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4 results on '"Lore Decoster"'

1. Is cancer biology different in older patients?

Author

Yannick Van Herck, MD, Annelies Feyaerts, MD, Shabbir Alibhai, ProfMD, Demetris Papamichael, MBBS, Lore Decoster, MD, Yentl Lambrechts, Michael Pinchuk, Oliver Bechter, MD, Jaime Herrera-Caceres, MD, Frédéric Bibeau, MD, Christine Desmedt, PhD, Sigrid Hatse, PhD, and Hans Wildiers, ProfPhD

Subjects
Geriatrics, RC952-954.6, Medicine
Abstract

Summary: Roughly 50% of cancer cases occur in people aged 65 years or older. Older people are often diagnosed at a later stage and might receive less (intensive) treatment, which might affect the outcome. In addition, an older age might be associated with biological differences in tumour and microenvironment behaviour, a domain that has been poorly studied so far. In this narrative Review of published literature, we explored the reported differences in tumour biology according to age in five major cancer types: breast, colorectal, prostate, lung, and melanoma. Our literature search uncovered clear differences in tumour histology and subtype distribution in older people compared with younger patients, as well as age-specific patterns of tumour mutations and other molecular alterations. Several studies also indicate notable changes in tumour-infiltrating immune cells in tumours of older versus younger people, although this research is still in its infancy. More research is needed and might lead to a better understanding of the biology of ageing in relation to malignancy. This knowledge could provide new perspectives for more personalised cancer treatments, eventually improving the global outcomes of older patients with cancer.

Published
2021
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2. 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

Author

Lore Decoster, Hendrik Everaert, Bart Ilsen, Karolien Vekens, Bart Neyns, Laboratory for Medical and Molecular Oncology, Medical Oncology, Pneumology, Supporting clinical sciences, Medical Imaging, Nuclear Medicine, Clinical sciences, Laboratory of Molecullar and Cellular Therapy, Medicine and Pharmacy academic/administration, and Radiology

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Cancer Research, medicine.medical_treatment, FDG PET biomarkers, Standardized uptake value, Immune checkpoint inhibitor, Metabolic tumor burden, 03 medical and health sciences, 0302 clinical medicine, Response prediction, Medicine, Lung cancer, medicine.diagnostic_test, business.industry, Immunotherapy, medicine.disease, Confidence interval, 030104 developmental biology, Response Evaluation Criteria in Solid Tumors, Positron emission tomography, Radiology Nuclear Medicine and imaging, 030220 oncology & carcinogenesis, oncology, Immunohistochemistry, advanced lung cancer, Fdg pet ct, business, Nuclear medicine
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.

Published
2021

3. Unplanned hospitalizations in older patients with cancer: Occurrence and predictive factors

Author

Elke Lodewijckx, Heidi Van den Bulck, Cindy Kenis, Pol Specenier, Guy Jerusalem, Katrien Geboers, Christine Langenaeken, B. Petit, Christian Focan, Inge De Groof, Ruud Van Rijswijk, Dirk Schrijvers, Johan Flamaing, Jean-Charles Goeminne, Gwenaëlle Debugne, Frank Cornelis, K. Vandenborre, J.-P. Praet, Jean-Pierre Lobele, Koen Milisen, Philip R. Debruyne, Dominique Bron, Vincent Verschaeve, Lore Decoster, Sylvie Luce, Christian Bachmann, Hans Wildiers, Faculty of Medicine and Pharmacy, Faculty of Economic and Social Sciences and Solvay Business School, Clinical sciences, Medical Oncology, Laboratory for Medical and Molecular Oncology, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'oncologie médicale

Subjects
medicine.medical_specialty, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Older patients, Belgium, Internal medicine, Neoplasms, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Geriatric Assessment, Aged, Cancer, Related factors, business.industry, Geriatric assessment, medicine.disease, Current analysis, Hospitalization, 030220 oncology & carcinogenesis, oncology, Female, Human medicine, Geriatrics and Gerontology, business, Cohort study
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

Published
2021

4. The prognostic value of patient-reported Health-Related Quality of Life and Geriatric Assessment in predicting early death in 6769 older (≥ 70 years) patients with different cancer tumors

Author

Johan Flamaing, Dominique Bron, B. Petit, Vincent Verschaeve, K. Vandenborre, Philip R. Debruyne, Heidi Van den Bulck, Frank Cornelis, Christine Langenaeken, Guy Jerusalem, Dirk Schrijvers, Chantal Quinten, J.-P. Praet, Michelle Lycke, Ruud Van Rijswijk, Cindy Kenis, Jean-Charles Goeminne, Hans Wildiers, Syvlie Luce, Lore Decoster, Christian Bachmann, Inge De Groof, Jean-Pierre Lobelle, Pol Specenier, Katrien Geboers, Gwenaëlle Debugne, Christian Focan, Koen Milisen, UCL - (MGD) Service d'oncologie médicale, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (SLuc) Unité d'oncologie médicale, Clinical sciences, Medical Oncology, Laboratory for Medical and Molecular Oncology, and Faculty of Economic and Social Sciences and Solvay Business School

Subjects
Male, medicine.medical_specialty, MEDLINE, Logistic regression, elderly, Odds, 03 medical and health sciences, 0302 clinical medicine, cancer tumors, Quality of life, early death, Internal medicine, Statistical significance, Neoplasms, medicine, Humans, 030212 general & internal medicine, Patient Reported Outcome Measures, Geriatric Assessment, patient-reported Health-Related Quality of Life, Aged, business.industry, Cancer, Odds ratio, medicine.disease, Prognosis, Confidence interval, PROGNOSTIC VALUE, Oncology, 030220 oncology & carcinogenesis, Quality of Life, Female, Human medicine, Geriatrics and Gerontology, Prediction, business
Abstract

Objectives: We aimed to determine the prognostic value of baseline Health-Related Quality Of Life (HRQOL) and geriatric assessment (GA) to predict three-month mortality in older patients with cancer undergoing treatment. Methods: Logistic regressions analysed HRQOL, as measured with the EORTC Global Health Status (GHS) scale, and geriatric information prognostic for early mortality controlling for oncology variables. The assessment was established with the odds ratio (OR), 95% confidence interval (CI) and level of significance set at p < 0.05. Discriminative power was evaluated with area under the curve (AUC). Results: In total, 6769 patients were included in the study, of whom 1259 (18.60%) died at three months. Our model showed higher odds of early death for patients with lower HRQOL (GHS, OR 0.98, 95% CI 0.98-0.99; p < 0.001), a geriatric risk profile (G8 Screening Tool, 1.94, 1.14-3.29; p = 0.014), cognitive decline (Mini Mental State Examination, 1.41, 1.15-1.72; p 0.001), being at risk for malnutrition (Mini Nutritional Assessment-Short Form, 1.54, 1.21-1.98; p = 0.001), fatigue (Visual Analogue Scale for Fatigue, 1.45, 1.16-1.82; p = 0.012) and comorbidities (Charlson Comorbidity index, 1.23, 1.02-1.49: p = 0.033). Additionally, older age, poor ECOG PS and being male increased the odds of early death, although the magnitude differed depending on tumor site and stage, and treatment (all p < 0.05). Predictive accuracy increased with 3.7% when including HRQOL and GA in the model. Conclusion: The results suggest that, in addition to traditional clinical measures, HRQOL and GA provide additional prognostic information for early death, but the odds differ by patient and tumor characteristics. (C) 2020 Elsevier Ltd. All rights reserved.

Published
2020

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