vandezande
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium
| | - M Vinckx
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - C Verslype
- Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - J Dekervel
- Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - F Van Herpe
- Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - E Van Cutsem
- Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
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Cappuyns S, Venken T, Stoffels S, Philips G, Laleman W, van der Merwe S, van Malenstein H, Lambrechts D, Dekervel J. PD-6 DNA methylome as a potential biomarker in biliary brushes and bile fluid samples to differentiate between benign and malignant biliary stenosis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Van Cutsem E, Melichar B, Van den Eynde M, Prausova J, Geboes K, Dekervel J, Vitaskova D, De Cuyper A, Linke Z, Van Acker N, Frenois F, Noel G, Prost J, Barret J, Jean B, Tabah-Fisch I. Phase 2 study results of murlentamab, a monoclonal antibody targeting the Anti-Mullerian-Hormone-Receptor II (AMHRII), acting through Tumor-Associated Macrophage engagement in advanced/metastatic colorectal cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz183.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bulens P, Debucquoy A, Joye I, Wolthuis A, D’Hoore A, Van Cutsem E, Dekervel J, Sagaert X, Dresen R, Vandecaveye V, Deroose C, Haustermans K. Comparison of surgical data and survival outcome of rectal cancer patients that need upfront surgery after chemoradiotherapy versus salvage surgery after watch-and-wait. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dekervel J, Popovic D, van Malenstein H, Windmolders P, Libbrecht L, Bulle A, de Moor B, Nevens F, Van Cutsem E, Verslype C, van Pelt J. O-013 A global risk gene score predicts early and late tumor recurrence after resection of hepatocellular carcinoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv235.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Verstraete M, Debucquoy A, Dekervel J, Van Pelt J, Chiritescu G, Dumon K, D'Hoore A, Sagaert X, Van Cutsem E, Haustermans K. OC-0253: Bevacizumab with chemoradiation in rectal cancer: clinical and translational results of the AXEBeam trial. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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