Julien Van Damme1, Bertrand Tombal1, Marco Gizzi2,3, Sandy Van Nieuwenhove4, Vassiliki Pasoglou4, Guillaume Grisay2,5, Emmanuel Seront2Published in the journal : March 2025Category : Urology
The standard treatment for non-metastatic muscle-invasive bladder cancer is neoadjuvant systemic chemotherapy followed by cystectomy or radiochemotherapy, regardless of the extent of tumor response. Recent studies have questioned the relevance of local treatment in cases of complete clinical response after systemic therapy. De-escalation strategies are limited by the poor correlation between clinical assessment of tumor response and the final pathology results from radical cystectomy specimens. Therefore, there is significant interest in developing and validating a multimodal signature to improve the prediction of response to systemic treatment using several available tools: cystoscopy with biopsies, multiparametric bladder MRI, quantification of circulating and urinary tumor DNA, and evaluation of urinary biomarkers. A more accurate assessment of tumor response to initial systemic treatment could help inform patients when choosing between standard treatment and a risk-adapted strategy: bladder-sparing procedures (clinical surveillance or intravesical treatments) for responders and immediate escalation of systemic therapy without local treatment for non-responders
Francesco Natalucci, Cecile Van Mullem, Stephanie Dierckx, Clément Triaille, Alexandra Avramovska, Tatiana Sokolova, Farah Tamirou, Frédéric Houssiau, Patrick DurezPublished in the journal : March 2025Category : Rheumatology
Recent advances in rheumatology reflect a shift toward early and personalized management of inflammatory and autoimmune diseases. In inflammatory rheumatic diseases, the advent of the ever-evolving Janus kinase (JAK) inhibitors represents a major breakthrough for 2024. By targeting the JAK-STAT pathway, these oral agents complement the current therapeutic armamentarium with a promising efficacy and tolerability profile.
In the field of systemic rheumatic diseases, particularly systemic lupus erythematosus, new recommendations encourage the early use of targeted therapies such as belimumab and anifrolumab, complemented by innovative approaches (CAR-T cells and bispecific antibodies) that offer promising prospects for deeper B-cell depletion and induce sustained remissions.
Finally, in rheumatoid arthritis, optimal patient management – from early to difficult-to-treat forms – relies on accurate identification of prognostic factors (seropositivity, bone erosions, comorbidities) and rapid therapeutic intervention aimed at reducing glucocorticoid exposure and improving treatment efficacy.
Taken together, these innovations illustrate the emergence of precision medicine in rheumatology, with the potential to sustainably improve patient prognosis and quality of life.
Ad Vandermeulen, Julien Pierrard, Sofie Heylen, Geneviève Van OoteghemPublished in the journal : March 2025Category : Radiothérapie
Innovations in radiotherapy have led to the optimization of oncology treatments by improving precision and exploring new therapeutic strategies. Three major advances illustrate this evolution in 2024.
First, online adaptive radiotherapy for rectal cancer allows treatment to be adjusted in real-time based on the patient’s daily anatomical variations. This technology, which has been available at the Cliniques universitaires Saint-Luc since 2021, reduces safety margins and enhances tumor boost delivery, thereby increasing complete response rates while minimizing toxicity.
Second, stereotactic ablative radiotherapy for kidney cancer offers a non-invasive alternative for patients who are ineligible for surgery. Thanks to high, precise radiation doses, this approach ensures optimal local control with minimal impact on renal function. The results of the FASTRACK II study confirm the efficacy and safety of this technique, which is now an integral part of clinical practice at the Cliniques universitaires Saint-Luc.
Finally, preoperative immunomodulatory radiotherapy in colorectal cancer aims to modify the tumor microenvironment to improve the response to immunotherapy. An experimental protocol initiated in 2023 is evaluating the impact of specific doses of radiotherapy on tumor immunity and the feasibility of surgical resection.
Bastien Camiola1,4, Viviana-Elena Tesinschi1,4, Sami Bou Saba1,4, Selena Toma1,4, Elin Malek2,4, Alexander Gerdom3,4Published in the journal : March 2025Category : Orthodontie et parodontologie
Cleft lip and palate are frequent congenital malformations, posing a surgical challenge, particularly for the correction of nasal deformity. Nasoalveolar Molding (NAM) is a pre-surgical orthopedic technique designed to improve anatomical relationships prior to surgery. By progressively realigning the labial and maxillary segments while reshaping the nasal cartilage, NAM reduces cleft width and optimizes primary surgery. This approach improves nasolabial esthetics, reduces tissue tension, and minimizes the need for secondary corrections. However, it remains demanding for clinicians and families. The emergence of digital technologies and artificial intelligence opens up new prospects for optimizing and facilitating this treatment.
Eléonore Longton1,5, Rachel Galot2,5, Jean-Pascal Machiels2,5, Michèle Magremanne3,5, Sandra Schmitz4,5Published in the journal : March 2025Category : Oncologie
Head and neck cancer requires multidisciplinary management, involving physicians and paramedical professionals. In 2024, the Department of Head and Neck Oncology introduced monthly meetings that bring together these different experts to ensure comprehensive, personalized care for each patient. This approach promotes better treatment adherence while improving patients' quality of life.
The cIMPACT-NOW 8 (2024) update refines meningioma classification by incorporating copy number variations (CNV) and reconsidering brain invasion, whose presence alone is no longer sufficient for Grade 2 classification. 1p loss with 22q deletion warrants Grade 2, while additional genetic alterations improve risk stratification. Some biomarkers remain under investigation, and molecular classification may guide patient selection for radiotherapy and targeted therapies.
Jean-Louis Bayart1-4, Lise Colmant2,5, Emilien Boyer2, Lara Huyghe2, Lisa Quenon2,5, Thomas Gerard2,6, Pascal Kienlen-Campard2, Renaud Lhommel2,6, Adrian Ivaniou2,5, Jonathan Douxfils3, Bernard Hanseeuw2,5Published in the journal : March 2025Category : Neurology
Alzheimer’s disease is characterized by the accumulation of amyloid plaques and neurofibrillary tangles of tau protein. Current biomarkers measured by imaging or in the cerebrospinal fluid have improved diagnosis, but these methods remain costly and/or invasive. Blood biomarkers, particularly p-tau217, are attracting increasing interest. A study conducted by IoNS (UCLouvain) validated the plasma p-tau217 assay in more than 200 patients, showing an average increase of 450% in patients with amyloidopathy, with a sensitivity of 95% and a specificity of 94% to distinguish patients with amyloidopathy and tauopathy from those without. This test is reserved for patients with objective cognitive impairment and is not intended for mass screening, as there is currently no preventive treatment. It is essential to account for potential confounding factors (renal insufficiency, stroke, recent head trauma). Finally, p-tau217 could help identify patients eligible for new treatments in the pipeline for approval in the near future, such as lecanemab.
Nathalie Demoulin, Mohamed Amine El Kesri, Elliott Van Regemorter, Guillaume Fernandes, Ines Dufour, Valentine Gillion, Laura Labriola, Michel Jadoul, Eric Goffin, Arnaud Devresse, Nada KanaanPublished in the journal : March 2025Category : Nephrology
The year 2024 saw significant advances in the therapeutic management of patients with IgA nephropathy. Strict control of proteinuria is essential to slow down the progression to kidney failure. The first immunomodulatory agent to target the pathogenesis of IgA nephropathy is now available in Belgium, and promising new targeted therapies are being investigated. In kidney transplantation, the prophylaxis and treatment of CMV disease have benefited from the advent of new drugs. Since March 2024, maribavir has been reimbursed in Belgium for the treatment of refractory or resistant CMV disease, or in cases of intolerance to treatment due to myelotoxicity or nephrotoxicity.
The fight against the human immunodeficiency virus (HIV) has made great progress since its beginnings but remains a major current medical, scientific, and societal challenge. Adherence to daily medication intake among treated patients is sometimes imperfect. Lenacapavir is a new antiretroviral with a new action mechanism and very long duration of action. Thus, it is a promising new tool in this fight, particularly in pre-exposure prophylaxis of HIV infection.
Anja Kerschen1,2,3, Etienne Danse4, Jessica Vanhaebost1,2,3, Grégory Schmit1,2,3Published in the journal : March 2025Category : Médecine forensique
The year 2024 was full of events for the forensic medicine department at the Cliniques universitaires Saint-Luc. Thanks to government funding aimed at creating regional forensic institutes, we were able to strengthen the department’s team. Improvements to the autopsy room and morgue infrastructure are also planned in the next few months. Through this article, we would like to share with you this new chapter for our department and our recent scientific advancements, particularly in the field of forensic imaging.