Movin' On Up!
Authors: Tempero M PMID: 29891517 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Integrated Histogenetic Analysis Reveals BAP1-Mutated Epithelioid Mesothelioma in a Patient With Cancer of Unknown Primary.
Authors: Bochtler T, Endris V, Reiling A, Leichsenring J, Schweiger MR, Klein S, Stögbauer F, Goeppert B, Schirmacher P, Krämer A, Stenzinger A Abstract This case report presents a male patient with epithelioid mesothelioma that was initially misdiagnosed as cancer of unknown primary (CUP) and correctly identified using molecular panel sequencing. The patient had a prior history of colon and breast cancer. To assess the enlarged mediastinal lymph nodes, retrosternal lymphadenectomy was performed in 2016. The lymph nodes were histologically deemed unrelated to the known breast cancer by the reference patho...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Metachronous Medulloblastoma in a Child With Successfully Treated Neuroblastoma: Case Report and Novel Findings of DNA Sequencing.
This report presents the clinical case of a 23-month-old child who was diagnosed with an anaplastic medulloblastoma 5 months after completing treatment for stage IV neuroblastoma. The patient was treated with complete surgical resection and adjuvant chemoradiation followed by maintenance chemotherapy at an outside institution and came to our institution for further management. A pathologic diagnosis and review of both the suprarenal and posterior fossa masses were performed, as well as a genetic analysis of both cerebellar tumor tissue and blood using next-generation gene sequencing. At our institution, the patient was sub...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

NCCN Guidelines Insights: Neuroendocrine and Adrenal Tumors, Version 2.2018.
Authors: Shah MH, Goldner WS, Halfdanarson TR, Bergsland E, Berlin JD, Halperin D, Chan J, Kulke MH, Benson AB, Blaszkowsky LS, Eads J, Engstrom PF, Fanta P, Giordano T, He J, Heslin MJ, Kalemkerian GP, Kandeel F, Khan SA, Kidwai WZ, Kunz PL, Kuvshinoff BW, Lieu C, Pillarisetty VG, Saltz L, Sosa JA, Strosberg JR, Sussman CA, Trikalinos NA, Uboha NA, Whisenant J, Wong T, Yao JC, Burns JL, Ogba N, Zuccarino-Catania G Abstract The NCCN Guidelines for Neuroendocrine and Adrenal Tumors provide recommendations for the management of adult patients with neuroendocrine tumors (NETs), adrenal gland tumors, pheochromocytomas,...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Receipt of Guideline-Concordant Care Among Older Women With Stage I-III Breast Cancer: A Population-Based Study.
Conclusions: Fewer than half of older women with breast cancer received GCC, with the lowest rates observed among the oldest age groups, racial/ethnic minorities, and women with later-stage cancers. However, patients with more aggressive tumor characteristics and greater access to oncology resources were more likely to receive GCC. Considering that older women have the highest incidence of breast cancer and that many are diagnosed at stages requiring more aggressive treatment, efforts to increase rates of earlier stage diagnosis and the development of less toxic treatments could help improve GCC and survival while preservi...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Clinical Impact of Local Progression in Pancreatic Cancer.
This study aimed to define the complications and hospitalizations from local versus distant disease progression among a retrospective cohort of patients with pancreatic cancer. Methods: Records of 298 cases of pancreatic cancer treated at a single institution from 2004 through 2015 were retrospectively reviewed, and cancer-related symptoms and complications requiring hospitalization were recorded. Hospitalizations related to pancreatic cancer were attributed to either local or distant progression. Cumulative incidence analyses were used to estimate the incidence of hospitalization, and multivariable Fine-Gray regression mo...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Outcomes From a Patient-Centered, Interprofessional, Palliative Consult Team in Oncology.
Conclusions: Patients who completed this interdisciplinary palliative consult service appeared to experience a reduction in their most severe symptoms. Visits to patients during existing appointments or having them attend a half-day clinic appears to have reached those referred. With interdisciplinary integration, clinicians are able to collaborate to address patient care needs. Considerations include how to further integrate palliative and psychosocial care to achieve additional benefits and ongoing monitoring of changes in symptom burden. PMID: 29891523 [PubMed - in process] (Source: Journal of the National Comprehen...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Early Versus Delayed Initiation of Salvage Androgen Deprivation Therapy and Risk of Prostate Cancer-Specific Mortality.
This study sought to ascertain whether there is an association between prostate cancer (PC)-specific mortality (PCSM) and timing of salvage androgen deprivation therapy (ADT) among men with short versus long prostate-specific antigen doubling times (PSA-DTs). Methods: The study cohort was selected from 206 men with localized unfavorable-risk PC randomized to radiation therapy (RT) or RT plus 6 months of ADT between 1995 and 2001. A total of 54 men who received salvage ADT for PSA failure after a median follow-up of 18.72 years following randomization defined the study cohort. The Fine-Gray competing risks regression model ...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Weekend Effect in Emergency Colon and Rectal Cancer Surgery: A Prospective Study Using Data From the Dutch ColoRectal Audit.
Conclusions: Weekend emergency colon cancer surgery was associated with higher mortality and severe complication rates. More research is needed to understand which factors explain and contribute to these differences. PMID: 29891525 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.
Authors: Bichakjian CK, Olencki T, Aasi SZ, Alam M, Andersen JS, Blitzblau R, Bowen GM, Contreras CM, Daniels GA, Decker R, Farma JM, Fisher K, Gastman B, Ghosh K, Grekin RC, Grossman K, Ho AL, Lewis KD, Loss M, Lydiatt DD, Messina J, Nehal KS, Nghiem P, Puzanov I, Schmults CD, Shaha AR, Thomas V, Xu YG, Zic JA, Hoffmann KG, Engh AM Abstract This selection from the NCCN Guidelines for Merkel Cell Carcinoma (MCC) focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and systemic therapy. Inc...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Radiotherapy in the Multidisciplinary Management of Merkel Cell Carcinoma.
This article discusses the indications, treatment considerations, and recommended dose prescriptions for RT in the management of early- and advanced-stage disease. Considerable hope exists that immunotherapy advances will synergize with RT to further enhance clinical outcomes. PMID: 29891527 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Advances in Immunotherapy for Metastatic Merkel Cell Carcinoma: A Clinician's Guide.
This article reviews the safety and efficacy data from the key clinical trials of immune checkpoint inhibitors for metastatic MCC, and discusses several issues relevant to the clinical use of these agents. Finally, emerging immunotherapies for MCC, including cellular therapies and adjuvant systemic therapies, are reviewed. PMID: 29891528 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Palliative Care: Who is Responsible?
Authors: Rosenblum AM, Chasen MR PMID: 29891529 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

The NCCN 23rd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care.
Authors: Carlson RW PMID: 29784733 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

New NCCN Guidelines: Recognition and Management of Immunotherapy-Related Toxicity.
Authors: Thompson JA Abstract Immune checkpoint inhibitors (ICIs) are now FDA-approved for the treatment of 8 different cancers, and more approvals are likely, including use of these drugs in combinations. Although ICIs represent a true advance in cancer care, they can cause a range of immune-related adverse events. As more experience with ICIs is gained, more information is becoming available on immunotoxicity and optimal management. Physicians and patients need to be educated about potential adverse events and management of ICI-associated toxicity. In recognition of the need for better information, NCCN in collab...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

New NCCN Guidelines: Cancer Management in People Living With HIV.
Authors: Suneja G Abstract Since the emergence of HIV in the United States in the 1980s, cancer has been a part of the story. The good news is that antiretroviral therapy has improved survival for those living with HIV infection, with life expectancy now approaching that of uninfected people. Consequently, this patient population is living long enough to develop different types of cancer. At the 23rd NCCN Annual Conference, Gita Suneja, MD, MSHP, presented the debut of the new NCCN Guidelines for Cancer in People Living With HIV, discussing the intersection between cancer and HIV infection, the cancers most likely ...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Targeted Therapy for Patients With Metastatic Non-Small Cell Lung Cancer.
Authors: Reckamp KL Abstract Molecular testing is recommended for initial diagnosis in patients with non-small cell lung cancer (NSCLC), according to the updated NCCN Guidelines, because targeted therapies are available that can improve patient outcomes. Targeted therapies are currently approved for EGFR mutations, ALK and ROS1 gene rearrangements, and BRAF mutations, with the list of emerging "actionable" targets growing. The 2018 NCCN Guidelines for NSCLC incorporate new therapies, including the EGFR tyrosine kinase inhibitor osimertinib and the ALK inhibitor alectinib, as first-line preferences. PM...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

NCCN Guidelines Updates: Breast Cancer.
Authors: Giordano SH, Elias AD, Gradishar WJ Abstract The emergence of CDK4/6 inhibitors has changed the treatment algorithm for advanced/metastatic estrogen receptor-positive breast cancer. In pivotal trials of palbociclib, ribociclib, and abemaciclib, doubling in progression-free survival has been seen. All 3 agents in this class are now included in the NCCN Guidelines for Breast Cancer, and clinicians should be incorporating these agents into their treatment algorithms. The other important issue in this breast cancer setting is extended duration of endocrine therapy. Most of the benefit is modest and toxicity is...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Optimizing Adjuvant Therapy for Localized Colon Cancer and Treatment Selection in Advanced Colorectal Cancer.
Authors: Grothey A, Venook AP Abstract Results from the pivotal IDEA trial, which evaluated 3 versus 6 months of adjuvant oxaliplatin-based chemotherapy, are incorporated into the NCCN Guidelines for Colon Cancer. The guidelines recommend that for patients with low-risk stage III disease, the preferred regimen is CAPEOX for 3 months or FOLFOX for 3 to 6 months. For patients with high-risk stage III disease, the preferred regimen is CAPEOX for 3 to 6 months or FOLFOX for 6 months. In metastatic disease, tumor sidedness should be a consideration when choosing a biologic. For BRAF-mutated disease, several triplets are...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Management of Locoregional Rectal Cancer.
Authors: Willett CG Abstract The NCCN Guidelines for Rectal Cancer are now more closely aligned with those for colon cancer. A new MRI-based definition of the rectum has been included and the use of MRI in staging has been elevated in importance. There is a new emphasis on neoadjuvant therapy, especially the concurrent use of chemotherapy and radiotherapy. One of the biggest changes is more acceptance of an observational approach-"watch and wait, nonoperative management"-for select patients experiencing a complete clinical response with no evidence of residual disease after neoadjuvant therapy. PMID: ...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

NCCN Guidelines Updates: Prostate Cancer and Prostate Cancer Early Detection.
Authors: Carroll PH, Mohler JL Abstract Peter H. Carroll, MD, MPH, and James L. Mohler, MD, updated attendees on what is new in the 2018 NCCN Guidelines for Prostate Cancer Early Detection and for Prostate Cancer, respectively. Their presentations touched on new screening recommendations, shared decision-making, risk stratification, the role of genomic and molecular testing, active surveillance, and newer systemic treatments. PMID: 29784740 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Management of Multiple Myeloma.
Authors: Kumar SK Abstract The most recent NCCN Guidelines for Multiple Myeloma include a ranking of the many treatment options for various settings as "preferred," "other," and "useful in certain circumstances." For patients eligible for autologous stem cell transplant (ASCT), the preferred regimen remains bortezomib/lenalidomide/dexamethasone (category 1) or bortezomib/cyclophosphamide/dexamethasone. Upfront ASCT also remains a preferred strategy for patients who are transplant-eligible, despite highly effective newer agents such as induction therapy. Double (tandem) ASCT may benefit...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

NCCN Frameworks for Resource Stratification of NCCN Guidelines: Adult Cancer Pain and Palliative Care.
Authors: Swarm RA, Dans M Abstract The NCCN Framework aims to provide adapted guidelines for low- and middle-resource countries to improve the experience of patients with cancer. In particular, the NCCN Frameworks for Adult Cancer Pain and Palliative Care and were designed to help expand access to pain management and palliative care for patients in low-resource countries. The NCCN Framework is one of several tools that can improve cancer care in the developing world. The NCCN Harmonized Guidelines for Sub-Saharan Africa, a collaborative effort between NCCN, American Cancer Society, Clinton Health Access Initiative,...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

New Therapies for Ovarian Cancer.
Authors: Armstrong DK Abstract In the latest NCCN Guidelines for Ovarian Cancer, the histologic subtypes of ovarian cancer are described in more depth as they vary by frequency, typical age and disease stage at presentation, treatment recommendations, and survival probabilities. The less common subtypes are also discussed. The update with the greatest impact on the treatment of ovarian cancer, however, is probably the use of maintenance therapy with poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors, and 3 PARP inhibitors are now included in the guidelines. These drugs have made a large difference in o...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

The Changing Treatment Landscape for Metastatic Urothelial Carcinoma.
Authors: Flaig TW Abstract Urothelial carcinoma is the predominant histologic type of bladder cancer. After 30 years of minimal progress in the treatment of advanced-stage disease, recent advances in the genomic characterization of urothelial cancer and breakthroughs in bladder cancer therapeutics have rejuvenated the field. Nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab are among the exciting recent novel therapeutic advances gaining approvals by the FDA for treatment of advanced-stage urothelial carcinoma. Yet the challenge for clinicians is to determine the optimal choice of agents as first-lin...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Updates to the Management of Kidney Cancer.
Authors: Jonasch E Abstract Several updates were made to the 2018 NCCN Guidelines for Kidney Cancer. Adjuvant sunitinib is the first adjuvant therapy to be endorsed by the panel for patients with stage II and III clear cell histology renal cell carcinoma (RCC; category 2B). A promising new treatment-ipilimumab plus nivolumab for patients at intermediate and poor risk in the frontline setting-was added to the guidelines as well. Cabozantinib was added as a first-line option for poor- and intermediate-risk patients with advanced RCC. PMID: 29784745 [PubMed - in process] (Source: Journal of the National Comprehens...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Role of Molecular Pathology in the Treatment of Anaplastic Gliomas and Glioblastomas.
Authors: Holdhoff M Abstract The 2016 WHO Classification of Tumors of the Central Nervous System integrated molecular biomarkers into the classifications of malignant gliomas. Several markers now play a key role in our understanding of these tumors and are integral for clinical decision-making; these include codeletion of 1p and 19q and IDH1 and IDH2 mutations. The presentation by Matthias Holdhoff, MD, PhD, at the NCCN 23rd Annual Conference discussed the current understanding of anaplastic gliomas (WHO grade III) in the context of the new classification and its implications on clinical practice. The 2018 NCCN Gui...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

New NCCN Guidelines for Uveal Melanoma and Treatment of Recurrent or Progressive Distant Metastatic Melanoma.
Authors: Barker CA, Salama AK Abstract The NCCN Guidelines Panel for Melanoma debuted new guidelines for uveal melanoma at the NCCN 23rd Annual Conference. Although uveal melanoma and cutaneous melanoma share the same name, they do have different characteristics and treatments. The NCCN Guidelines describe how tumor size guides therapeutic options, which for most tumors is radiotherapy. Predictors of melanoma-related mortality include advanced age, larger tumor size, and histopathologic and molecular features. The NCCN Guidelines for Cutaneous Melanoma have not changed notably, but adjuvant therapy with immunothera...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Emerging Treatment Options for Acute Lymphoblastic Leukemia: Focus on CAR T-Cell Therapy.
Authors: Brown PA, Shah B Abstract Acute lymphoblastic leukemia (ALL) comprises a heterogeneous group of diseases with different morphologic, cytogenetic, and molecular subgroups, some of which have significant therapeutic implications. It typically presents with an aggressive clinical course, and among adults, responds poorly to standard chemotherapy, and carries a high risk for relapse. Despite the significant progress made in inducing remission, frequent relapses remain a challenge. Novel drugs, such as potent later-generation tyrosine kinase inhibitors, antibody-drug conjugates, bispecific monoclonal antibodies...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Prognostic Significance of Molecular Markers and Targeted Regimens in the Management of Acute Myeloid Leukemia.
Authors: Tallman M Abstract The diagnosis, staging, and treatment of acute myeloid leukemia (AML) has evolved based on identification of important genetic alterations and drugs to target those genes. Cytogenetic abnormalities play a major role in managing AML. Achieving minimal residual disease is an increasingly important milestone. Four new targeted therapies are now available for the treatment of AML. PMID: 29784749 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Pregnancy in Patients With Chronic Myeloid Leukemia.
Authors: Berman E Abstract Estimates suggest that nearly 30% of patients diagnosed with chronic myeloid leukemia (CML) are aged
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Hepatocellular Carcinoma: Updates to Screening and Diagnosis.
Authors: Covey AM Abstract In what is considered to be "a global problem," liver cancer has tripled in incidence in the United States over the past 20 to 30 years, and is now present in 7 per 100,000 Americans. Thus, screening for disease should be at the forefront to effectively treat high-risk populations. At the 2018 NCCN 23rd Annual Conference, Dr. Anne M. Covey discussed the updated NCCN Guidelines for the screening and diagnosis of hepatocellular carcinoma, which place ultrasound as the most cost-effective and least toxic primary screening option, with a screening interval of approximately 6 months ...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Head and Neck Cancers: Advantages of Advanced Radiation Therapy and Importance of Supportive Care.
Authors: Spencer S Abstract For more than a decade, the incidence of head and neck cancers has been increasing in the United States. Worldwide, they are the ninth most common cancer. Today, newer advances in radiotherapy (RT), such as fractionation, 4-dimensional cone-beam CT, and intensity-modulated RT, have provided clinicians with the opportunity for improved patient outcomes. At the NCCN 23rd Annual Conference, Sharon Spencer, MD, described the advantages of advances in RT and the means to mitigate untoward side effects. PMID: 29784752 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Use of Direct Oral Anticoagulants for Treating Venous Thromboembolism in Patients With Cancer.
Authors: Soff GA Abstract For patients with cancer who experience venous thromboembolism (VTE), low-molecular-weight heparin (LMWH) remains the standard of care in the NCCN Guidelines for VTE, but under certain conditions direct oral anticoagulants (DOACs) are acceptable alternatives. A growing body of literature suggests that DOACs may more effective than LMWHs in preventing recurrences, but they do carry some increased risk of bleeding. Most of this risk is seen in patients with gastrointestinal or urinary pathology or implanted devices. DOACs are also acceptable when the pain, cost, and inconvenience of LMWHs ar...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 24, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Getting Into the Weeds.
Authors: Tempero M PMID: 29752317 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

PACIFIC: An Ocean of Hope in Patients With Stage III Unresectable Non-Small Cell Lung Cancer.
Authors: Uprety D, Marinier DE PMID: 29752318 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Misdiagnosis of Li-Fraumeni Syndrome in a Patient With Clonal Hematopoiesis and a Somatic TP53 Mutation.
This report presents a patient with fallopian tube carcinoma who underwent multigene panel testing for cancer predisposition and was found to have a mutation in the TP53 gene, c.733G>T (p.Gly245Cys). Since the TP53 mutation had an allelic fraction of approximately 50%, it was interpreted as being germline, and the patient was diagnosed as having LFS. A year later, she developed acute myelogenous leukemia. Subsequent mutational analysis showed that the TP53 mutation was absent in her benign tissue sample but present in leukemic cells. Furthermore, sequencing of the fallopian tube tumor tissue revealed a different TP53 ge...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Rediagnosis of Lung Cancer as NUT Midline Carcinoma Based on Clues From Tumor Genomic Profiling.
This report describes a case in which evaluation of tumor sequencing results by a molecular tumor board (MTB) led to rediagnosis of a non-small cell lung cancer as highly aggressive NUT midline carcinoma, with implications for targeted therapy using an investigational bromodomain and extraterminal (BET) inhibitor. We discuss the molecular biology and diagnosis of this rare tumor, and suggest how improved annotation of tumor sequencing reports and multidisciplinary expertise of MTBs can facilitate timely diagnosis of rare tumors and application of potential targeted therapies. PMID: 29752320 [PubMed - in process] (Sourc...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Redefining Quality Measurement in Cancer Care.
Authors: Nardi EA, McCanney J, Winckworth-Prejsnar K, Schatz AA, Adelson K, Neubauer M, Smith ML, Walters R, Carlson RW Abstract Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in t...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018.
Authors: Colevas AD, Yom SS, Pfister DG, Spencer S, Adelstein D, Adkins D, Brizel DM, Burtness B, Busse PM, Caudell JJ, Cmelak AJ, Eisele DW, Fenton M, Foote RL, Gilbert J, Gillison ML, Haddad RI, Hicks WL, Hitchcock YJ, Jimeno A, Leizman D, Maghami E, Mell LK, Mittal BB, Pinto HA, Ridge JA, Rocco J, Rodriguez CP, Shah JP, Weber RS, Witek M, Worden F, Zhen W, Burns JL, Darlow SD Abstract The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided f...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Effectiveness and Safety of Rivaroxaban in Patients With Cancer-Associated Venous Thrombosis.
Conclusions: Event rates observed in this rivaroxaban-treated cohort were overall consistent with previous studies of patients with rivaroxaban- and warfarin-managed CAT. PMID: 29752323 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Dances With Denial: Have Medical Oncology Outpatients Conveyed Their End-of-Life Wishes and Do They Want To?
Conclusions: Many patients would like to have discussions regarding EOL care with their doctor and involve their support persons in this process. Only a small percentage of respondents had discussed EOL care with their doctors, recorded their wishes, or appointed an enduring guardian. The first step requires clinicians to ask whether an individual patient wishes to discuss EOL issues, in what format, and at what level of detail. PMID: 29752324 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Sequential Versus Concurrent Chemoradiation Therapy by Surgical Margin Status in Resected Non-Small Cell Lung Cancer.
In this study, survival was compared between sCRT versus cCRT for M- and M+ disease; survival in patients who underwent sCRT was also assessed with chemotherapy-first versus radiotherapy (RT)-first. Methods: The National Cancer Database was queried for patients with primary NSCLC undergoing surgery followed by CRT. Patients were excluded if they received neoadjuvant chemotherapy or RT. Both M- and M+ (including R1 and R2) subcohorts were evaluated. Multivariable logistic regression ascertained factors associated with cCRT delivery. Kaplan-Meier analysis evaluated overall survival (OS); Cox proportional hazards modeling det...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Genetic Counseling Referral Rates in Long-Term Survivors of Triple-Negative Breast Cancer.
Conclusions: Among long-term TNBC survivors, the rate of referral to genetic counseling increased over time, and among those tested, 35% carried a BRCA pathogenic variant. Survivorship care provides an excellent opportunity to refer eligible patients for genetic counseling. PMID: 29752326 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Adherence to Guidelines for Breast Surveillance in Breast Cancer Survivors.
Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance breast imaging, particularly as time passes. Understanding factors associated with imaging in cancer survivors may help improve adherence to survivorship care guidelines. PMID: 29752327 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Soft Tissue Sarcoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology.
Authors: von Mehren M, Randall RL, Benjamin RS, Boles S, Bui MM, Ganjoo KN, George S, Gonzalez RJ, Heslin MJ, Kane JM, Keedy V, Kim E, Koon H, Mayerson J, McCarter M, McGarry SV, Meyer C, Morris ZS, O'Donnell RJ, Pappo AS, Paz IB, Petersen IA, Pfeifer JD, Riedel RF, Ruo B, Schuetze S, Tap WD, Wayne JD, Bergman MA, Scavone JL Abstract Soft tissue sarcomas (STS) are rare solid tumors of mesenchymal cell origin that display a heterogenous mix of clinical and pathologic characteristics. STS can develop from fat, muscle, nerves, blood vessels, and other connective tissues. The evaluation and treatment of patients with S...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Role of Molecular Profiling in Soft Tissue Sarcoma.
Authors: Lindsay T, Movva S Abstract Diagnosis and treatment of soft tissue sarcoma (STS) is a particularly daunting task, largely due to the profound heterogeneity that characterizes these malignancies. Molecular profiling has emerged as a useful tool to confirm histologic diagnoses and more accurately classify these malignancies. Recent large-scale, multiplatform analyses have begun the work of establishing a more complete understanding of molecular profiling in STS subtypes and to identify new molecular alterations that may guide the development of novel targeted therapies. This review provides a brief and gener...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

A Small Step Closer But Not Yet There: Oral Anti-Xa Agents and the Treatment of Cancer-Associated Venous Thromboembolism.
Authors: Leavitt AD PMID: 29752330 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - May 14, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Standing Together or Alone.
Authors: Tempero M PMID: 29632051 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - April 12, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research

Letter to the Editor: Panax Ginseng for Cancer-Related Fatigue.
Authors: Martoni AA, Cavanna L, Porzio G PMID: 29632052 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - April 12, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research