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Mizutani T, Cheung KL, Hakobyan Y, Lane H, Decoster L, Karnakis T, Puts M, Calderon O, Jørgensen TL, Boulahssass R, Wedding U, Karampeazis A, Chan WWL, Banerjee J, Falci C, van Leeuwen BL, Fonseca V, Gironés Sarrió R, Vetter M, Dougoud V, Naeim A, Ashman J, Musolino N, Kanesvaran R. Leave no one behind: A global survey of the current state of geriatric oncology practice by SIOG national representatives. J Geriatr Oncol 2024; 15:101709. [PMID: 38310661 DOI: 10.1016/j.jgo.2024.101709] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/06/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The Sustainable Development Goals of the United Nations include a commitment to "leave no one behind" as a universal goal. To achieve this in geriatric oncology (GO) worldwide, it is important to understand the current state of GO at an international level. The International Society of Geriatric Oncology (SIOG) has several National Representatives (NRs) who act as SIOG's delegates in their respective countries. The NRs took part in this international survey exploring the state of GO practice, identifying barriers and solutions. MATERIALS AND METHODS The NRs answered open-ended questions by email from February 2020 to October 2022. The questionnaire domains included the demographic information of older adults for their countries, and the NRs' opinions on whether GO is developing, what the barriers are to developing GO, and proposed actions to remove these barriers. The demographic data of each country reported in the survey was adjusted using literature and database searches. RESULTS Twenty-one of thirty countries with NRs (70%) participated in this questionnaire study: 12 European, four Asian, two North American, two South American, and one Oceanian. The proportion of the population aged ≥75 years varied from 2.2% to 15.8%, and the average life expectancy also varied from 70 years to 86 years. All NRs reported that GO was developing in their country; four NRs (18%) reported that GO was well developed. Although all NRs agreed that geriatric assessment was useful, only three reported that it was used day-to-day in their countries' clinical practice (14%). The major barriers identified were the lack of (i) evidence to support GO use, (ii) awareness and interest in GO, and (iii) resources (time, manpower, and funding). The major proposed actions were to (i) provide new evidence through clinical trials specific for GO patients, (ii) stimulate awareness through networking, and (iii) deliver educational materials and information to healthcare providers and medical students. DISCUSSION This current survey has identified the barriers to GO and proposed actions that could remove them. Broader awareness seems to be essential to implementing GO. Additional actions are needed to develop GO within countries and can be supported through international partnerships.
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Affiliation(s)
- Tomonori Mizutani
- Kyorin University Faculty of Medicine, Department of Medical Oncology, Tokyo, Japan.
| | - Kwok-Leung Cheung
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Yervand Hakobyan
- Hematology Center after Prof. Yeolyan, Hematology and Transfusion Medicine department of NIH Armenia, Yerevan, Armenia
| | - Heather Lane
- Sir Charles Gairdner Hospital, Geriatric and Rehabilitation Medicine Department, Perth, Australia
| | - Lore Decoster
- UZ Brussel, Vrije Universiteit Brussel, Department of Medical Oncology, Brussels, Belgium
| | - Theodora Karnakis
- The Cancer Institute of the State of São Paulo/University, Division of Geriatric Medicine, São Paulo, Brazil
| | - Martine Puts
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, Toronto, Canada
| | - Oscar Calderon
- Clínica Alemana de Santiago and Complejo Asistencial Dr. Sótero del Río, Department of Geriatric Medicine, Santiago, Chile
| | | | | | - Ulrich Wedding
- University Hospital Jena, Department of Palliative Care, Jena, Germany
| | | | | | - Joyita Banerjee
- All India Institute of Medical Sciences, Department of Geriatric Medicine, New Delhi, India
| | - Cristina Falci
- Medical Oncology 2, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy
| | - Barbara L van Leeuwen
- University medical center Groningen, Department of Surgery, Groningen, the Netherlands
| | - Vasco Fonseca
- Centro Hospitalar de Lisboa Ocidental, Department of Oncology, Lisboa, Portugal
| | - Regina Gironés Sarrió
- Hospital Universitari i Politècnic La FE, Department of Medical Oncology, Valencia, Spain
| | - Marcus Vetter
- Affiliation Cancer Center Baselland, Kantonsspital Baselland, Liestal, Switzerland
| | - Vérène Dougoud
- The HFR Hospital, Department of Medical Oncology, Fribourg, Switzerland
| | - Arash Naeim
- UCLA and Samueli School of Engineering and Applied Science, Departments of Medicine and Bioengineering, Calfornia, United States
| | - Jed Ashman
- Sandwell and West Birmingham NHS Trust, Birmingham City Hospital, Birmingham, United Kingdom; International Society of Geriatric Oncology, Geneva, Switzerland
| | - Najia Musolino
- International Society of Geriatric Oncology, Geneva, Switzerland
| | - Ravindran Kanesvaran
- National Cancer Centre Singapore, Department of Medical Oncology, Singapore, Singapore
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Joris S, Denys H, Collignon J, Rasschaert M, T'Kint de Roodenbeke D, Duhoux FP, Canon JL, Tejpar S, Mebis J, Decoster L, Aftimos P, De Grève J. Efficacy of olaparib in advanced cancers with germline or somatic mutations in BRCA1, BRCA2, CHEK2 and ATM, a Belgian Precision tumor-agnostic phase II study. ESMO Open 2023; 8:102041. [PMID: 37852034 PMCID: PMC10774963 DOI: 10.1016/j.esmoop.2023.102041] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The Belgian Precision initiative aims to maximize the implementation of tumor-agnostic next-generation sequencing in patients with advanced cancer and enhance access to molecularly guided treatment options. Academic tumor-agnostic basket phase II studies are part of this initiative. The current investigator-driven trial aimed to investigate the efficacy of olaparib in advanced cancers with a (likely) pathogenic mutation (germline or somatic) in a gene that plays a role in homologous recombination (HR). PATIENTS AND METHODS This open-label, multi-cohort, phase II study examines the efficacy of olaparib in patients with an HR gene mutation in their tumor and disease progression on standard of care. Patients with a somatic or germline mutation in the same gene define a cohort. For each cohort, a Simon minimax two-stage design was used. If a response was observed in the first 13 patients, 14 additional patients were included. Here, we report the results on four completed cohorts: patients with a BRCA1, BRCA2, CHEK2 or ATM mutation. RESULTS The overall objective response rate across different tumor types was 11% in the BRCA1-mutated (n = 27) and 21% in the BRCA2-mutated (n = 27) cohorts. Partial responses were seen in pancreatic cancer, gallbladder cancer, endocrine carcinoma of the pancreas and parathyroid cancer. One patient with a BRCA2 germline-mutated colon cancer has an ongoing complete response with 19+ months on treatment. Median progression-free survival in responding patients was 14+ months (5-34+ months). The clinical benefit rate was 63% in the BRCA1-mutated and 46% in the BRCA2-mutated cohorts. No clinical activity was observed in the ATM (n = 13) and CHEK2 (n = 14) cohorts. CONCLUSION Olaparib showed efficacy in different cancer types harboring somatic or germline mutations in the BRCA1/2 genes but not in ATM and CHEK2. Patients with any cancer type harboring BRCA1/2 mutations should have access to olaparib.
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Affiliation(s)
- S Joris
- Department of Medical Oncology, UZ Brussel, Brussels.
| | - H Denys
- Department of Medical Oncology, University Hospital Ghent, Ghent
| | | | | | | | - F P Duhoux
- Cliniques universitaires Saint-Luc, Brussels
| | | | | | | | - L Decoster
- Department of Medical Oncology, UZ Brussel, Brussels
| | - P Aftimos
- Institut Jules Bordet-Université libre de Bruxelles, Brussels
| | - J De Grève
- Department of Medical Oncology, UZ Brussel, Brussels; Department of Medical Genetics, UZ Brussel, Brussels, Belgium
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Martins-Branco D, Nader-Marta G, Gombos A, Barthelemy P, Goncalves A, Borcoman E, Clatot F, Holbrechts S, De Maio D'Esposito E, Cheymol C, Vanhaudenarde V, Duhoux FP, Duhem C, Decoster L, Denys H, Lefranc F, Canon JL, Clement PM, Gligorov J, Paesmans M, Kindt N, Awada A, Kotecki N. BrainStorm: a multicenter international study to tackle CNS metastases in solid tumors. Nat Med 2023; 29:2981-2982. [PMID: 37857713 DOI: 10.1038/s41591-023-02595-y] [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: 10/21/2023]
Affiliation(s)
- Diogo Martins-Branco
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Guilherme Nader-Marta
- Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Andrea Gombos
- Oncology Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | - Edith Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
| | - Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | | | | | | | | | | | - Caroline Duhem
- Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Florence Lefranc
- Cliniques Universitaire de Bruxelles - Hôpital Erasme, Brussels, Belgium
| | | | - Paul M Clement
- Department of Oncology, Leuven Cancer Institute, UZ Leuven and KU Leuven, Leuven, Belgium
| | - Joseph Gligorov
- Institut Universitaire de Cancérologie AP-HP Sorbonne Université, InsermU938, Association Sarah Penalver Gorsd, Paris, France
| | - Marianne Paesmans
- Data Center, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Nadège Kindt
- Laboratory of Clinical and Experimental Oncology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ahmad Awada
- Oncology Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Nuria Kotecki
- Oncology Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
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Gondry O, Xavier C, Raes L, Heemskerk J, Devoogdt N, Everaert H, Breckpot K, Lecocq Q, Decoster L, Fontaine C, Schallier D, Aspeslagh S, Vaneycken I, Raes G, Van Ginderachter JA, Lahoutte T, Caveliers V, Keyaerts M. Phase I Study of [ 68Ga]Ga-Anti-CD206-sdAb for PET/CT Assessment of Protumorigenic Macrophage Presence in Solid Tumors (MMR Phase I). J Nucl Med 2023; 64:1378-1384. [PMID: 37474271 PMCID: PMC10478821 DOI: 10.2967/jnumed.122.264853] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/05/2023] [Indexed: 07/22/2023] Open
Abstract
Macrophages play an important role throughout the body. Antiinflammatory macrophages expressing the macrophage mannose receptor (MMR, CD206) are involved in disease development, ranging from oncology to atherosclerosis and rheumatoid arthritis. [68Ga]Ga-NOTA-anti-CD206 single-domain antibody (sdAb) is a PET tracer targeting CD206. This first-in-human study, as its primary objective, evaluated the safety, biodistribution, and dosimetry of this tracer. The secondary objective was to assess its tumor uptake. Methods: Seven patients with a solid tumor of at least 10 mm, an Eastern Cooperative Oncology Group score of 0 or 1, and good renal and hepatic function were included. Safety was evaluated using clinical examination and blood sampling before and after injection. For biodistribution and dosimetry, PET/CT was performed at 11, 90, and 150 min after injection; organs showing tracer uptake were delineated, and dosimetry was evaluated. Blood samples were obtained at selected time points for blood clearance. Metabolites in blood and urine were assessed. Results: Seven patients were injected with, on average, 191 MBq of [68Ga]Ga-NOTA-anti-CD206-sdAb. Only 1 transient adverse event of mild severity was considered to be possibly, although unlikely, related to the study drug (headache, Common Terminology Criteria for Adverse Events grade 1). The blood clearance was fast, with less than 20% of the injected activity remaining after 80 min. There was uptake in the liver, kidneys, spleen, adrenals, and red bone marrow. The average effective dose from the radiopharmaceutical was 4.2 mSv for males and 5.2 mSv for females. No metabolites were detected. Preliminary data of tumor uptake in cancer lesions showed higher uptake in the 3 patients who subsequently progressed than in the 3 patients without progression. One patient could not be evaluated because of technical failure. Conclusion: [68Ga]Ga-NOTA-anti-CD206-sdAb is safe and well tolerated. It shows rapid blood clearance and renal excretion, enabling high contrast-to-noise imaging at 90 min after injection. The radiation dose is comparable to that of routinely used PET tracers. These findings and the preliminary results in cancer patients warrant further investigation of this tracer in phase II clinical trials.
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Affiliation(s)
- Odrade Gondry
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Catarina Xavier
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurens Raes
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Johannes Heemskerk
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Nick Devoogdt
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hendrik Everaert
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Karine Breckpot
- Laboratory for Molecular and Cellular Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Quentin Lecocq
- Laboratory for Molecular and Cellular Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Christel Fontaine
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Denis Schallier
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Sandrine Aspeslagh
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ilse Vaneycken
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Geert Raes
- Cellular and Molecular Immunology, Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; and
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium
| | - Jo A Van Ginderachter
- Cellular and Molecular Immunology, Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; and
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium
| | - Tony Lahoutte
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Vicky Caveliers
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Marleen Keyaerts
- MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium
- Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Depoorter V, Vanschoenbeek K, Decoster L, Silversmit G, Debruyne PR, De Groof I, Bron D, Cornélis F, Luce S, Focan C, Verschaeve V, Debugne G, Langenaeken C, Van Den Bulck H, Goeminne JC, Teurfs W, Jerusalem G, Schrijvers D, Petit B, Rasschaert M, Praet JP, Vandenborre K, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. Long-term health-care utilisation in older patients with cancer and the association with the Geriatric 8 screening tool: a retrospective analysis using linked clinical and population-based data in Belgium. Lancet Healthy Longev 2023; 4:e326-e336. [PMID: 37327806 DOI: 10.1016/s2666-7568(23)00081-8] [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: 12/22/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Little evidence is available on the long-term health-care utilisation of older patients with cancer and whether this is associated with geriatric screening results. We aimed to evaluate long-term health-care utilisation among older patients after cancer diagnosis and the association with baseline Geriatric 8 (G8) screening results. METHODS For this retrospective analysis, we included data from three cohort studies for patients (aged ≥70 years) with a new cancer diagnosis who underwent G8 screening between Oct 19, 2009 and Feb 27, 2015, and who survived more than 3 months after G8 screening. The clinical data were linked to cancer registry and health-care reimbursement data for long-term follow-up. The occurrence of outcomes (inpatient hospital admissions, emergency department visits, use of intensive care, contacts with general practitioner [GP], contacts with a specialist, use of home care, and nursing home admissions) was assessed in the 3 years after G8 screening. We assessed the association between outcomes and baseline G8 score (normal score [>14] or abnormal [≤14]) using adjusted rate ratios (aRRs) calculated from Poisson regression and using cumulative incidence calculated as a time-to-event analysis with the Kaplan-Meier method. FINDINGS 7556 patients had a new cancer diagnosis, of whom 6391 patients (median age 77 years [IQR 74-82]) met inclusion criteria and were included. 4110 (64·3%) of 6391 patients had an abnormal baseline G8 score (≤14 of 17 points). In the first 3 months after G8 screening, health-care utilisation peaked and then decreased over time, with the exception of GP contacts and home care days, which remained high throughout the 3-year follow-up period. Compared with patients with a normal baseline G8 score, patients with an abnormal baseline G8 score had more hospital admissions (aRR 1·20 [95% CI 1·15-1·25]; p<0·0001), hospital days (1·66 [1·64-1·68]; p<0·0001), emergency department visits (1·42 [1·34-1·52]; p<0·0001), intensive care days (1·49 [1·39-1·60]; p<0·0001), general practitioner contacts (1·19 [1·17-1·20]; p<0·0001), home care days (1·59 [1·58-1·60]; p<0·0001), and nursing home admissions (16·7% vs 3·1%; p<0·0001) in the 3-year follow-up period. At 3 years, of the 2281 patients with a normal baseline G8 score, 1421 (62·3%) continued to live at home independently and 503 (22·0%) had died. Of the 4110 patients with an abnormal baseline G8 score, 1057 (25·7%) continued to live at home independently and 2191 (53·3%) had died. INTERPRETATION An abnormal G8 score at cancer diagnosis was associated with increased health-care utilisation in the subsequent 3 years among patients who survived longer than 3 months. FUNDING Stand up to Cancer, the Flemish Cancer Society.
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Affiliation(s)
| | | | - Lore Decoster
- Department of Medical Oncology, Vrije Universiteit Brussel, University Hospitals Brussels, Brussels, Belgium
| | | | - Philip R Debruyne
- Division of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, Kortrijk, Belgium; Medical Technology Research Centre, School of Life Sciences, Anglia Ruskin University, Cambridge, UK; School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Inge De Groof
- Department of Geriatric Medicine, Iridium Network Antwerp, Sint-Augustinus Cancer Center, Wilrijk, Belgium
| | - Dominique Bron
- Department of Hematology, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Frank Cornélis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Sylvie Luce
- Department of Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Christian Focan
- Department of Oncology, Clinique CHC MontLégia, Liège, Belgium
| | - Vincent Verschaeve
- Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Gwenaëlle Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | | | | | - Jean-Charles Goeminne
- Department of Medical Oncology, Centre Hospitalier Universitaire UCL-Namur, Namur, Belgium
| | - Wesley Teurfs
- Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman, Liège University, Liège, Belgium
| | - Dirk Schrijvers
- Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - Bénédicte Petit
- Department of Medical Oncology, Centre Hospitalier Jolimont, La Louvière, Belgium
| | - Marika Rasschaert
- Department of Medical Oncology, University Hospital Antwerp, Edegem, Belgium
| | - Jean-Philippe Praet
- Department of Geriatric Medicine, Centre Hospitalier Universitaire St-Pierre, Free Universities Brussels, Brussels, Belgium
| | | | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Cindy Kenis
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Freija Verdoodt
- Research Department, Belgian Cancer Registry, Brussels, Belgium
| | - Hans Wildiers
- Department of Oncology, KU Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
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Depoorter V, Vanschoenbeek K, Decoster L, Silversmit G, Debruyne PR, De Groof I, Bron D, Cornélis F, Luce S, Focan C, Verschaeve V, Debugne G, Langenaeken C, Van Den Bulck H, Goeminne JC, Teurfs W, Jerusalem G, Schrijvers D, Petit B, Rasschaert M, Praet JP, Vandenborre K, De Schutter H, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage. Cancers (Basel) 2023; 15:3349. [PMID: 37444458 DOI: 10.3390/cancers15133349] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023] Open
Abstract
This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009-2015) originally included in a previous multicentric study were selected if they died before the end of follow-up (2019). At the time of cancer diagnosis, patients underwent geriatric screening with Geriatric 8 (G8) followed by GA in case of a G8 score ≤14/17. These data were linked to the cancer registry and healthcare reimbursement data for follow-up. EOL care was assessed in the last three months before death, and associations were analyzed using logistic regression. A total of 3546 deceased older patients with cancer with a median age of 79 years at diagnosis were included. Breast, colon, and lung cancer were the most common diagnoses. In the last three months of life, 76.3% were hospitalized, 49.1% had an emergency department visit, and 43.5% received SPC. In total, 55.0% died in the hospital (38.5% in a non-palliative care unit and 16.4% in a palliative care unit). In multivariable analyses, functional and cognitive impairment at cancer diagnosis was associated with less SPC. Further research on optimizing EOL healthcare utilization and broadening access to SPC is needed.
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Affiliation(s)
| | | | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Geert Silversmit
- Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
| | - Philip R Debruyne
- Division of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, 8500 Kortrijk, Belgium
- School of Life Sciences, Medical Technology Research Centre (MTRC), Anglia Ruskin University, Cambridge CB1 1PT, UK
- School of Nursing & Midwifery, University of Plymouth, Plymouth PL4 8AA, UK
| | - Inge De Groof
- Department of Geriatric Medicine, Iridium Cancer Network Antwerp, Sint-Augustinus, 2610 Wilrijk, Belgium
| | - Dominique Bron
- Department of Hematology, ULB-Institute Jules Bordet, 1070 Brussels, Belgium
| | - Frank Cornélis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc-UCLouvain, 1200 Brussels, Belgium
| | - Sylvie Luce
- Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles ULB, 1000 Brussels, Belgium
| | - Christian Focan
- Department of Oncology, Groupe Santé CHC-Liège, Clinique CHC-MontLégia, 4000 Liège, Belgium
| | - Vincent Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, 6000 Charleroi, Belgium
| | - Gwenaëlle Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, 7700 Mouscron, Belgium
| | | | | | | | - Wesley Teurfs
- Department Medical Oncology, ZNA Stuivenberg, 2060 Antwerp, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman, Liège University, 4000 Liège, Belgium
| | - Dirk Schrijvers
- Department of Medical Oncology, ZNA Middelheim, 2020 Antwerp, Belgium
| | - Bénédicte Petit
- Department of Medical Oncology, Centre Hospitalier Jolimont, 7100 La Louvière, Belgium
| | - Marika Rasschaert
- Department of Medical Oncology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - Jean-Philippe Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, 1000 Brussels, Belgium
| | | | | | - Koen Milisen
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
- Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| | - Cindy Kenis
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Freija Verdoodt
- Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
| | - Hans Wildiers
- Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
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7
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Depoorter V, Vanschoenbeek K, Decoster L, De Schutter H, Debruyne PR, De Groof I, Bron D, Cornélis F, Luce S, Focan C, Verschaeve V, Debugne G, Langenaeken C, Van Den Bulck H, Goeminne JC, Teurfs W, Jerusalem G, Schrijvers D, Petit B, Rasschaert M, Praet JP, Vandenborre K, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. Linking clinical and population-based data in older patients with cancer in Belgium: Feasibility and clinical outcomes. J Geriatr Oncol 2023; 14:101428. [PMID: 36804333 DOI: 10.1016/j.jgo.2023.101428] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Geriatric screening and geriatric assessment (GS/GA) have proven their benefits in the care for older patients with cancer. However, less is known about the predictive value of GS/GA for outcomes. To research this, clinical data on GS/GA can be enriched with population-based data. In this article we describe the methods and feasibility of data linkage, and first clinical outcomes (GS/GA results and overall survival). MATERIALS AND METHODS A large cohort study consisting of patients aged ≥70 years with a new cancer diagnosis was established using linked data from clinical and population-based databases. Clinical data were derived from a previous prospective study where older patients with cancer were screened with G8, followed by GA in case of an abnormal result (GS/GA study; 2009-2015). These data were linked to cancer registration data from the Belgian Cancer Registry (BCR), reimbursement data of the health insurance companies (InterMutualistic Agency, IMA), and hospital discharge data (Technical Cell, TCT). Cox regression analyses were conducted to evaluate the prognostic value of the G8 geriatric screening tool. RESULTS Of the 8067 eligible patients with a new cancer diagnosis, linkage of data from the GS/GA study and data from the BCR was successful for 93.7%, resulting in a cohort of 7556 patients available for the current analysis. Further linkage with the IMA and TCT database resulted in a cohort of 7314 patients (96.8%). Based on G8 geriatric screening, 67.9% of the patients had a geriatric risk profile. Malnutrition and functional dependence were the most common GA-identified risk factors. An abnormal baseline G8 score (≤14/17) was associated with lower overall survival (adjusted HR [aHR] = 1.62 [1.50-1.75], p < 0.001). DISCUSSION Linking clinical and population-based databases for older patients with cancer has shown to be feasible. The GS/GA results at cancer diagnosis demonstrate the vulnerability of this population and the G8 score showed prognostic value for overall survival. The established cohort of almost 8000 patients with long-term follow-up will serve as a basis in the future for detailed analyses on long-term outcomes beyond survival.
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Affiliation(s)
| | | | - Lore Decoster
- Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Oncologisch Centrum - Department of Medical Oncology, Brussels, Belgium
| | | | - Philip R Debruyne
- General Hospital Groeninge, Kortrijk Cancer Centre, Kortrijk, Belgium; Anglia Ruskin University, Medical Technology Research Centre (MTRC), School of Life Sciences, Cambridge, UK; University of Plymouth, School of Nursing & Midwifery, Plymouth, UK
| | - Inge De Groof
- Iridium Cancer Network Antwerp - Sint-Augustinus, Department of Geriatric Medicine, Wilrijk, Belgium
| | - Dominique Bron
- ULB Institute Jules Bordet, Department of Hematology, Brussels, Belgium
| | - Frank Cornélis
- Cliniques Universitaires Saint-Luc - UCLouvain, Department of Medical Oncology, Brussels, Belgium
| | - Sylvie Luce
- University Hospital Erasme- Université Libre de Bruxelles ULB, Department Medical Oncology, Brussels, Belgium
| | - Christian Focan
- Clinique CHC-MontLégia, Groupe Santé CHC-Liège, Department of Oncology, Liège, Belgium
| | - Vincent Verschaeve
- GHDC Grand Hôpital de Charleroi, Department of Medical Oncology, Charleroi, Belgium
| | - Gwenaëlle Debugne
- Centre Hospitalier de Mouscron, Department of Geriatric Medicine, Mouscron, Belgium
| | | | | | | | - Wesley Teurfs
- ZNA Stuivenberg, Department Medical Oncology, Antwerp, Belgium
| | - Guy Jerusalem
- Centre Hospitalier Universitaire Sart Tilman - Liège University, Department of Medical Oncology, Liège, Belgium
| | - Dirk Schrijvers
- ZNA Middelheim, Department of Medical Oncology, Antwerp, Belgium
| | - Bénédicte Petit
- Centre Hospitalier Jolimont, Department of Medical Oncology, La Louvière, Belgium
| | - Marika Rasschaert
- University Hospital Antwerp, Department of Medical Oncology, Edegem, Belgium
| | - Jean-Philippe Praet
- CHU St-Pierre - Free Universities Brussels, Department of Geriatric Medicine, Brussels, Belgium
| | | | - Koen Milisen
- University Hospitals Leuven - KU Leuven, Department of Geriatric Medicine - Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Johan Flamaing
- University Hospitals Leuven - KU Leuven, Department of Geriatric Medicine - Department of Public Health and Primary Care, Gerontology and Geriatrics, Leuven, Belgium
| | - Cindy Kenis
- University Hospitals Leuven, Department of General Medical Oncology - Department of Geriatric Medicine, Leuven, Belgium
| | - Freija Verdoodt
- Belgian Cancer Registry, Research Department, Brussels, Belgium
| | - Hans Wildiers
- University Hospitals Leuven - KU Leuven, Department of General Medical Oncology - Department of Oncology, Leuven, Belgium.
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Lambrechts Y, Hatse S, Kenis C, Decoster L, de Azambuja E, Jerusalem G, Neven P, Lago LD, Denys H, Vuylsteke P, Cornelis F, Punie K, Floris G, Desmedt C, Laenen A, Pondé N, Wildiers H. Abstract P4-01-29: Ribociclib plus letrozole alters the immune subset composition in older (≥70 yrs.) patients with HR+/HER2- metastatic breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-01-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background The combination of CDK4/6 inhibitors and endocrine therapy is the current standard first-line therapy for patients with HR+/HER2- metastatic breast cancer (mBC). Preliminary data suggest that CDK4/6 inhibitors not only induce tumor response by blocking CDK-dependent cell growth but that they can also alter the host immune function and stimulate tumor cell-directed immunity. However, clinical data are scarce, and no data exist about the impact of age and frailty, which are known to impact host immunity (immunosenescence). Materials and methods This prospective ongoing study is evaluating the efficacy and toxicity of the CDK4/6 inhibitor ribociclib and letrozole in older (≥ 70 years) patients with HR+/HER2- mBC (RIBOB, NCT03956654). In the associated blood biomarker sub-study, we investigate the impact of ribociclib and letrozole on the immune subset composition. Immune cell subsets were analyzed using flowcytometry (BD FACSVerse™) of peripheral blood mononuclear cells isolated at baseline (before ribociclib administration) and after three months of ribociclib treatment. In total, six multicolor flow cytometry staining panels were set up to investigate the changes in the immune cell subsets (CD4+ T-cell subsets, CD8+ T-cell subsets, general immune cell subsets, T-regulatory cell subsets, T-cell activation status subsets, and myeloid-derived suppressor cells subsets). Frailty status was assessed at baseline using the G8 screening tool (range score: 0-17) as a proxy. The paired t-test and matched-pairs Wilcoxon signed-rank test are used to evaluate changes in immune subset composition between baseline and after three months. The unpaired t-test and Mann-Whitney U test are used to evaluate differences in immune subset composition between frail and fit patients. Results Immune cell subset distribution and evolution were available for 15 older patients (median age: 77 yrs.; IQR 74-83), 4 considered fit (G8-score >14), and 11 frail (G8-score ≤14). Firstly, we analyzed the difference in immune subset composition between baseline and three months for the whole cohort. There was a significant increase of naïve T-regulatory cells (p=0.0012) and a significant increase in CD8+ T-cell activation indicated by an upregulation of HLA-DR+ (p=0.0055) and CD38+ (p=0.0203). Secondly, the difference in immune subset composition between fit and frail persons was assessed showing a lower activation status of CD4+ and CD8+ T-cell subsets in frail persons at baseline, as assessed by several activation markers: CD4+PD1+ (p=0.0051), CD4+PD1+CD69+ (p=0.0013), CD8+PD1+ (p=0.0073), and CD8+PD1+CD69+ (p=0.0339). These significant differences between fit and frail disappeared after three months, largely because of increased T-cell activation in the frail subset. Conclusion Ribociclib plus letrozole treatment for three months results in an upregulation of the T-regulatory cells’ naïve subset, suggesting an expansion of the T-cell repertoire, which is compatible with immune cell activation. Furthermore, the activation status of the CD8+ T-cells was upregulated. These observations confirm recent findings reported by Scirocchi F. et al. (Lancet, 2022). In addition, frail older patients show a lower baseline T-cell activation status compared to fit older patients but seem to have increased T-cell activation after treatment exposure. In the future, correlations with treatment response will be evaluated when follow-up data matures. Our data encourage the further assessment of immune cell modulation in combination with CDK4/6 inhibitors in the treatment of patients with metastatic breast cancer.
Citation Format: Yentl Lambrechts, Sigrid Hatse, Cindy Kenis, Lore Decoster, Evandro de Azambuja, Guy Jerusalem, Patrick Neven, Lissandra Dal Lago, Hannelore Denys, Peter Vuylsteke, Frank Cornelis, Kevin Punie, Giuseppe Floris, Christine Desmedt, Annouschka Laenen, Noam Pondé, Hans Wildiers. Ribociclib plus letrozole alters the immune subset composition in older (≥70 yrs.) patients with HR+/HER2- metastatic breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-01-29.
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Affiliation(s)
| | - Sigrid Hatse
- 2Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - Lore Decoster
- 4Department of Medical Oncology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Evandro de Azambuja
- 5Academic Trials Promoting Team and Medical Oncology Department, Institut Jules Bordet and l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Guy Jerusalem
- 6Department of Medical Oncology, University Hospital of Liege, CHU Sart Tilman, Liege, Belgium
| | - Patrick Neven
- 7Universitair Ziekenhuis Leuven, Leuven, Vlaams-Brabant, Belgium
| | | | - Hannelore Denys
- 9Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
| | | | - Frank Cornelis
- 11Medical Oncology Department, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Kevin Punie
- 12Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute and University Hospitals Leuven, Belgium
| | | | - Christine Desmedt
- 14Laboratory for Translation Breast Cancer Research/KU Leuven, Belgium
| | | | - Noam Pondé
- 16Department of Medical Oncology, A.C. Camargo Cancer Center, São Paulo, Brazil
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Kenis C, Decoster L, Flamaing J, Debruyne PR, De Groof I, Focan C, Cornélis F, Verschaeve V, Bachmann C, Bron D, Van den Bulck H, Schrijvers D, Langenaeken C, Specenier P, Jerusalem G, Praet JP, De Cock J, Lobelle JP, Wildiers H, Milisen K. Incidence of falls and fall-related injuries and their predictive factors in frail older persons with cancer: a multicenter study. BMC Geriatr 2022; 22:877. [PMCID: PMC9675153 DOI: 10.1186/s12877-022-03574-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 10/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background Falls and fall-related injuries are a major public health problem. Data on falls in older persons with cancer is limited and robust data on falls within those with a frailty profile are missing. The aim of this study is to investigate the incidence and predictive factors for falls and fall-related injuries in frail older persons with cancer. Methods This study is a secondary data analysis from data previously collected in a large prospective multicenter observational cohort study in older persons with cancer in 22 Belgian hospitals (November 2012–February 2015). Patients ≥70 years with a malignant tumor and a frailty profile based on an abnormal G8 score were included upon treatment decision and evaluated with a Geriatric Assessment (GA). At follow-up, data on falls and fall-related injuries were documented. Results At baseline 2141 (37.2%) of 5759 included patients reported at least one fall in the past 12 months, 1427 patients (66.7%) sustained an injury. Fall-related data of 3681 patients were available at follow-up and at least one fall was reported by 769 patients (20.9%) at follow-up, of whom 289 (37.6%) fell more than once and a fall-related injury was reported by 484 patients (62.9%). Fear of falling was reported in 47.4% of the patients at baseline and in 55.6% of the patients at follow-up. In multivariable analysis, sex and falls history in the past 12 months were predictive factors for both falls and fall-related injuries at follow-up. Other predictive factors for falls, were risk for depression, cognitive impairment, dependency in activities of daily living, fear of falling, and use of professional home care. Conclusion Given the high number of falls and fall-related injuries and high prevalence of fear of falling, multifactorial falls risk assessment and management programs should be integrated in the care of frail older persons with cancer. Further studies with long-term follow-up, subsequent impact on cancer treatment and interventions for fall prevention, and integration of other important topics like medication and circumstances of a fall, are warranted. Trial registration B322201215495.
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Affiliation(s)
- Cindy Kenis
- grid.410569.f0000 0004 0626 3338Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium
| | - Lore Decoster
- grid.8767.e0000 0001 2290 8069Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Flamaing
- grid.410569.f0000 0004 0626 3338Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven – University of Leuven, Leuven, Belgium
| | - Philip R. Debruyne
- grid.5115.00000 0001 2299 5510Department of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, Kortrijk, Belgium & Medical Technology Research Centre (MTRC), School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Inge De Groof
- Department of Geriatric Medicine, St. Augustinus, Wilrijk, Belgium
| | - Christian Focan
- grid.433083.f0000 0004 0608 8015Department of Oncology, Clinique CHC Montlégia, Liège, Belgium
| | - Frank Cornélis
- grid.48769.340000 0004 0461 6320Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Vincent Verschaeve
- grid.490655.bDepartment of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Dominique Bron
- grid.418119.40000 0001 0684 291XDepartment of Hematology, ULB Institut Jules Bordet, Brussels, Belgium
| | - Heidi Van den Bulck
- grid.414579.a0000 0004 0608 8744Department of Medical Oncology, Imelda hospital, Bonheiden, Belgium
| | - Dirk Schrijvers
- grid.417406.00000 0004 0594 3542Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - Christine Langenaeken
- grid.420031.40000 0004 0604 7221Department Medical Oncology, AZ Klina, Brasschaat, Belgium
| | - Pol Specenier
- grid.411414.50000 0004 0626 3418Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - Guy Jerusalem
- grid.411374.40000 0000 8607 6858Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium
| | - Jean-Philippe Praet
- grid.50545.310000000406089296Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium
| | - Jessie De Cock
- grid.8767.e0000 0001 2290 8069Department of Geriatric Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jean-Pierre Lobelle
- grid.5596.f0000 0001 0668 7884Department of Oncology, Laboratory of Experimental Oncology, KU Leuven – University of Leuven, Leuven, Belgium
| | - Hans Wildiers
- grid.410569.f0000 0004 0626 3338Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven – University of Leuven, Leuven, Belgium
| | - Koen Milisen
- grid.410569.f0000 0004 0626 3338Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium
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Meert G, Kenis C, Milisen K, Debruyne PR, De Groof I, Focan C, Cornélis F, Verschaeve V, Bachmann C, Bron D, Den Bulck HV, Schrijvers D, Langenaeken C, Specenier P, Jerusalem G, Praet JP, Lobelle JP, Flamaing J, Wildiers H, Decoster L. Functional status in older patients with cancer and a frailty risk profile: A multicenter observational study. J Geriatr Oncol 2022; 13:1162-1171. [PMID: 36085275 DOI: 10.1016/j.jgo.2022.08.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/02/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Functional status (FS) and frailty are significant concerns for older adults, especially those with cancer. Data on FS (Activities of Daily Living [ADL]; Instrumental Activities of Daily Living [IADL]) and its evolution during cancer treatment in older patients and a frailty risk profile are scarce. Therefore, this study examines FS and its evolution in older patients with cancer and a frailty risk profile and investigates characteristics associated with functional decline. MATERIAL AND METHODS This secondary data-analysis, focusing on FS, uses data from a large prospective multicenter observational cohort study. Patients ≥70 years with a solid tumor and a frailty risk profile based on the G8 screening tool (score ≤ 14) were included. A geriatric assessment was performed including evaluation of FS based on ADL and IADL. At approximately three months of follow-up, FS was reassessed. Univariable and multivariable logistic regression analyses were used to identify predictive factors for functional decline in ADL and IADL. RESULTS Data on ADL and IADL were available at baseline and follow-up in 3388 patients. At baseline 1886 (55.7%) patients were dependent for ADL, whereas 2085 (61.5%) patients were dependent at follow-up. Functional decline was observed in 23.6% of patients. For IADL 2218 (65.5%) patients were dependent for IADL, whereas 2591 (76.5%) patients were dependent at follow-up. Functional decline in IADL was observed in 41.0% of patients. In multivariable analysis, disease stage III or IV, comorbidities, falls history in the past twelve months, and FS measured by IADL were predictive factors for functional decline in both ADL and IADL. Other predictive factors for functional decline in ADL were polypharmacy, Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) score 2-4, and cognitive impairment, and for functional decline in IADL were female sex, fatigue, and risk for depression. DISCUSSION Functional impairments are frequent in older persons with cancer and a frailty risk profile, and several characteristics are identified that are significantly associated with functional decline. Therefore, FS is an essential part of the geriatric assessment which should be standard of care for this patient population. Next step is to proceed with directed interventions with the aim to limit the risk of functional decline as much as possible.
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Affiliation(s)
- Glen Meert
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Cindy Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium
| | - Koen Milisen
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium
| | - Philip R Debruyne
- Department of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, Kortrijk, Belgium; Medical Technology Research Centre (MTRC), School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Inge De Groof
- Department of Geriatric Medicine, St. Augustinus, Wilrijk, Belgium
| | - Christian Focan
- Department of Oncology, Clinique CHC Montlégia, Liège, Belgium
| | - Frank Cornélis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Vincent Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Dominique Bron
- Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium
| | | | - Dirk Schrijvers
- Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - Christine Langenaeken
- Department Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium
| | - Pol Specenier
- Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium
| | - Jean-Philippe Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium
| | - Jean-Pierre Lobelle
- Consultant in Statistics, Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven - University of Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
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11
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Depoorter V, Vanschoenbeek K, Decoster L, De Schutter H, Debruyne P, De Groof I, Bron D, Cornelis F, Luce S, Focan C, Verschaeve V, Debugne G, Langenaeken C, van den Bulck H, Goeminne JC, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. 1265MO Cause and place of death in older patients with cancer: Results from a large cohort study using linked clinical and population-based data. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1398] [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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Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
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Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
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13
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Depoorter V, Vanschoenbeek K, Decoster L, De Schutter H, Debruyne PR, DeGroof I, Bron D, Cornélis F, Luce S, Focan CNJ, Verschaeve V, Debugne G, Langenaeken CMLH, Van Den Bulck H, Goeminne JC, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. General practitioner contacts, hospitalizations, and nursing home transfers in older patients up to three years after new cancer diagnosis: Results from a large data linkage cohort study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.12041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12041 Background: Long-term outcomes after cancer diagnosis in older persons are largely unexplored because of limited follow-up in clinical studies. By linking clinical data with population-based data, studying long-term outcomes in large cohorts becomes feasible. The current study aims to explore long-term outcomes in the care trajectory of older patients with cancer and to assess their association with baseline geriatric screening and assessment (GS/GA) results. Methods: A large cohort study of older patients with a new cancer diagnosis was set up by linking clinical, cancer registry and administrative health data based on a unique patient identifier. Clinical data were derived from a previously performed prospective multicentric Belgian study (2009-2015). Patients aged ≥ 70 years were screened with G8 followed by GA in case of an abnormal result (≤14/17). Tumor characteristics and vital status were derived from cancer registry data and long-term outcomes (general practitioner (GP) contacts, hospitalizations and nursing home transfers) from administrative health data. In patients that survived at least 3 months since inclusion, outcomes were assessed from the day after inclusion until 3 years after. Event rates were calculated using person-time at risk to allow for varying follow-up time. Patients were censored 3 months before death to exclude influence of end-of-life care. Results: After data linkage, 6,391 older patients with a new cancer diagnosis were available for this analysis. The median age was 77 (range: 70–100) and 59.8% was female. Diagnoses included solid (92.8%) and hematologic malignancies (7.2%). In the patients with a solid tumor, breast, colorectal and lung cancer were the most common and 20.1% of patients had stage IV. 64.3% of patients had an abnormal baseline G8 score. During the 3 year follow-up, 2,602 (40.7%) of the included patients died. In these 3 years, 5,985 (95.2%) patients had at least one contact with a GP and 4,634 (72.5%) had at least one new hospital admission (event rates in Table 1). Of the 3,724 patients living independently at inclusion and still alive after 3 years, 281 (7.5%) had been transferred to a nursing home and of those, 240 (85.4%) patients had an abnormal baseline G8 score. Conclusions: Older patients with an abnormal baseline G8 score have more GP contacts, hospital admissions and nursing home transfers in the 3 years following a new cancer diagnosis compared to patients with normal baseline G8 score. Baseline G8 could help identify patients at risk for higher long-term healthcare utilization.[Table: see text]
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Affiliation(s)
| | | | | | | | | | | | | | - Frank Cornélis
- Cliniques Universitaires Saint-Luc - UCLouvain, Brussels, Belgium
| | - Sylvie Luce
- University Hospital Erasme, Brussels, Belgium
| | - C. N. J. Focan
- Clinique Saint-Joseph - CHC-Liège Hospital Group, Liège, Belgium
| | | | | | | | | | | | | | | | - Cindy Kenis
- University Hospitals Leuven, Leuven, Belgium
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14
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Sibille A, Bustin F, Carestia L, Catala G, Compère C, Cuppens K, Colinet B, Coulon S, De Brucker N, Decoster L, Decoster L, Demedts I, Derijcke S, Deschepper K, Galdermans D, Janssens A, Ocak S, Oyen C, Pat K, Pieters T, Pruniau V, Surmont V, Vandekeere S, Vansteenkiste J. A prospective, multicenter, noninterventional study of decision factors in the first-line treatment of metastatic non-small cell lung cancer. Acta Oncol 2022; 61:773-776. [PMID: 35574825 DOI: 10.1080/0284186x.2022.2063700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Anne Sibille
- Department of Pulmonology, University Hospital of Liège, Liège, Belgium
| | | | - Luciano Carestia
- Department of Pulmonology, Clinique Saint-Pierre Ottignies, Ottignies, Belgium
| | - Gaetan Catala
- Department of Oncology, CH Jolimont, Haine-St-Paul, La Louvière, Belgium
| | - Christophe Compère
- Department of Pulmonology, CCI (CHIREC Cancer Institute), CHIREC Hospital, Brussels, Belgium
| | - Kristof Cuppens
- Department of Pulmonology and Thoracic Oncology, Jessa Hospital, Hasselt, Belgium
| | - Benoit Colinet
- Department of Pulmonology, Grand Hôpital de Charleroi, Gilly, Belgium
| | | | - Nele De Brucker
- Department of Pneumonology, Imelda Hospital, Bonheiden, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lynn Decoster
- Department of Pulmonology, AZ Turnhout, Turnhout, Belgium
| | - Ingel Demedts
- Department of Pulmonary Diseases, AZ Delta, Roeselare, Belgium
| | - Sofie Derijcke
- Department of Pulmonology, AZ Groeninge, Kortrijk, Belgium
| | | | | | - Annelies Janssens
- MOCA Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Sebahat Ocak
- Division of Pulmonology, CHU UCL Namur, Godinne Site, Yvoir, Belgium
- Pole of Pneumology, ENT, and Dermatology (PNEU), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Christel Oyen
- Respiratory Oncology Unit, University Hospitals KU Leuven, Leuven, Belgium
| | - Karin Pat
- Department of Pulmonology and Thoracic Oncology, Jessa Hospital, Hasselt, Belgium
| | - Thierry Pieters
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Veerle Surmont
- Department of Respiratory Medicine, Ghent University, Ghent, Belgium
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15
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Mizutani T, Cheung K, Hakobyan Y, Lane H, Decoster L, Karnakis T, Puts M, Calderon O, Jørgensen T, Boulahssass R, Wedding U, Karampeazis T, Banerjee J, Falci C, van Leeuwen B, Fonseca V, Gironés Sarrió R, Dougoud V, Naeim A, Shahrokni A, Kanesvaran R. An Overview of Geriatric Oncology in Global Clinical Practice: a SIOG National Representatives’ Survey. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00464-1] [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: 10/19/2022]
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16
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Depoorter V, Vanschoenbeek K, Decoster L, De Schutter H, Debruyne P, De Groof I, Bron D, Cornélis F, Luce S, Focan C, Verschaeve V, Debugne G, Langenaeken C, Van Den Bulck H, Goeminne J, Teurfs W, Jerusalem G, Schrijvers D, Petit B, Geboers K, Forceville K, Praet J, Vandenborre K, Milisen K, Flamaing J, Kenis C, Verdoodt F, Wildiers H. Geriatric screening and assessment among older patients with cancer: evaluation of long-term outcomes in a multicentric cohort of > 7, 000 patients. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00457-4] [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: 10/19/2022]
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17
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Reijmen E, De Mey S, Van Damme H, De Ridder K, Gevaert T, De Blay E, Bouwens L, Collen C, Decoster L, De Couck M, Laoui D, De Grève J, De Ridder M, Gidron Y, Goyvaerts C. Transcutaneous Vagal Nerve Stimulation Alone or in Combination With Radiotherapy Stimulates Lung Tumor Infiltrating Lymphocytes But Fails to Suppress Tumor Growth. Front Immunol 2021; 12:772555. [PMID: 34925341 PMCID: PMC8671299 DOI: 10.3389/fimmu.2021.772555] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022] Open
Abstract
The combination of radiotherapy (RT) with immunotherapy represents a promising treatment modality for non-small cell lung cancer (NSCLC) patients. As only a minority of patients shows a persistent response today, a spacious optimization window remains to be explored. Previously we showed that fractionated RT can induce a local immunosuppressive profile. Based on the evolving concept of an immunomodulatory role for vagal nerve stimulation (VNS), we tested its therapeutic and immunological effects alone and in combination with fractionated RT in a preclinical-translational study. Lewis lung carcinoma-bearing C57Bl/6 mice were treated with VNS, fractionated RT or the combination while a patient cohort with locally advanced NSCLC receiving concurrent radiochemotherapy (ccRTCT) was enrolled in a clinical trial to receive either sham or effective VNS daily during their 6 weeks of ccRTCT treatment. Preclinically, VNS alone or with RT showed no therapeutic effect yet VNS alone significantly enhanced the activation profile of intratumoral CD8+ T cells by upregulating their IFN-γ and CD137 expression. In the periphery, VNS reduced the RT-mediated rise of splenic, but not blood-derived, regulatory T cells (Treg) and monocytes. In accordance, the serological levels of protumoral CXCL5 next to two Treg-attracting chemokines CCL1 and CCL22 were reduced upon VNS monotherapy. In line with our preclinical findings on the lack of immunological changes in blood circulating immune cells upon VNS, immune monitoring of the peripheral blood of VNS treated NSCLC patients (n=7) did not show any significant changes compared to ccRTCT alone. As our preclinical data do suggest that VNS intensifies the stimulatory profile of the tumor infiltrated CD8+ T cells, this favors further research into non-invasive VNS to optimize current response rates to RT-immunotherapy in lung cancer patients.
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MESH Headings
- Aged
- Animals
- Carcinoma, Lewis Lung/immunology
- Carcinoma, Lewis Lung/pathology
- Carcinoma, Lewis Lung/radiotherapy
- Carcinoma, Lewis Lung/therapy
- Carcinoma, Non-Small-Cell Lung/immunology
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/radiotherapy
- Carcinoma, Non-Small-Cell Lung/therapy
- Combined Modality Therapy
- Female
- Humans
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Lung Neoplasms/radiotherapy
- Lung Neoplasms/therapy
- Lymphocytes, Tumor-Infiltrating/immunology
- Male
- Mice, Inbred C57BL
- Middle Aged
- Tumor Burden
- Vagus Nerve Stimulation
- Mice
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Affiliation(s)
- Eva Reijmen
- Laboratory for Molecular and Cellular Therapy, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sven De Mey
- Department of Radiotherapy, Oncology Centre University Hospital Brussels (Universitair Ziekenhuis (UZ) Brussel), Brussels, Belgium
| | - Helena Van Damme
- Myeloid Cell Immunology Lab, Vlaams Instituut voor Biotechnologie (VIB) Center for Inflammation Research, Brussels, Belgium
- Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kirsten De Ridder
- Laboratory for Molecular and Cellular Therapy, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Thierry Gevaert
- Department of Radiotherapy, Oncology Centre University Hospital Brussels (Universitair Ziekenhuis (UZ) Brussel), Brussels, Belgium
| | - Emmy De Blay
- Cell Differentiation Lab, Vrije Universiteit Brussel, Brussels, Belgium
| | - Luc Bouwens
- Cell Differentiation Lab, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christine Collen
- Department of Radiotherapy, Oncology Centre University Hospital Brussels (Universitair Ziekenhuis (UZ) Brussel), Brussels, Belgium
| | - Lore Decoster
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis (UZ) Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Marijke De Couck
- Department of Public Health, Mental Health and Wellbeing Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Health Care, University College Odisee, Aalst, Belgium
| | - Damya Laoui
- Myeloid Cell Immunology Lab, Vlaams Instituut voor Biotechnologie (VIB) Center for Inflammation Research, Brussels, Belgium
- Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jacques De Grève
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis (UZ) Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Mark De Ridder
- Department of Radiotherapy, Oncology Centre University Hospital Brussels (Universitair Ziekenhuis (UZ) Brussel), Brussels, Belgium
| | - Yori Gidron
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Cleo Goyvaerts
- Laboratory for Molecular and Cellular Therapy, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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18
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Van Herck Y, Feyaerts A, Alibhai S, Papamichael D, Decoster L, Lambrechts Y, Pinchuk M, Bechter O, Herrera-Caceres J, Bibeau F, Desmedt C, Hatse S, Wildiers H. Is cancer biology different in older patients? The Lancet Healthy Longevity 2021; 2:e663-e677. [DOI: 10.1016/s2666-7568(21)00179-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022]
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19
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de la Fouchardiere C, Decoster L, Samalin E, Terret C, Kenis C, Droz JP, Coutzac C, Smyth E. Advanced oesophago-gastric adenocarcinoma in older patients in the era of immunotherapy. A review of the literature. Cancer Treat Rev 2021; 100:102289. [PMID: 34583303 DOI: 10.1016/j.ctrv.2021.102289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 12/15/2022]
Abstract
Gastric (G) and gastro-esophageal junction (GEJ) adenocarcinomas are of the most common and deadly cancers worldwide and affect mainly patients over 70 years at diagnosis. Older age has been associated in gastric cancers with distal tumour location, well-differentiated adenocarcinoma and microsatellite instability and is not identified itself as an independent prognostic factor. As immune checkpoint inhibitors recently changed the landmark of advanced G and GEJ adenocarcinomas treatment, we decided to perform a literature review to define the evidence-level of clinical data in older patients. This work underlined the lasting low -inclusion rate of older patients and -implementation rate of frailty screening tools in clinical trials in G/GEJ carcinomas. In the first-line metastatic setting, two prospective randomized phase III studies have specifically assessed the efficacy of chemotherapy in older patients with HER2-negative gastric cancers, demonstrating the feasibility of reduced dose oxaliplatin-based chemotherapy regimen in this population. Only few data are available in HER2-positive tumors, or in the second-line setting. Furthermore, no specific trial with immune checkpoint inhibitors was performed in older frail patients whereas their benefit/adverse events ratio make them attractive candidates in this patient's population. We conclude that older fit patients can be treated in the same way as younger ones and included in clinical trials. Improving the outcome of older frail patients should be the oncology community next focus by implementing targeted interventions before initiating cancer therapy and designing specific clinical trials. Frailty screening tools and geriatric data collection have to be implemented in routine-practice and clinical trials.
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Affiliation(s)
| | - L Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - E Samalin
- Medical Oncology Department, Institut du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France.
| | - C Terret
- Medical Oncology Department, Centre Léon Bérard, 28 rue Laennec, Lyon, France
| | - C Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium.
| | - J P Droz
- Medical Oncology, Claude-Bernard Lyon1 University, Lyon, France.
| | - C Coutzac
- Medical Oncology Department, Centre Léon Bérard, 28 rue Laennec, Lyon, France.
| | - E Smyth
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
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20
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Bar J, Kian W, Wolner M, Derijcke S, Girard N, Rottenberg Y, Dudnik E, Metro G, Hochmair M, Aboubakar F, Cuppens K, Decoster L, Reck M, Limon D, Blanco AC, Astaras C, Häfliger S, Peled N, Addeo A. 1206P UNcommon EGFR mutations: International Case series on efficacy of Osimertinib in Real-life practice in first-liNe setting (UNICORN). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Battisti NML, Decoster L, Williams GR, Kanesvaran R, Wildiers H, Ring A. Targeted Therapies in Older Adults With Solid Tumors. J Clin Oncol 2021; 39:2128-2137. [PMID: 34043448 PMCID: PMC8260907 DOI: 10.1200/jco.21.00132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/07/2021] [Accepted: 02/23/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Nicolò Matteo Luca Battisti
- Department of Medicine—Breast Unit, The Royal Marsden NHS Foundation Trust, Breast Cancer Research Division, The Institute of Cancer Research, Surrey, United Kingdom
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis (UZ) Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Grant R. Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | | | - Hans Wildiers
- Department of General Medical Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven Cancer Institute, Laboratory of Experimental Oncology, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Alistair Ring
- Department of Medicine—Breast Unit, The Royal Marsden NHS Foundation Trust, Breast Cancer Research Division, The Institute of Cancer Research, Surrey, United Kingdom
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Cuppens K, Lodewyckx L, Demedts I, Decoster L, Colinet B, Deschepper K, Janssens A, Galdermans D, Pieters T. Real-World Treatment Patterns, Epidermal Growth Factor Receptor (EGFR) Testing and Outcomes in EGFR-Mutated Advanced Non-small Cell Lung Cancer Patients in Belgium: Results from the REVEAL Study. Drugs Real World Outcomes 2021; 8:141-152. [PMID: 33710523 PMCID: PMC8128953 DOI: 10.1007/s40801-021-00243-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Treatment of patients with epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) continues to evolve expeditiously. OBJECTIVES This retrospective study investigated real-world treatment patterns and EGFR mutation testing in patients with EGFRm advanced NSCLC in Belgium. METHODS Data were extracted from medical records of adults diagnosed with EGFRm locally advanced/metastatic NSCLC between 1 September 2015 and 31 December 2017. Patients were followed retrospectively from diagnosis until 1 September 2018, end of clinical activity or death. Data on demographics, patient outcomes and disease characteristics, treatment patterns and EGFR mutation testing at diagnosis and progression were analyzed descriptively. RESULTS A total of 141 patients were enrolled. At diagnosis, median age was 69 years, 63.1% were female, 88.7% had metastatic disease, 94.3% had adenocarcinoma histology, 76.6% had ECOG 0/1, 70.9% had common EGFR mutations and 29.1% had only rare mutations. In first line, 73.8% of patients received first/second-generation EGFR-tyrosine kinase inhibitors (1G/2G EGFR-TKIs), while 21.9% received other systemic treatments. Among 61 patients progressing on and discontinuing a first 1G/2G EGFR-TKI, 45 (73.8%) received subsequent systemic treatment while 16 (26.2%) did not; 20 (32.8%) received osimertinib. Among 65 patients progressing on a first 1G/2G EGFR-TKI, 47 (72.3%) were tested for T790M, of whom 25 (53.2%) were positive. CONCLUSION These real-world data from Belgium show that a substantial fraction of patients with EGFRm NSCLC do not receive 1G/2G EGFR-TKIs in first line and do not receive subsequent systemic treatment after progression on 1G/2G EGFR-TKIs. Only a third receive osimertinib upon progression on 1G/2G EGFR-TKIs. These observations should be considered in first-line treatment decisions. TRIAL REGISTRATION ClinicalTrials.gov: NCT03761901-December 3, 2018.
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Affiliation(s)
- Kristof Cuppens
- Department of Pulmonology and Thoracic Oncology, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
| | | | - Ingel Demedts
- Department of Pulmonary Diseases, AZ Delta, Roeselare, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Vrije Universiteit Brussel, BrusselJette, UZ, Belgium
| | - Benoît Colinet
- Department of Pneumology and Thoracic Oncology, Grand Hôpital de Charleroi, Notre Dame, Charleroi, Belgium
| | | | - Annelies Janssens
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | | | - Thierry Pieters
- Department of Pulmonology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Kotecki N, Franzoi MAB, Paesmans M, Clatot F, Borcoman E, Goncalves A, Barthelemy P, Cheymol C, Delord JP, Gombos A, Vanhaudenarde V, Holbrechts S, Duhoux FP, Canon JLR, Decoster L, denys H, Duhem C, Kindt N, Awada A. BrainStorm: A brain metastases research platform to tackle the challenge of central nervous system (CNS) metastases in solid tumors (Oncodistinct 006). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS2066 Background: Better knowledge on the evolving epidemiology and biology of CNS metastases are key elements for the development of new treatment strategies and identification of promising therapeutic targets. A multidisciplinary Brain Metastases Clinical Research Platform called BrainStorm was launched by the Jules Bordet Institute and the Oncodistinct network. The BrainStorm program includes mainly patients with non-CNS metastatic solid tumors with high risk of developing CNS metastases allowing to build a large database focusing on three time periods: before the diagnosis of CNS metastases (Part A), at diagnosis (Part B) and after the diagnosis of CNS metastases (Part C). Methods: Subjects with newly diagnosed non-CNS metastases or up to 24 months from diagnosis of non-CNS metastases from triple-negative and HER2-positive breast cancer, lung cancer and melanoma are eligible for part A of the program. Subjects presenting with a 1st CNS event and not yet enrolled (previously mentioned cohorts and a cohort of other tumor types) can enter directly in parts B and subsequently part C of the study. Eligible subjects are followed for 48 months for relevant clinical data, neurological examinations, quality of life, survival status, and undergo examinations and samplings (Table 1). A total of 280 subjects (40 per cohort) with a 1st CNS event will be enrolled. The main objectives of the program are to collect clinical and biological data with the aim to identify risk factors for CNS metastases development (Part A) and to better understand the biology of CNS metastases (brain and leptomeningeal –Parts B and C) aiming to discover new targets for therapy and intensify the multidisciplinary approach for the management of CNS metastases from solid tumors. The translational part of the program will evaluate among others the use of cerebrospinal fluid circulating tumor DNA (CSF-ctDNA) as a surrogate for CNS metastases in order to characterize its molecular landscape. Currently, the study is recruiting in several sites within the Oncodistinct network. The data collected will help to develop innovative multidisciplinary research projects that could be implemented in all parts of the BrainStorm program. Clinical trial information: NCT04109131. [Table: see text]
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Affiliation(s)
| | - Maria Alice B Franzoi
- Oncology Department, Institut Jules Bordet, and Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Marianne Paesmans
- Data Centre, Institut Jules Bordet - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Florian Clatot
- INSERM U1245, IRON Group, Centre Henri Becquerel, University Hospital, University of Normandy, Rouen, France
| | | | - Anthony Goncalves
- Aix-Marseille Univ, CNRS, INSERM, Institut Paoli-Calmettes, Department of Medical Oncology, CRCM, Marseille, France
| | | | | | - Jean-Pierre Delord
- Department of Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | | | | | | | - Francois P. Duhoux
- Department of Medical Oncology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Jean-Luc Re Canon
- Department of Oncology-Hematology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | | | | | - Nadège Kindt
- Institut Jules Bordet - Université Libre de Bruxelles, Bruxelles, Belgium
| | - Ahmad Awada
- Department of Oncology Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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McDonald F, Mornex F, Garassino M, Filippi A, Christoph D, Haakensen V, Agbarya A, Van den Heuvel M, Vercauter P, Chouaid C, Pichon E, Siva S, Steinbusch L, Peretz I, Solomon B, Decoster L, Sawyer W, Allen A, Licour M, Girard N. 79MO PACIFIC-R: Real-world characteristics of unresectable stage III NSCLC patients treated with durvalumab after chemoradiotherapy. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01921-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vekens K, Everaert H, Neyns B, Ilsen B, Decoster L. The Value of 18F-FDG PET/CT in Predicting the Response to PD-1 Blocking Immunotherapy in Advanced NSCLC Patients with High-Level PD-L1 Expression. Clin Lung Cancer 2021; 22:432-440. [PMID: 33879398 DOI: 10.1016/j.cllc.2021.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The objective of this study was to evaluate if 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)-derived parameters are useful in predicting response and survival after programmed cell death protein 1 (PD-1) blocking immunotherapy in patients with advanced NSCLC characterized by a high programmed death-ligand 1 (PD-L1) expression (≥50%) on immunohistochemistry. PATIENTS AND METHODS In 30 patients with advanced stage IV non-small-cell lung cancer (NSCLC) and high PD-L1 expression, 18F-FDG PET/CT parameters before start of treatment with PD-1 blocking immunotherapy were evaluated retrospectively. In 24 out of the 30 patients, 18F-FDG PET/CT was available 8 to 9 weeks after start of the treatment. Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and metabolic responses assessed on 18F-FDG PET/CT were compared. RESULTS Median follow-up was 20 months (range, 4.2-37.6). Median PD-L1 expression was 80%. The objective response rate with RECIST 1.1 was 53.3%. Median progression-free survival (PFS) was 12.4 months (95% confidence interval [CI], 1.0-37.8), and median overall survival (OS) was 14.9 months (95% CI, 2.4-38.2). Baseline 18F-FDG PET/CT parameters did not differ between responders and non-responders (all P > .05). The maximum standardized uptake value (SUVmax) was the only 18F-FDG PET/CT parameter associated with PFS (P = .04), with a trend for OS (P = .06). At first evaluation, response according to total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) were associated with PFS and OS (both P < .0001). This was not the case for RECIST 1.1 (P = .29 for PFS and P = .38 for OS). CONCLUSION Clinical response and survival were independent from metabolic tumor volume at baseline. Reduction of metabolic tumor volume after 8 to 9 weeks of treatment was a better predictor for prolonged survival than RECIST 1.1.
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Affiliation(s)
- Karolien Vekens
- Respiratory Division, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Hendrik Everaert
- Department of Nuclear Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Ilsen
- Radiology Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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Abstract
PURPOSE OF REVIEW This review highlights the latest development in the use of geriatric assessment(GA) and frailty assessment for older adults with cancer. RECENT FINDINGS From 2019, there were six large randomized controlled trials (RCTs) completed of GA for older adults with cancer, as well as several studies of frailty screening tools. SUMMARY The findings in this review highlight the benefits of implementing GA, followed by interventions to address the identified issues (GA -guided interventions). Four of six RCTs that implemented GA for older adults with cancer showed positive impact on various outcomes, including treatment toxicity and quality of life. GA implementation varied significantly between studies, from oncologist acting on GA summary, geriatrician comanagement, to full GA by a multidisciplinary team. However, there were several barriers reported to implementing GA for all older adults with cancer, such as access to geriatrics and resource issues. Future research needs to elucidate how to best operationalize GA in various cancer settings. The authors also reviewed frailty screening tools and latest evidence on their use and impact.
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Affiliation(s)
- Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Wee Kheng Soo
- Eastern Health Clinical School, Monash University
- Cancer Services, Eastern Health
- Aged Medicine Program, Eastern Health, Box Hill, Australia
| | - Ewa Szumacher
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Lodewijckx E, Kenis C, Flamaing J, Debruyne P, De Groof I, Focan C, Cornélis F, Verschaeve V, Bachmann C, Bron D, Luce S, Debugne G, Van den Bulck H, Goeminne JC, Schrijvers D, Geboers K, Petit B, Langenaeken C, Van Rijswijk R, Specenier P, Jerusalem G, Praet JP, Vandenborre K, Lobele JP, Milisen K, Wildiers H, Decoster L. Unplanned hospitalizations in older patients with cancer: Occurrence and predictive factors. J Geriatr Oncol 2020; 12:368-374. [PMID: 33223483 DOI: 10.1016/j.jgo.2020.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study aims to investigate the occurrence of unplanned hospitalizations in older patients with cancer and to determine predictive factors. METHODS A prospective Belgian multicentre (n = 22), observational cohort study was performed. Patients ≥70 years with a malignant tumor were included. Patients underwent G8 screening followed by geriatric assessment (GA) if abnormal at baseline and were followed for unplanned hospitalizations at approximately three months. Uni- and multivariable regression models were performed to determine predictive factors associated with unplanned hospitalizations in older patients with an abnormal G8. RESULTS In total, 7763 patients were included in the current analysis of which 2409 (31%) patients with a normal G8 score and 5354 (69%) with an abnormal G8 score. Patients with an abnormal G8 were hospitalized more frequently than patients with a normal G8 (22.9% versus 12.4%; p < 0.0001). Reasons for unplanned hospitalizations were most frequently cancer related (25.7%) or cancer therapy related (28%). In multivariable analysis, predictive factors for unplanned hospitalizations in older patients with cancer and an abnormal G8 were female gender, absence of surgery, chemotherapy, ADL dependency, malnutrition and presence of comorbidities. CONCLUSION Older patients with cancer and an abnormal G8 screening present a higher risk (23%) for unplanned hospitalizations. Predictive factors for these patients were identified and include not only patient and treatment related factors but also GA related factors.
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Affiliation(s)
- Elke Lodewijckx
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven and Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven, Belgium
| | - Philip Debruyne
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - Inge De Groof
- Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium
| | - Christian Focan
- Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liège, Belgium
| | - Frank Cornélis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium
| | - Vincent Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Dominique Bron
- Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium
| | - Sylvie Luce
- Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gwenaelle Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | | | - Jean-Charles Goeminne
- Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur, Belgium
| | - Dirk Schrijvers
- Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - Katrien Geboers
- Centre for Oncology and Hematology, AZ Turnhout, Turnhout, Belgium
| | - Benedicte Petit
- Department of Medical Oncology, Centre Hospitalier Jolimont, La Louvière, Belgium
| | - Christine Langenaeken
- Department Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium
| | | | - Pol Specenier
- Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium
| | - Jean-Philippe Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium
| | | | | | - Koen Milisen
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
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Reck M, Mileham K, Clump D, Decoster L, Estival A, Felip E, Fried P, Paz-Ares L, Sebastian M, Segarra NV, Surmont V, Wagner A, Galdy S, Smit E. 1420TiP A phase I/II trial of radium-223 (Ra-223) in combination with pembrolizumab in patients (pts) with stage IV non-small cell lung cancer (NSCLC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cuppens K, Froyen G, Cruys B, Geerdens E, Zhang S, Zhang B, Decoster L, Thomeer M, Maes B. 1037P Tumour mutational burden and HLA diversity by TruSight oncology 500 (TSO500) next generation sequencing panel and clinical outcome in non-small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cuppens K, Lodewyckx L, Demedts I, Decoster L, Colinet B, Deschepper K, Janssens A, Pauwels P, Galdermans D, Pieters T. 2000P Real-world EGFR testing in patients with advanced EGFRm NSCLC in Belgium (REVEAL). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1306] [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: 10/23/2022] Open
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Cuppens K, Lodewyckx L, Demedts I, Decoster L, Colinet B, Deschepper K, Janssens A, Galdermans D, Pieters T. 1363P Real-world treatment patterns of patients with locally advanced/metastatic EGFRm NSCLC in Belgium (REVEAL). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1677] [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: 11/16/2022] Open
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Boeckx B, Shahi RB, Smeets D, De Brakeleer S, Decoster L, Van Brussel T, Galdermans D, Vercauter P, Decoster L, Alexander P, Berchem G, Ocak S, Vuylsteke P, Deschepper K, Lambrechts M, Cappoen N, Teugels E, Lambrechts D, De Greve J. The genomic landscape of nonsmall cell lung carcinoma in never smokers. Int J Cancer 2020; 146:3207-3218. [DOI: 10.1002/ijc.32797] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Bram Boeckx
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Rajendra B. Shahi
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Dominiek Smeets
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Sylvia De Brakeleer
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Lore Decoster
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Thomas Van Brussel
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | | | | | - Lynn Decoster
- Department of PulmonologyAZ Turnhout Turnhout Belgium
| | | | - Guy Berchem
- Centre Hospitalier de Luxembourg Luxembourg City Luxemburg
| | - Sebahat Ocak
- CHU UCL Namur (Godinne Site) Yvoir Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pneumology Pole, Université Catholique de Louvain (UCL) Ottignies‐Louvain‐la‐Neuve Belgium
| | - Peter Vuylsteke
- Université Catholique de Louvain, CHU UCL Namur, Site Sainte Elisabeth Namur Belgium
| | | | | | - Nadia Cappoen
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Erik Teugels
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Diether Lambrechts
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Jacques De Greve
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
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Joris S, Pieters T, Sibille A, Bustin F, Jacqmin L, Kalantari HR, Surmont V, Goeminne JC, Clinckart F, Pat K, Demey W, Deschepper K, Lambrechts M, Holbrechts S, Schallier D, Decoster L. Real life safety and effectiveness of nivolumab in older patients with non-small cell lung cancer: Results from the Belgian compassionate use program. J Geriatr Oncol 2020; 11:796-801. [DOI: 10.1016/j.jgo.2019.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/01/2019] [Accepted: 09/30/2019] [Indexed: 01/06/2023]
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Fontaine C, Renard V, Van den Bulck H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, Awada A, Wildiers H, De Brakeleer S, Teugels E, De Grève J. Abstract P1-10-05: Evaluation of germline whole exome sequencing of early breast cancer patients with triple negative breast cancer (TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p1-10-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BSMO 2014-01 is a published prospective phase 2 study evaluating the efficacy of neoadjuvant EC and PC in the treatment of TNBC patients. (1) The addition of weekly carboplatin to neoadjuvant paclitaxel and dose-dense EC lead to a pathologic complete response (pCR) of 54%, comparable to prior studies. A secondary endpoint was to correlate pCR to homologous recombination (HR) and DNA damaging repair (DDR) deficiency due to germline mutations. Methods: Sixty-three patients (pts) of which nine already identified with a BRCA 1/2 mutation were considered. Peripheral blood was collected in 52 pts after obtaining informed consent for a broad genomic DNA analysis. Whole Exome Sequencing was performed, and only rare variants (M.A.F. <0.01) with a strong impact on protein structure (nonsense, frameshift or splice-site variants) in genes involved in DNA damage repair (DDR) were further taken into consideration. The correlation between pCR rate and DDR deficiency or deficiency in Homologous Recombination repair or HR, a subclass of DDR deficiency, was analyzed using the Fisher's exact test. Results: Twenty nine out of the 52 investigated patients carried a germline mutation in a DDR gene. Twenty of these 29 pts had a pCR, while a pCR was observed in 8/23 patients without an DDR mutation (p=0.014). In 13/15 with an HR gene mutation a pCR was obtained, while the pCR was 15/37 in pts without an HR deficiency (p=0.003). DDR deficiency not involving HR genes lead to a pCR rate of 7/14, while this was 8/23 in pts without a mutation (p= 0.3). Conclusions: This is the first genomic study in early TNBC pts which demonstrates, that a germline mutation in any of the genes involved in DNA repair by homologous recombination, strongly predicts for a pCR on neoadjuvant chemotherapy with EC and PC. Other DDR gene mutations do not predict for an enhanced pCR rate compared to pts with no DDR gene mutations identified in their germline. Ref: C. Fontaine, V. Renard, H. Van den Bulk, P. Vuylsteke et al. Weekly carboplatin plus neoadjuvant anthracycline-taxane-based regimen in early triple-negative breast cancer: a prospective phase II trial by the Breast Cancer Task Force of the Belgian Society of Medical Oncology (BSMO). Breast Cancer Res Treat 2019.
Citation Format: Christel Fontaine, Vincent Renard, Heidi Van den Bulck, Peter Vuylsteke, Philippe Glorieux, Catherine Dopchie, Lore Decoster, Ahmad Awada, Hans Wildiers, Sylvie De Brakeleer, Erik Teugels, Jacques De Grève. Evaluation of germline whole exome sequencing of early breast cancer patients with triple negative breast cancer (TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-10-05.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Erik Teugels
- 9Laboratory of Medical and Molecular Oncology(VUB), Jette, Belgium
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35
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Kenis C, Decoster L, Flamaing J, Debruyne PR, De Groof I, Focan C, Cornélis F, Verschaeve V, Bachmann C, Bron D, Luce S, Debugne G, Van den Bulck H, Goeminne JC, Schrijvers D, Geboers K, Petit B, Langenaeken C, Van Rijswijk R, Specenier P, Jerusalem G, Praet JP, Vandenborre K, Lobelle JP, Lycke M, Milisen K, Wildiers H. Adherence to geriatric assessment-based recommendations in older patients with cancer: a multicenter prospective cohort study in Belgium. Ann Oncol 2019; 29:1987-1994. [PMID: 29905766 DOI: 10.1093/annonc/mdy210] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background In the general older population, geriatric assessment (GA)-guided treatment plans can improve overall survival, quality of life and functional status (FS). In GA-related research in geriatric oncology, studies mainly focused on geriatric screening and GA but not on geriatric recommendations, interventions and follow-up. The aim of this study was to investigate the adherence to geriatric recommendations and subsequent actions undertaken in older patients with cancer. Patient and methods A prospective Belgian multicenter (N = 22) cohort study included patients ≥70 years with a malignant tumor upon oncologic treatment decision. Patients with an abnormal result on the geriatric screening (G8 ≤14/17) underwent GA. Geriatric recommendations were formulated based on GA results. At follow-up the adherence to geriatric recommendations was documented including a description of actions undertaken. Results From November 2012 till February 2015, G8 screening was carried out in 8451 patients, of which 5838 patients had an abnormal result. Geriatric recommendations data were available for 5631 patients. Geriatric recommendations were made for 4459 patients. Geriatric interventions data were available for 4167 patients. A total of 12 384 geriatric recommendations were made. At least one different geriatric recommendation was implemented in 2874 patients. A dietician, social worker and geriatrician intervened most frequently for problems detected on the nutritional, social and functional domain. A total of 7569 actions were undertaken for a total of 5725 geriatric interventions, most frequently nutritional support and supplements, extended home care and psychological support. Conclusions This large-scale Belgian study focuses on the adherence to geriatric recommendations and subsequent actions undertaken and contributes to the optimal management of older patients with cancer. We identified the domains for which geriatric recommendations are most frequently made and adhered to, and which referrals to other health care workers and facilities are frequently applied in the multidisciplinary approach of older patients with cancer.
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Affiliation(s)
- C Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven
| | - L Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels
| | - J Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven; Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven
| | - P R Debruyne
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium; Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - I De Groof
- Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk
| | - C Focan
- Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liège
| | - F Cornélis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels
| | - V Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi
| | - C Bachmann
- Department of Geriatric Medicine, AZ Sint-Lucas, Gent
| | - D Bron
- Department of Hematology, ULB Institut Jules Bordet, Brussels
| | - S Luce
- Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels
| | - G Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron
| | | | - J-C Goeminne
- Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur
| | - D Schrijvers
- Department of Medical Oncology, ZNA Middelheim, Antwerp
| | - K Geboers
- Centre for Oncology and Hematology, AZ Turnhout, Turnhout
| | - B Petit
- Department of Medical Oncology, Centre Hospitalier Jolimont, La Louvière
| | - C Langenaeken
- Department Medical Oncology, Iridium Cancer Network Antwerp AZ Klina, Brasschaat
| | | | - P Specenier
- Department of Medical Oncology, University Hospital Antwerp, Antwerp
| | - G Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liège University, Liège
| | - J-P Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels
| | - K Vandenborre
- Department of Medical Oncology, AZ Vesalius, Tongeren
| | | | - M Lycke
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium; Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - K Milisen
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven; Department of Oncology, KU Leuven, Leuven, Belgium.
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De Breucker S, Luce S, Njemini R, Bautmans I, Decoster L, Mets T, Pepersack T. Analysis of inflammatory markers and hormones in old cancer patients: A descriptive study. Exp Gerontol 2019; 130:110787. [PMID: 31794851 DOI: 10.1016/j.exger.2019.110787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/19/2019] [Revised: 10/21/2019] [Accepted: 11/20/2019] [Indexed: 12/31/2022]
Abstract
Advanced cancers are associated with a chronic inflammation, especially high interleukin-6 (IL-6) and with various levels of adipokines (leptin and adiponectin), while ghrelin counteracts the anorexigenic effect of leptin in cancer-induced anorexia-cachexia syndrome. We aimed to understand how IL-6, adipokines and ghrelin plasma levels could be influenced by cancer on the one hand, and by age, frailty, and nutritional status in old cancer patients on the other hand. Ninety-nine patients aged 79[76-83] years old were included. Sixty-six percent had advanced stages of cancer, and 34% had cachexia. Fifty percent were at risk of malnutrition, and 10% had overt malnutrition. None of the variables studied was significantly correlated with the advanced stage, or cachexia. In multiple regression, the only parameter significantly and positively associated with age was adiponectin (p = 0.008). Despite a high prevalence of frailty in our study, we did not find any independent association of frailty (assessed by G8) with IL-6, leptin, adiponectin, or ghrelin in multivariate analysis. We observed that a low albumin level was independently associated with a higher level of IL-6 (p < 0.0001), but not with the MNA score. However, leptin showed a positive correlation with BMI (p < 0.0001), confirming the persistence of a relationship between leptin and adiposity, even in older cancer patients. Finally, high IL-6 level was associated with a higher mortality rate (p = 0.027). In conclusion, IL-6, leptin, adiponectin, and ghrelin are not associated with advanced stages of cancer or cancer-induced cachexia in older subjects with cancer, but they are significantly correlated with anthropometric factors and body composition.
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Affiliation(s)
- Sandra De Breucker
- Department of Geriatrics, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium.
| | - Sylvie Luce
- Department of Oncology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium.
| | - Rose Njemini
- Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
| | - Ivan Bautmans
- Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
| | - Tony Mets
- Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
| | - Thierry Pepersack
- Department of Medical Oncolgy, Oncogeriatric Unit, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 121, 1000 Brussels, Belgium.
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Peeters L, De Cock J, Kenis C, Wildiers H, Decoster L, Laethem L, Peters L, Olkuski L, Flamaing J, Lobelle J, Milisen K. RISK FACTORS FOR FALLS IN OLDER PERSONS WITH CANCER: A MULTICENTER STUDY. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31157-9] [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: 11/28/2022]
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Kenis C, Ponde N, Decoster L, de Azambuja E, Jerusalem G, Neven P, Dal Lago L, Denys H, Vuylsteke P, Duhoux F, Wildiers H. RIBOB: A study on the efficacy and safety of ribociclib in combination with letrozole in older women (≥70 years) with hormone receptor-positive (HR+) HER2-negative (HER2-) advanced breast cancer (aBC) with no prior systemic therapy for advanced disease. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.080] [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: 11/13/2022] Open
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de Filette JMK, Pen JJ, Decoster L, Vissers T, Bravenboer B, Van der Auwera BJ, Gorus FK, Roep BO, Aspeslagh S, Neyns B, Velkeniers B, Kharagjitsingh AV. Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review. Eur J Endocrinol 2019; 181:363-374. [PMID: 31330498 PMCID: PMC6709545 DOI: 10.1530/eje-19-0291] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To better define the rare adverse event (AE) of diabetes mellitus associated with immune checkpoint inhibitors (ICIs). DESIGN AND METHODS We report the case of a lung cancer patient with diabetic ketoacidosis (DKA) and autoimmune thyroiditis during pembrolizumab treatment. We provide a systematic review of all published cases (PubMed/Web of Science/Cochrane, through November 2018) of autoimmune diabetes mellitus related to blockade of the cytotoxic T-lymphocyte antigen 4 (CTLA-4)-, programmed cell death 1 (PD-1) receptor or its ligand (PD-L1) or combination (ICI) therapy. RESULTS Our literature search identified 90 patient cases (our case excluded). Most patients were treated with anti-PD-1 or anti-PD-L1 as monotherapy (79%) or in combination with CTLA-4 blockade (15%). On average, diabetes mellitus was diagnosed after 4.5 cycles; earlier for combination ICI at 2.7 cycles. Early-onset diabetes mellitus (after one or two cycles) was observed during all treatment regimens. Diabetic ketoacidosis was present in 71%, while elevated lipase levels were detected in 52% (13/25). Islet autoantibodies were positive in 53% of patients with a predominance of glutamic acid decarboxylase antibodies. Susceptible HLA genotypes were present in 65% (mostly DR4). Thyroid dysfunction was the most frequent other endocrine AE at 24% incidence in this patient population. CONCLUSION ICI-related diabetes mellitus is a rare but often life-threatening metabolic urgency of which health-care professionals and patients should be aware. Close monitoring of blood glucose and prompt endocrine investigation in case of hyperglycemia is advisable. Predisposing factors such as HLA genotype might explain why some individuals are at risk.
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Affiliation(s)
- Jeroen M K de Filette
- Department of Endocrinology, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Correspondence should be addressed to J M K de Filette;
| | - Joeri J Pen
- Diabetes Clinic, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Thomas Vissers
- Medical Library, Haaglanden Medical Center, Hague, The Netherlands
| | - Bert Bravenboer
- Department of Endocrinology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Frans K Gorus
- Diabetes Research Center, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart O Roep
- Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
- Department of Diabetes Immunology, Diabetes & Metabolism Research Institute, City of Hope, Duarte, California, USA
| | - Sandrine Aspeslagh
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Bart Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Brigitte Velkeniers
- Department of Endocrinology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Aan V Kharagjitsingh
- Department of Endocrinology, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Diabetes Clinic, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Diabetes Research Center, Vrije Universiteit Brussel, Brussels, Belgium
- Section Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Joris S, Fontaine C, Decoster L, Vanacker L, Schallier D, De Grève J. Retrospective comparison of two consecutive cohorts of adjuvant chemotherapy regimens of cyclophosphamide with either docetaxel or paclitaxel in older patients with early breast cancer. Breast J 2019; 25:663-666. [DOI: 10.1111/tbj.13306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Sofie Joris
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
| | - Christel Fontaine
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
| | - Leen Vanacker
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
| | - Denis Schallier
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
| | - Jacques De Grève
- Department of Medical Oncology, Oncologisch Centrum UZ Brussel Jette Belgium
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Decoster L, Schallier D. Treatment of older patients with advanced non-small cell lung cancer: A challenge. J Geriatr Oncol 2019; 10:528-533. [DOI: 10.1016/j.jgo.2018.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/27/2018] [Accepted: 09/19/2018] [Indexed: 01/06/2023]
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Fontaine C, Renard V, Van den Bulk H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, Vanacker L, de Azambuja E, De Greve J, Awada A, Wildiers H. Weekly carboplatin plus neoadjuvant anthracycline-taxane-based regimen in early triple-negative breast cancer: a prospective phase II trial by the Breast Cancer Task Force of the Belgian Society of Medical Oncology (BSMO). Breast Cancer Res Treat 2019; 176:607-615. [PMID: 31069589 DOI: 10.1007/s10549-019-05259-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/26/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the pCR rate and toxicity of the addition of weekly carboplatin (Cp) to paclitaxel (wP) and dose-dense (dd) epirubicin/cyclophosphamide (EC) in an open-label phase II study in TNBC patients. METHODS Patients were included if they had stage II and III TNBC and received wP (80 mg/m2/week) concurrent with weekly Cp (AUC = 2) for 12 weeks, followed by bi-weekly epirubicin (90 mg/m2) and cyclophosphamide (600 mg/m2) plus granulocyte colony-stimulating factor (G-CSF) for four cycles, followed by surgery. The primary endpoint was the rate of pCR [(ypT0/isypN0)]. Secondary endpoints included safety and drug delivery. RESULTS Sixty-three eligible patients were included. Median age was 51 years (range 29-74); 88.9% had stage II disease, 46% were clinically node positive, and 77.8% had grade 3 tumors. Fifty-four percent achieved a pCR. Twelve percent missed two or more doses of wP, whereas at least two cycles of EC were missed in 9.5%. The rate of tolerance without delays or dose reductions is very low (16%). Sixty-two percent had G3/4 neutropenia. Febrile neutropenia occurred in 18 patients of which more than eighty percent occurred during EC despite primary prophylaxis with G-CSF. Thrombocytopenia grade 3/4 was noticed in 11 pts. Three patients developed grade 3 peripheral neuropathy. CONCLUSION The addition of weekly carboplatin to neoadjuvant paclitaxel and dd EC leads to a pCR rate comparable to prior studies (54%). However, hematological toxicity and febrile neutropenia rate was unexpectedly high. Future investigations could focus on reversing the sequence, which may lead to better hematological tolerability.
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Affiliation(s)
- Christel Fontaine
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium.
| | - Vincent Renard
- Medical Oncology Department, AZ Sint-Lucas, Ghent, Belgium
| | | | | | - Philip Glorieux
- Medical Oncology Department, Cliniques Sud-Luxembourg, Virton, Belgium
| | | | - Lore Decoster
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Leen Vanacker
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Evandro de Azambuja
- Medical Oncology Department, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Jacques De Greve
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Ahmad Awada
- Medical Oncology Department, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology and Department of Oncology, University Hospitals Leuven, Louvain, Belgium
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Keyaerts M, Xavier C, Everaert H, Vaneycken I, Fontaine C, Decoster L, Vanhoeij M, Caveliers V, Lahoutte T. Phase II trial of HER2-PET/CT using 68Ga-anti-HER2 VHH1 for characterization of HER2 presence in brain metastases of breast cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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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Fontaine C, Van den Eynden G, de Wind R, Boisson A, Renard V, Van den Bulck H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, De Grève J, Awada A, Wildiers H, Willard-Gallo K. Abstract P2-08-47: Evaluation of stromal tumor-infiltrating lymphocytes (sTIL) and tertiary lymphoid structures (TLS) in early breast cancer patients with triple negative breast cancer(TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with Epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BSMO 2014-01 is a completed prospective phase 2 study evaluating the efficacy of neoadjuvant EC and PC. One of the secondary endpoints was the correlation of sTIL with response, pCR and survival. We also assessed the relationship between sTIL and TLS in the diagnostic biopsies.
Methods: Stromal TIL (sTIL) were evaluated on H&E stained tumor biopsies before the start of the NAC according to the criteria described by Salgado et al(1). Scores were defined as "low" or "high" if lymphocytic infiltration in the stroma around the tumor was ≤ 10% or > 10%. TLS are ectopic lymph node-like structures recently identified in breast cancer. TLS were counted using a dual IHC stain for CD3 (T cells) and CD20 (B cells) and categorized as "little" if the TLS occupied < 10% or "moderate to abundant" if they occupied ≥ 10% of the adjacent tissue. The correlation between sTIL and pathologic parameters was analyzed using the chi-square test; DFS and OS between the groups was estimated by using the log-rank test.
Results: So far we could quantify the number of sTIL in 38 out of 63 TNBC pts treated with neoadjuvant EC-PC. Twenty eight pts had a high sTIL score and 10 pts had a low sTIL score. The high-sTIL group (19/28) achieved a numerical higher pathologic complete remission (pCR) rate than the low-sTIL group (5/10) (p=0.3); both groups had a comparable disease free survival of 28.6 mths and 26.7 mths respectively (p=0.7). The overall survival was similar:29 mths and 27.8 mths respectively (p=0.8). Stromal TLS were identified in 10 out 23 samples available for this analysis and we could demonstrate a positive correlation between high levels of sTIL and high levels of moderate to abundant TLS(CD3) in the adjacent tissue in six out of the ten samples in which TLS were present (p=0.1).
Conclusion: These preliminary results could not confirm the results published by Denkert et al earlier this year(2). A trend for correlation of the presence of high sTIL with moderate to abundant levels of TLS was found. Analysis on the remaining samples of all patients included in the study and correlation with outcome is ongoing and these completed results will be presented.
(1)Assessing Tumor-infiltrating lymphocytes in solid tumors. Hendry S, Salgado R et al. Adv Anat Pathol 2017; 235-251.
(2)Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer. Denkert C et al. Lancet Oncol 2018; 40-50.
Citation Format: Fontaine C, Van den Eynden G, de Wind R, Boisson A, Renard V, Van den Bulck H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, De Grève J, Awada A, Wildiers H, Willard-Gallo K. Evaluation of stromal tumor-infiltrating lymphocytes (sTIL) and tertiary lymphoid structures (TLS) in early breast cancer patients with triple negative breast cancer(TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with Epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-47.
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Affiliation(s)
- C Fontaine
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - G Van den Eynden
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - R de Wind
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - A Boisson
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - V Renard
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - H Van den Bulck
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - P Vuylsteke
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - P Glorieux
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - C Dopchie
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - L Decoster
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - J De Grève
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - A Awada
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - H Wildiers
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - K Willard-Gallo
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
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Quinten C, Kenis C, Decoster L, Debruyne PR, De Groof I, Focan C, Cornelis F, Verschaeve V, Bachmann C, Bron D, Luce S, Debugne G, Van den Bulck H, Goeminne JC, Baitar A, Geboers K, Petit B, Langenaeken C, Van Rijswijk R, Specenier P, Jerusalem G, Praet JP, Vandenborre K, Lycke M, Flamaing J, Milisen K, Lobelle JP, Wildiers H. Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery. Qual Life Res 2018; 28:663-676. [PMID: 30511255 DOI: 10.1007/s11136-018-2062-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
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Affiliation(s)
- C Quinten
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, Leuven, Belgium. .,Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - C Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - L Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - P R Debruyne
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - I De Groof
- Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium
| | - C Focan
- Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liege, Belgium
| | - F Cornelis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium
| | - V Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium
| | - C Bachmann
- Department of Geriatric Medicine, AZ Sint-Lucas, Ghent, Belgium
| | - D Bron
- Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium
| | - S Luce
- Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - G Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | - H Van den Bulck
- Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium
| | - J C Goeminne
- Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur, Belgium
| | - A Baitar
- Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - K Geboers
- Centre for Oncology and Hematology, AZ Turnhout, Turnhout, Belgium
| | - B Petit
- Department of Medical Oncology, Centre Hospitalier Jolimon, La Louvière, Belgium
| | - C Langenaeken
- Department of Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium
| | - R Van Rijswijk
- Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium
| | - P Specenier
- Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - G Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium
| | - J P Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium
| | - K Vandenborre
- Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium
| | - M Lycke
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - J Flamaing
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven, Belgium
| | - K Milisen
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | | | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
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Kenis C, Baitar A, Decoster L, De Grève J, Lobelle JP, Flamaing J, Milisen K, Wildiers H. The added value of geriatric screening and assessment for predicting overall survival in older patients with cancer. Cancer 2018; 124:3753-3763. [DOI: 10.1002/cncr.31581] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/22/2018] [Accepted: 03/14/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Cindy Kenis
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
| | | | - Lore Decoster
- Department of Medical Oncology, Oncology Center, University Hospital Brussels; Vrije Universiteit Brussel; Brussels Belgium
| | - Jacques De Grève
- Department of Medical Oncology, Oncology Center, University Hospital Brussels; Vrije Universiteit Brussel; Brussels Belgium
| | | | - Johan Flamaing
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
- Department of Chronic Diseases, Metabolism, and Aging; Catholic University of Leuven; Leuven Belgium
| | - Koen Milisen
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
- Department of Public Health and Primary Care, Health Services and Nursing Research; Catholic University of Leuven; Leuven Belgium
| | - Hans Wildiers
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
- Department of Oncology; Catholic University of Leuven; Leuven Belgium
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Baitar A, Kenis C, Decoster L, De Grève J, Lobelle JP, Flamaing J, Milisen K, Wildiers H. The prognostic value of 3 commonly measured blood parameters and geriatric assessment to predict overall survival in addition to clinical information in older patients with cancer. Cancer 2018; 124:3764-3775. [DOI: 10.1002/cncr.31580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/23/2018] [Accepted: 03/12/2018] [Indexed: 12/20/2022]
Affiliation(s)
| | - Cindy Kenis
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
| | - Lore Decoster
- Department of Medical Oncology; Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel; Brussels Belgium
| | - Jacques De Grève
- Department of Medical Oncology; Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel; Brussels Belgium
| | | | - Johan Flamaing
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
- Department of Clinical and Experimental Medicine; KU Leuven; Leuven Belgium
| | - Koen Milisen
- Department of Geriatric Medicine; University Hospitals Leuven; Leuven Belgium
- Department of Public Health and Primary Care; Health Services and Nursing Research, KU Leuven; Leuven Belgium
| | - Hans Wildiers
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
- Department of Oncology; KU Leuven; Leuven Belgium
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48
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Decoster L, Fontaine C, Vanacker L, Schallier D, De Grève J. Docetaxel/cyclophosphamide chemotherapy in older patients with breast cancer. Breast J 2018; 24:695-697. [DOI: 10.1111/tbj.12990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Lore Decoster
- Department of Medical Oncology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis Brussel (UZ Brussel); Oncologisch Centrum; Brussel Belgium
| | - Christel Fontaine
- Department of Medical Oncology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis Brussel (UZ Brussel); Oncologisch Centrum; Brussel Belgium
| | - Leen Vanacker
- Department of Medical Oncology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis Brussel (UZ Brussel); Oncologisch Centrum; Brussel Belgium
| | - Denis Schallier
- Department of Medical Oncology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis Brussel (UZ Brussel); Oncologisch Centrum; Brussel Belgium
| | - Jacques De Grève
- Department of Medical Oncology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis Brussel (UZ Brussel); Oncologisch Centrum; Brussel Belgium
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49
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Decoster L, Cappoen N, Aftimos PG, Raicevic G, Rolfo CD, Rottey S, Duhoux FP, Collignon J, Hebrant A, Vandenbulcke M, De Greve J. An explorative phase 2 study of afatinib for advanced cancers carrying an EGFR, a HER2 or a HER3 mutation: A Precision trial of the Belgian Society of Medical Oncology. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Philippe Georges Aftimos
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Sylvie Rottey
- Ghent University Hospital, Heymans Institute of Pharmacology, Ghent, Belgium
| | - Francois P. Duhoux
- Department of Medical Oncology, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique (Pôle MIRO), Université Catholique de Louvain, Brussels, Belgium
| | | | - Aline Hebrant
- Wetenschappelijk Instituut Volksgezondheid België, Brussels, Belgium
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50
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Decoster L, Quinten C, Kenis C, Flamaing J, Debruyne PR, DeGroof I, Focan CNJ, Cornelis F, Verschaeve V, Bachmann C, Bron D, Luce S, Debugne G, Van Den Bulck H, Goeminne JC, Schrijvers DL, Lobelle JP, Lycke M, Milisen K, Wildiers H. Quality of life (QoL) in older patients (pts) with cancer and prognostic factors for QoL decline. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Chantal Quinten
- European Center for Disease Prevention and Control, Surveillance and Response Support Epidemiological Methods Unit, Stockholm, Sweden
| | - Cindy Kenis
- Department of General Medical Oncology Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
| | | | | | - C. N. J. Focan
- Department of Oncology, Centre Hospitalier Chrétien, Clinique Saint-Joseph, Liege, Belgium
| | | | | | | | | | - Sylvie Luce
- University Hospital Erasme, Brussels, Belgium
| | | | | | | | | | | | | | - Koen Milisen
- Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
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