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Content Update

May 7, 2019

ASCO Practice Guidelines on Management of Immune-Related Adverse Events in Patients Treated with Immune Checkpoint Inhibitors: In February 2018, the American Society of Clinical Oncology (ASCO) published a new guideline regarding the management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy. Recommendations are outlined by organ-specific toxicities with diagnosis and management criteria presented. Differences in treatment approaches exist, but most patients with Grade 1 toxicities may continue immune checkpoint inhibitor therapy. Corticosteroids may be initiated for Grade 3 toxicities and higher and must be tapered over at least 4 to 6 weeks. In severe and refractory cases, other immunosuppressive therapies may be required to control immune-related adverse events. In most cases, immune checkpoint inhibitor therapy is permanently discontinued with Grade 4 toxicities.

Content Update

March 4, 2019

Larotrectinib Approved for NTRK Fusion Cancers: Larotrectinib (Vitrakvi®) is the first disease agnostic small molecule inhibitor approved by the FDA and is indicated for adult and pediatric patients with NTRK fusion cancers. While NTRK fusions are rare, occurring in ~ 1% of all cancers, they are common in some rare cancers such as secretory carcinoma of the breast. Overall response rate in NTRK fusion cancers is 75%. The most common adverse effects are elevations in LFTs and anemia, with serious neuropathies in about 1% of patients. Larotrectinib is first line therapy in metastatic disease if no standard therapies are available or after initial disease progression.

Content Update

May 3, 2018

American Society of Clinical Oncology (ASCO) Statement on Biosimilars in Oncology: ASCO published a statement providing guidance on biosimilar use in the cancer setting, including: naming, labeling, and other regulatory issues; safety and efficacy; interchangeability, switching, and substitution; value; and prescriber and patient education. To date, the US Food and Drug Administration has approved one biosimilar for supportive cancer care (filgrastim-sndz) and two biosimilars for treatment of cancer (bevacizumab-awwb, trastuzumab-dkst). The statement also affirms ASCO's commitment to providing education to healthcare providers and patients that increases understanding and acceptance of biosimilars, which can improve access to "high-quality, high-value" patient care.

KEY CONCEPTS

KEY CONCEPTS

  • Image not available. Carcinogenesis is a multistep process that includes initiation, promotion, conversion, and progression.

  • Image not available. Cancer cells demonstrate unique traits that distinguish them from normal cells. Cancer cells can stimulate their own growth, resist inhibitory signals, avoid programmed cell death, grow new blood vessels (angiogenesis), invade local tissues, and spread to distant sites (ie, metastases).

  • Image not available. Screening programs are designed to detect cancers in asymptomatic people who are at risk of a specific cancer.

  • Image not available. Diagnosis and staging informs the treatment goals and helps select the most appropriate anticancer therapy. The treatment goal may be cure, control, or palliation. The therapy typically includes a combination of surgery, radiation therapy, and systemic anticancer agents. Systemic anticancer agents include chemotherapy, targeted drugs, and biologic therapies.

  • Image not available. Chemotherapy inhibits cancer growth by killing rapidly proliferating cells. These agents can be identified ...

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