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Journal of the National Comprehensive Cancer Network: JNCCN

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https://www.readbyqxmd.com/read/28515262/smoking-cessation-in-patients-with-cancer-treatment-advances-and-the-oncologist-s-role
#1
Paul Cinciripini
The harms of smoking cigarettes are well-known, and the benefits of smoking cessation are well-established. Smoking cessation is especially important for patients with cancer, because smoking compromises the effects of cancer treatment and shortens survival. Interventions to achieve tobacco abstinence include pharmacotherapy and counseling, and these often must be repeated. Patients should be encouraged at every juncture to continue attempts to stop smoking.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515261/life-after-treatment-quality-of-life-concerns-in-patients-treated-for-cancer
#2
Mindy E Goldman
Traditionally, the physical, psychological, and psychosocial long-term needs of cancer survivors have received little attention compared with screening for cancer recurrence and secondary cancers. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Survivorship offer recommendations for various survivorship concerns, and those for improving menopausal symptoms were presented at the NCCN 22nd Annual Conference. Key considerations in managing menopausal symptoms in cancer survivors were reviewed, with chemotherapy-induced amenorrhea, fertility concerns, and both hormonal and nonhormonal therapeutic options featured...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515260/multigene-testing-for-hereditary-cancer-when-why-and-how
#3
Kenneth Offit
Multigene testing is a complicated area, with advantages and disadvantages of testing for hereditary cancer syndromes. Currently, NCCN does not endorse routing multiplex testing outside of a research setting, and/or intensive genetic counseling regarding risks and benefits. The 2017 NCCN Clinical Practice Guidelines in Oncology for Genetic/Familial High-Risk Assessment: Breast and Ovarian and Colorectal provide suggestions for mutation carriers identified by panel tests.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515259/novel-treatment-options-for-neuroendocrine-tumors
#4
Matthew H Kulke
Neuroendocrine tumors (NETs) are not as rare as once thought, with a current prevalence that is estimated to be higher than that of many other gastrointestinal tumors. Multiple treatment options are available for these tumors, which are categorized according to their histology and site of origin. For patients with metastatic disease, somatostatin analogues are often the initial treatment, with other options considered when these drugs fail.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515258/evolving-treatment-of-soft-tissue-sarcoma
#5
Suzanne George
Soft tissue sarcomas comprise multiple histologic subtypes, occur at a number of anatomic sites, and require individualized treatment. Over the past 5 years, 4 new drugs were approved for sarcoma, most of which are driven by histology or the anticipated response to treatment. Surgical resection remains the primary treatment for resectable tumors. For unresectable or metastatic disease, doxorubicin remains the backbone of chemotherapy, but other agents have improved on its single-agent efficacy. Chief among them is olaratumab, which, in combination with doxorubicin, is preferred over doxorubicin alone in the updated NCCN Clinical Practice Guidelines in Oncology for Soft Tissue Sarcoma...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515257/minimally-invasive-techniques-for-treating-gynecologic-malignancies
#6
Amanda N Fader
For many women with endometrial and cervical cancers, minimally invasive surgery represents an alternative standard of care to open abdominal procedures, with fewer complications, better postoperative quality of life, and overall lower cost. At the NCCN 22nd Annual Conference, Amanda N. Fader, MD, reviewed several minimally invasive strategies for treating gynecologic cancers, including conventional laparoscopy, robotic-assisted laparoscopy, sentinel lymph node technology, and single-port surgery; highlighted some of the contemporary literature on the role of these procedures; and explored some of the challenges and barriers to their successful performance...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515256/opportunities-and-challenges-human-papillomavirus-and-cancer
#7
Christina S Chu, David G Pfister
Mucosal exposure to human papillomavirus (HPV) can lead to anogenital and head and neck (H&N) cancer. Vaccination at a young age can be almost 100% effective in preventing HPV infection with the viral subtypes in both men and women, at least for disease in the anogenital tract. Therapeutic strategies targeting HPV in cervical dysplasia and cancer are showing promise as well in regressing dysplasia and controlling disease. That HPV-positive H&N cancer is a different disease from HPV-negative disease, with different molecular and clinical features and prognosis, is becoming better appreciated...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515255/active-systemic-treatment-of-pancreatic-cancer
#8
Margaret Tempero
By 2020, pancreatic cancer is expected to be the second most common cause of cancer-related death, exceeded only by lung cancer. During her presentation at the NCCN 22nd Annual Conference, Dr. Margaret Tempero offered an update on the current state of systemic treatment of pancreatic cancer, focusing on resectable/borderline resectable, locally advanced, and metastatic disease.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515254/nccn-debuts-new-guidelines-for-myeloproliferative-neoplasms
#9
Ruben A Mesa
For the first time, NCCN has published guidelines specifically geared toward treating myeloproliferative neoplasms (MPNs). The first set of guidelines was developed for myelofibrosis (MF), and was presented at the NCCN 22nd Annual Conference. Future guidelines will be issued for polycythemia vera, essential thrombocytopenia, and atypical MPNs. Patients with MF can have an unpredictable course, one that is largely dependent on the presence of certain molecular alterations. Models are currently emerging that take into account molecular factors...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515253/strategies-for-management-of-relapsed-or-refractory-hodgkin-lymphoma
#10
Leo I Gordon
The advent of effective therapies has improved outcomes for those with newly diagnosed Hodgkin lymphoma (HL), with a resulting cure rate of at least 80%. However, with limited data on therapeutic options in the setting of advanced disease, individualized treatment is recommended, and potential long-term effects of therapy remain a key consideration. At the NCCN 22nd Annual Conference, Dr. Leo I. Gordon explored strategies for systemic therapy in the relapsed or refractory setting, focusing primarily on the standard of high-dose therapy/autologous stem cell rescue, the CD30-targeted antibody drug conjugate brentuximab vedotin, and checkpoint inhibition...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515252/chronic-lymphocytic-leukemia-individualizing-treatment-approach
#11
Andrew D Zelenetz
A host of new therapies are now available for treating patients with chronic lymphocytic leukemia (CLL) in both the upfront and relapsed or refractory settings. Although the optimal use of these agents is still being defined, established and emerging prognostic markers aid in the selection of appropriate treatment with the best chance of success. At the NCCN 22nd Annual Conference, Dr. Andrew Zelenetz discussed the role of the CLL-International Prognostic Index for risk stratification, reviewed optimal first-line therapy options, and then presented updated clinical trial data on the novel agents being used in the relapsed or refractory setting...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515251/new-treatment-options-for-the-management-of-multiple-myeloma
#12
Shaji K Kumar
Multiple myeloma (MM) is a complex disease characterized by considerable genetic heterogeneity. The updated NCCN Guidelines for MM have added new "preferred" regimens for transplant and nontransplant candidates, and have moved some formerly "preferred" regimens to the "other" category. Supportive care has improved outcomes for patients, and new treatments in combination have extended survival for patients with MM. Novel agents on the horizon are poised to raise the bar even further.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515250/challenges-of-toxicity-management-in-immuno-oncology
#13
Stephanie Andrews
Immunotherapies are conveying unprecedented efficacy in some tumor types, but with this success comes challenges in managing toxicities that are distinct from those of cytotoxic agents. Although most immune-related adverse events can be ameliorated by temporarily withholding the drug and administering steroids, grade 3 to 4 toxicities can be challenging and some adverse effects can be long-lasting. NCCN has developed an immunotherapy teaching and monitoring tool that can help in evaluating and managing these autoimmune-mediated inflammatory conditions, which can affect virtually all organ systems...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515249/incorporating-new-systemic-therapies-in-kidney-cancer-treatment
#14
Eric Jonasch
In 2017, pazopanib and sunitinib remain the mainstays of frontline therapy for advanced renal cell carcinoma. Independent review of frontline cabozantinib therapy may alter standard of care for patients at intermediate and poor risk. Multiple agents show a survival advantage in the second-line setting, including nivolumab, cabozantinib, and combination lenvatinib and everolimus. Selection of subsequent therapy will depend on patient disease status, comorbidities, and resource availability.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515248/systemic-management-of-colorectal-cancer
#15
Wells A Messersmith
Advances have been made in the systemic treatment of colorectal cancer, with approximately 12 chemotherapy or biologic agents approved for use as a single agent or in a combination. However, numerous gaps in our understanding of the disease remain, such as the lack of benefit with biologics in the adjuvant setting, the absence of biomarkers for most systemic therapies, and the reason why left-sided and right-sided tumors behave differently. At the 22nd NCCN Annual Conference, Dr. Wells A. Messersmith presented several impactful updates to the 2017 NCCN Clinical Practice Guidelines in Oncology for Colon Cancer and reviewed the outcomes with a host of therapies used for both early-stage and metastatic disease...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515247/keynote-address-when-breath-becomes-air-as-physician-becomes-patient
#16
Lucy Kalanithi, Heather Wakelee, Robert W Carlson
As part of the NCCN 22nd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care, Lucy Kalanithi, MD, wife of now-deceased best-selling author Paul Kalanithi (When Breath Becomes Air), and Heather Wakelee, MD, Paul's oncologist, discussed-for the first time together in a public forum-Paul's experience of going from a neurosurgery resident to a patient with cancer with a terminal diagnosis. Robert Carlson, MD, moderated the discussion.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515246/immunotherapies-for-lung-cancer
#17
Matthew A Gubens
In 2017, immunotherapy is the standard of care for patients with non-small cell lung cancer (NSCLC) either in the first or second line depending on programmed death ligand-1 (PD-L1) and mutation status. For first-line therapy, pembrolizumab is currently the standard of care for patients whose tumors express PD-L1 >50%. All patients with NSCLC should undergo PD-L1 testing before initiating treatment on pembrolizumab. For patients not eligible in the first line, immunotherapy is the standard of care for most in the second line...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515245/biomarker-based-treatment-selection-in-non-small-cell-lung-cancer
#18
Wallace Akerley
Patients with non-small cell lung cancer must be tested for biomarkers. Currently, treatments directed against EGFR, ALK, and ROS1 mutations are standard of care. A number of emerging new targets and treatments are on the horizon.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515244/what-when-and-how-of-biomarker-testing-in-non-small-cell-lung-cancer
#19
Gregory L Riely
Biomarker testing is recommended for all patients diagnosed with non-small cell lung cancer. At a minimum, testing should include the mutations/fusions EGFR, ALK, ROS1, and the protein programmed death ligand-1 (PD-L1), because FDA-approved therapies are available for these alterations. Other actionable molecular findings include RET rearrangements, BRAF(V600E) mutations, and MET exon 14 alterations. If adequate testing was not performed at treatment initiation, molecular testing should be performed before administration of subsequent lines of therapy...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515243/nccn-guidelines-update-evolving-radiation-therapy-recommendations-for-breast-cancer
#20
Kilian E Salerno
In the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer, among adjuvant radiotherapy options for whole-breast irradiation after breast-conserving surgery, hypofractionation is preferred. For the use of accelerated partial-breast irradiation, the NCCN Guidelines have adopted the updated definition of "suitability" used by the American Society for Radiation Oncology. Regional nodal irradiation is indicated-either in the setting of breast-conserving surgery or after mastectomy-for women with ≥4 positive nodes and should be strongly considered for 1 to 3 positive lymph nodes and select patients with node-negative disease deemed at high risk for recurrence...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
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