First-line treatment in metastatic clear cell renal cell carcinoma: from active surveillance to immunotherapy-based combinations

Ilektra Iakovidou (1), Grégoire Desimpel (1), Damien Hoolans (1), Marco Gizzi (2), Julien Van Damme (3), Bertrand Tombal (3), Emmanuel Seront (1) Published in the journal : December 2024 Category : Oncologie médicale

Metastatic clear cell renal cell carcinoma (ccRCC) is a major challenge for clinicians. Although immunotherapy has revolutionized the management of patients with ccRCC, responses remain inconsistent and often transient, ultimately leading to therapeutic resistance. As a result, new strategies have been developed involving novel molecules with innovative mechanisms of action. This review sheds light on the pathogenic mechanisms and the advances in therapeutic strategies for metastatic ccRCC.

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Innovations in 2023 in Medical Oncology

Emmanuel Seront1, Cédric Van Marcke1, Paulina Bartoszek4, Stéphanie van Raemdonck2, Louise Favaretto2, Laura Krolikowska3, Frank Cornélis1, Jean-François Baurain1 Published in the journal : February 2024 Category : Oncologie médicale

The year 2023 witnessed a significant revolution in oncology, marked by the emergence of new anti-cancer molecules and innovative strategies.

Antibody conjugates have considerably improved patient survival in numerous cancer types. These treatments are likely to play a key role in advanced-stage disease of urothelial cancers and in several breast cancer types as well, including triple-negative, HER2-positive, and a new entity known as “HER2 weak”.

Considering renal cancer, targeting the HIF transcription factor by means of a targeted therapy that inhibits not only angiogenesis, but also various survival pathways, looks rather promising. This novel therapeutic strategy can be administered either as a single agent or in combination.

Uveal melanoma is the most common primary malignant intraocular tumor. Despite the efficacy of local treatments, half of all affected patients experience extra-ocular recurrence, with liver involvement observed in 90% of them. Median survival for patients with metastatic disease has been proven to range between 6 and 12 months. Targeted treatments, such as thermo-ablation or surgery, likely improve the prognosis of patients with single-site recurrences. Chemotherapy is not very effective. Treatment with immune checkpoint inhibitors, such as anti-PD-1 antibodies, only modestly increases overall survival in metastatic disease patients. Tebentafusp, a new form of immunotherapy, is the first molecule to demonstrate a real improvement in overall survival of metastatic patients. Tebentafusp is a T-cell receptor coupled with an anti-CD3 antibody, being able to transform all lymphocytes into anti-melanocyte lymphocytes. Nevertheless, only patients with an HLA-A*02:01 allele, meaning 50% of Caucasians, are likely to benefit from this therapeutic innovation.

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The role of immunotherapy in urothelial cancers

Hélène Houssiau MD1, Emmanuel Seront MD PhD1 Published in the journal : March 2022 Category : Oncologie médicale

Immune checkpoint inhibitors (ICIs) have significantly improved the outcome of patients with urothelial cancer. Several ICIs are currently approved in Belgium, such as pembrolizumab, avelumab, atezolizumab, and nivolumab. These ICIs were first evaluated in the metastatic setting, following failure of platinum-based chemotherapy. New strategies have been evaluated over the last years, including ICI plus chemotherapy, ICI monotherapy, or maintenance therapy, referring to introducing ICI after chemotherapy without waiting for disease progression. Other clinical trials are currently ongoing, which evaluate ICI in perioperative setting, be it neoadjuvant or adjuvant. This paper sought to review the current knowledge concerning ICIs in urothelial carcinoma, in addition to the new indications of these agents in this specific domain.

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ONCOVID, or how not to harm

Alice Kalantari, Jean-Pascal Machiels, Cédric Van Marcke Published in the journal : May 2020 Category : Oncologie médicale

The management of oncology patients during a pandemic is a challenge on several levels. We have never faced before a pandemic of this magnitude, especially in the era of advanced medicine that uses many immunosuppressive or immunomodulating drugs.

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