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Update Summary
March 25, 2023
The following updates to this chapter were made:
Introduction and Figure 149-1: updated estimated 2023 statistics
Table 149-1: updated references
Figure 149-2: corrected reference citation
The following drugs were either added or removed from Table 149-7 and Systemic Therapy sections due to changes in FDA approvals
Chemotherapy: Alkylating agents: Melphalan flufenamide – removed
Targeted agents: Small Molecules
Specifically Targeting the ABL Myristoyl Pocket (STAMP) Inhibitor, asciminib – added
Bruton’s Tyrosine Kinase (BTK) Inhibitors: pirobrutinib – added
Epidermal Growth Factor Receptor (EGFR) Inhibitors: mobocertinib – added
Fibroblast Growth Factor Receptor (FGFR) Inhibitors: futibatinib – added
Histone Deacetylase (HDAC) Inhibitors: panobinostat – removed
Hypoxia-inducible Factor 2 Alpha (HIF-2α): belzutifan – added
Isocitrate Dehydrogenase (IDH) Inhibitors: olutasidenib – added
Phosphatidylinositide 3-Kinase (PI3K) Inhibitors: umbralisib – removed
Ras Inhibitors: adagrasib - added
Targeted agents: mAbs & ADCs
Antibodies that target BCMA (B-Cell Maturation Antigen): belantamab mafodotin – removed
Antibodies that target folate receptor alpha: mirvetuximab soravtansine – added
Antibodies that target tissue factor: tisotumab vedotin – added
Bispecific T-cell engagers: mosunetuzumab and teclistamab – added
Fusion proteins – tebentafusp – added
Immunotherapy – tremelimumab and nivolumab/relatlimab – added
Table 149-7: corrected reference citation
Information was added to therapeutic radiopharmaceuticals: Lutetium Lu 177 on lutetium Lu 177 vipivotide tetraxetan
Information was updated on the following drugs in Table 149-7 and Systemic Therapy sections
Information was updated in Systemic Therapy, targeted agents: small molecules
BRAF inhibitors section – dabrafenib holds agnostic approval for solid tumors harboring V600E mutation
CDK inhibitors section – revised section to generalize indications of palbociclib, ribociclib, and abemaciclib in combination with endocrine therapy
EGFR inhibitors section – revised section to focus more on osimertinib and mobocertinib
HER2 Inhibitors – revised antidiarrheal prophylaxis for neratinib to include dose escalation strategy
PI3K Inhibitors – revised indications for idelalisib and duvelisib
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KEY CONCEPTS
Carcinogenesis is a multistep process that includes initiation, promotion, conversion, and progression.
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).
Screening programs are designed to detect cancers in asymptomatic people who are at risk of a specific cancer.
Diagnosis and staging inform the treatment goals and help select the most appropriate anticancer therapy. The treatment goal may be cure, control, or palliation. The therapy may include a combination of surgery, radiation therapy, or systemic anticancer agents. Systemic anticancer agents include chemotherapy, targeted agents, and immunotherapy.
Chemotherapy inhibits cancer growth by killing rapidly proliferating cells. These agents can be categorized as either cell-cycle phase-specific, targeting one specific ...