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Prospective study of the real impact of fusion centered genomic assays in patient management in a national collaborative group: the GETHI-XX-16 study. 以融合为中心的基因组检测对国家协作组患者管理实际影响的前瞻性研究:GETHI-XX-16 研究。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1007/s12094-024-03745-5
Paloma Navarro, Carmen Beato, Juan Francisco Rodriguez-Moreno, Sergio Ruiz-Llorente, Xabier Mielgo, Estela Pineda, Miguel Navarro, Gema Bruixola, Tatiana P Grazioso, Antonio Viudez, Jose Fuster, Esther Nogueron, Maria Dolores Mediano, Carmen Balaña, Carlos Mendez, Rosa María Rodriguez, Sonia Del Barco Berron, Beatriz Gongora, Alberto Carmona-Bayonas, Jesus Garcia-Donas

Purpose: Precision medicine represents a paradigm shift in oncology. Access to genetic testing and targeted therapies is frequently limited. Assays based on DNA sequencing can miss druggable alterations. We aimed to determine the impact of a free access program to RNA tests in patient management.

Methods: We designed a multicenter prospective observational study within the Spanish National Group for Translational Oncology and Rare and Orphan Tumors (GETTHI). Eligible patients were adults with solid cancers that had progressed on standard therapies. Tumor samples were analyzed using two RNA sequencing assays (Trailblaze PharosTM and Archer FusionPlex Solid TumorTM). A central committee evaluated the actionability of genetic alterations and reported the findings to attending physicians, who made the final clinical management decisions.

Results: Between November 2016 and April 2019, 395 patients with 41 different tumors across 30 hospitals were included. Molecular analysis revealed actionable genetic alterations in 57 individuals (14.4%). Targeted therapies were advised for 23 and seven received a matched targeted therapy: two lung cancers (EML4-ALK and CD74-ROS1 fusion), three glioblastomas (EGFR point mutations), one oligodendroglioma (FGFR3-TACC3 fusion) and a prostate cancer (SND1-BRAF fusion). The outcomes included two tumor responses, one disease stabilization, one early withdrawal due to toxicity, one progression, and one unknown.

Conclusion: Despite the growing knowledge of cancer biology and its translation to drug development, the overall impact of personalized treatments remains low. Access to comprehensive molecular tests covering properly all known actionable alterations and programs for a wide access to targeted therapies seem to be critical steps.

目的:精准医疗代表着肿瘤学的范式转变。基因检测和靶向治疗的途径往往有限。基于DNA测序的检测可能会漏掉可用药的改变。我们旨在确定免费获取 RNA 检测项目对患者管理的影响:我们设计了一项多中心前瞻性观察研究,该研究由西班牙国家转化肿瘤学及罕见和孤儿肿瘤小组(GETTHI)负责。符合条件的患者均为接受标准疗法后病情恶化的成人实体瘤患者。采用两种 RNA 测序方法(Trailblaze PharosTM 和 Archer FusionPlex Solid TumorTM)对肿瘤样本进行分析。中央委员会评估基因改变的可操作性,并向主治医师报告结果,由主治医师做出最终临床管理决定:结果:2016 年 11 月至 2019 年 4 月间,30 家医院共纳入了 395 名患有 41 种不同肿瘤的患者。分子分析显示有 57 人(14.4%)存在可操作的基因改变。建议对23人进行靶向治疗,7人接受了匹配的靶向治疗:2例肺癌(EML4-ALK和CD74-ROS1融合)、3例胶质母细胞瘤(表皮生长因子受体点突变)、1例少突胶质细胞瘤(FGFR3-TACC3融合)和1例前列腺癌(SND1-BRAF融合)。结果包括两种肿瘤反应、一种病情稳定、一种因毒性而提前退出、一种病情进展、一种情况不明:结论:尽管癌症生物学知识不断增长,并将其转化为药物开发,但个性化治疗的总体影响仍然较低。获得涵盖所有已知可操作改变的全面分子检测和广泛获得靶向治疗的计划似乎是至关重要的步骤。
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引用次数: 0
SEOM-GEICO clinical guideline on epithelial ovarian cancer (2023). SEOM-GEICO 上皮性卵巢癌临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-15 DOI: 10.1007/s12094-024-03531-3
Jose Alejandro Perez-Fidalgo, Fernando Gálvez-Montosa, Eva María Guerra, Ainhoa Madariaga, Aranzazu Manzano, Cristina Martin-Lorente, Maria Jesús Rubio-Pérez, Jesus Alarcón, María Pilar Barretina-Ginesta, Lydia Gaba

In recent years, the incorporation of new strategies to the therapeutic armamentarium has completely changed the outcomes of epithelial ovarian cancer (EOC). The identification of new predictive and prognostic biomarkers has also enabled the selection of those patients more likely to respond to targeted agents. Nevertheless, EOC is still a highly lethal disease and resistance to many of these new agents is common. The objective of this guideline is to summarize the most relevant strategies to manage EOC, to help the clinician throughout the challenging diagnostic and therapeutic processes and to provide evidence-based recommendations.

近年来,新疗法的加入彻底改变了上皮性卵巢癌(EOC)的治疗效果。新的预测和预后生物标志物的发现,也使我们能够选择那些更有可能对靶向药物产生反应的患者。尽管如此,EOC 仍然是一种致死率很高的疾病,而且对许多新药产生耐药性的情况也很普遍。本指南旨在总结治疗 EOC 的最相关策略,帮助临床医生完成具有挑战性的诊断和治疗过程,并提供循证建议。
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引用次数: 0
SEOM-GEINO clinical guidelines for grade 2 gliomas (2023). SEOM-GEINO 2 级胶质瘤临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-04-25 DOI: 10.1007/s12094-024-03456-x
María Ángeles Vaz-Salgado, Belén Cigarral García, Isaura Fernández Pérez, Beatriz Jiménez Munárriz, Paula Sampedro Domarco, Ainhoa Hernández González, María Vieito Villar, Raquel Luque Caro, María Luisa Villamayor Delgado, Juan Manuel Sepúlveda Sánchez

The 2021 World Health Organization (WHO) classification has updated the definition of grade 2 gliomas and the presence of isocitrate dehydrogenase (IDH) mutation has been deemed the cornerstone of diagnosis. Though slow-growing and having a low proliferative index, grade 2 gliomas are incurable by surgery and complementary treatments are vital to improving prognosis. This guideline provides recommendations on the multidisciplinary treatment of grade 2 astrocytomas and oligodendrogliomas based on the best evidence available.

世界卫生组织(WHO)2021年的分类更新了2级胶质瘤的定义,异柠檬酸脱氢酶(IDH)突变被认为是诊断的基石。2级胶质瘤虽然生长缓慢、增殖指数低,但手术无法治愈,辅助治疗对改善预后至关重要。本指南基于现有的最佳证据,为 2 级星形细胞瘤和少突胶质瘤的多学科治疗提供建议。
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引用次数: 0
SEOM-GETNE-TTCC Clinical guideline thyroid cancer (2023). SEOM-GETNE-TTCC 甲状腺癌临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-26 DOI: 10.1007/s12094-024-03736-6
Teresa Alonso-Gordoa, Paula Jimenez-Fonseca, Javier Martinez-Trufero, Miguel Navarro, Ignacio Porras, Jordi Rubió-Casadevall, Marta Arregui Valles, Neus Basté, Jorge Hernando, Lara Iglesias Docampo

Thyroid cancer (TC) represents 3% of global cancer incidence. Recent changes have optimized treatment decisions based on risk assessment, molecular profiling, and imaging assessment, leading the development of targeted agents that have modified the natural history of this disease. This increasing complexity on treatment options requires careful assessment at the different stages of the disease to provide the most suitable approach from diagnosis to long-term follow-up. This guideline aims to offer a comprehensive and practical overview on the current status and last updates of TC management.

甲状腺癌(TC)占全球癌症发病率的 3%。最近的变化优化了基于风险评估、分子谱分析和成像评估的治疗决策,导致靶向药物的开发,改变了这种疾病的自然病史。治疗方案日趋复杂,需要在疾病的不同阶段进行仔细评估,以提供从诊断到长期随访的最合适方法。本指南旨在全面、实用地概述慢性阻塞性肺疾病管理的现状和最新进展。
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引用次数: 0
SEOM clinical guidelines for cancer anorexia-cachexia syndrome (2023). SEOM 癌症厌食-腹痛综合征临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-06-01 DOI: 10.1007/s12094-024-03502-8
Ainara Soria Rivas, Yolanda Escobar Álvarez, Ana Blasco Cordellat, Margarita Majem Tarruella, Kevin Molina Mata, Marta Motilla de la Cámara, Mª Del Mar Muñoz Sánchez, Marta Zafra Poves, Carmen Beato Zambrano, Luis Cabezón Gutierrez

Cancer-related anorexia-cachexia syndrome (CACS) is a debilitating condition afflicting up to 80% of advanced-stage cancer patients. Characterized by progressive weight loss, muscle wasting, and metabolic abnormalities, CACS significantly compromises patients' quality of life and treatment outcomes. This comprehensive review navigates through its intricate physiopathology, elucidating its stages and diagnostic methodologies. CACS manifests in three distinct stages: pre-cachexia, established cachexia, and refractory cachexia. Early detection is pivotal for effective intervention and is facilitated by screening tools, complemented by nutritional assessments and professional evaluations. The diagnostic process unravels the complex interplay of metabolic dysregulation and tumor-induced factors contributing to CACS. Management strategies, tailored to individual patient profiles, encompass a spectrum of nutritional interventions. These include dietary counseling, oral nutritional supplements, and, when necessary, enteral nutrition and a judicious use of parenteral nutrition. Specific recommendations for caloric intake, protein requirements, and essential nutrients address the unique challenges posed by CACS. While pharmacological agents like megestrol acetate may be considered, their use requires careful evaluation of potential risks. At its core, this review underscores the imperative for a holistic and personalized approach to managing CACS, integrating nutritional interventions and pharmacological strategies based on a nuanced understanding of patient's condition.

癌症相关厌食-痛风综合征(CACS)是一种使人衰弱的病症,多达 80% 的晚期癌症患者都会受到这种病症的困扰。CACS 的特点是进行性体重减轻、肌肉萎缩和代谢异常,严重影响患者的生活质量和治疗效果。这篇全面的综述介绍了其复杂的生理病理,阐明了其分期和诊断方法。CACS 表现为三个不同的阶段:恶病质前期、恶病质确立期和恶病质难治期。早期发现是有效干预的关键,筛查工具、营养评估和专业评价对早期发现有很大帮助。诊断过程揭示了导致 CACS 的代谢失调和肿瘤诱发因素之间复杂的相互作用。根据患者个体情况制定的管理策略包括一系列营养干预措施。其中包括饮食咨询、口服营养补充剂,必要时还包括肠内营养和慎重使用肠外营养。针对热量摄入、蛋白质需求和必需营养素的具体建议可应对 CACS 带来的独特挑战。虽然可以考虑使用醋酸甲孕酮等药物,但需要对其潜在风险进行仔细评估。本综述的核心内容是强调必须采用全面和个性化的方法来管理 CACS,在对患者病情有细致入微的了解的基础上整合营养干预和药物治疗策略。
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引用次数: 0
SEOM-GEM clinical guidelines for cutaneous melanoma (2023). SEOM-GEM 皮肤黑色素瘤临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-05-15 DOI: 10.1007/s12094-024-03497-2
Iván Márquez-Rodas, Eva Muñoz Couselo, Juan F Rodríguez Moreno, Ana Mª Arance Fernández, Miguel Ángel Berciano Guerrero, Begoña Campos Balea, Luis de la Cruz Merino, Enrique Espinosa Arranz, Almudena García Castaño, Alfonso Berrocal Jaime

Cutaneous melanoma incidence is rising. Early diagnosis and treatment administration are key for increasing the chances of survival. For patients with locoregional advanced melanoma that can be treated with complete resection, adjuvant-and more recently neoadjuvant-with targeted therapy-BRAF and MEK inhibitors-and immunotherapy-anti-PD-1-based therapies-offer opportunities to reduce the risk of relapse and distant metastases. For patients with advanced disease not amenable to radical treatment, these treatments offer an unprecedented increase in overall survival. A group of medical oncologists from the Spanish Society of Medical Oncology (SEOM) and Spanish Multidisciplinary Melanoma Group (GEM) has designed these guidelines, based on a thorough review of the best evidence available. The following guidelines try to cover all the aspects from the diagnosis-clinical, pathological, and molecular-staging, risk stratification, adjuvant therapy, advanced disease therapy, and survivor follow-up, including special situations, such as brain metastases, refractory disease, and treatment sequencing. We aim help clinicians in the decision-making process.

皮肤黑色素瘤的发病率正在上升。早期诊断和治疗是提高生存率的关键。对于可以通过完全切除术治疗的局部晚期黑色素瘤患者来说,采用靶向疗法--BRAF和MEK抑制剂--以及免疫疗法--抗PD-1疗法--进行辅助治疗以及最近的新辅助治疗,可以降低复发和远处转移的风险。对于无法接受根治性治疗的晚期患者来说,这些疗法能前所未有地提高总生存率。西班牙肿瘤内科学会(SEOM)和西班牙多学科黑色素瘤小组(GEM)的一组肿瘤内科医生在对现有最佳证据进行全面审查的基础上制定了这些指南。以下指南试图涵盖诊断--临床、病理和分子分期、风险分层、辅助治疗、晚期疾病治疗和幸存者随访等各个方面,包括脑转移、难治性疾病和治疗排序等特殊情况。我们旨在帮助临床医生做出决策。
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引用次数: 0
SEOM-GEMCAD-TTD clinical guidelines for the management of hepatocarcinoma patients (2023). SEOM-GEMCAD-TTD 肝癌患者管理临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-06-24 DOI: 10.1007/s12094-024-03568-4
Carlos López López, Mariona Calvo, Juan Carlos Cámara, Beatriz García-Paredes, Carlos Gómez-Martin, Ana María López, Roberto Pazo-Cid, Javier Sastre, Ricardo Yaya, Jaime Feliu

Hepatocellular carcinoma (HCC) is the most common primary malignancy in the liver and is the third cause of cancer-related death worldwide. Surveillance with abdominal ultrasound should be offered to individuals at high risk for developing HCC. Accurate diagnosis, staging, and liver function are crucial when determining the optimal therapeutic approach. The BCLC staging system is widely endorsed in Western countries. Managing this pathology requires a multidisciplinary, personalized approach, generally with a multimodal strategy. Surgery remains the only curative option, albeit local and systemic therapy may also increase survival when surgery is not suitable. In advanced disease, systemic treatment should be offered to patients with ECOG/PS 0-1 and Child-Pugh class A.

肝细胞癌(HCC)是肝脏中最常见的原发性恶性肿瘤,也是全球癌症相关死亡的第三大原因。对于罹患 HCC 的高危人群,应通过腹部超声进行监测。在确定最佳治疗方法时,准确的诊断、分期和肝功能至关重要。BCLC 分期系统在西方国家得到广泛认可。治疗这种病变需要采取多学科、个性化的方法,通常采用多模式策略。手术仍然是唯一的治愈选择,尽管在不适合手术的情况下,局部和全身治疗也可以提高生存率。在晚期疾病中,ECOG/PS 0-1 和 Child-Pugh 分级为 A 的患者应接受系统治疗。
{"title":"SEOM-GEMCAD-TTD clinical guidelines for the management of hepatocarcinoma patients (2023).","authors":"Carlos López López, Mariona Calvo, Juan Carlos Cámara, Beatriz García-Paredes, Carlos Gómez-Martin, Ana María López, Roberto Pazo-Cid, Javier Sastre, Ricardo Yaya, Jaime Feliu","doi":"10.1007/s12094-024-03568-4","DOIUrl":"10.1007/s12094-024-03568-4","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the most common primary malignancy in the liver and is the third cause of cancer-related death worldwide. Surveillance with abdominal ultrasound should be offered to individuals at high risk for developing HCC. Accurate diagnosis, staging, and liver function are crucial when determining the optimal therapeutic approach. The BCLC staging system is widely endorsed in Western countries. Managing this pathology requires a multidisciplinary, personalized approach, generally with a multimodal strategy. Surgery remains the only curative option, albeit local and systemic therapy may also increase survival when surgery is not suitable. In advanced disease, systemic treatment should be offered to patients with ECOG/PS 0-1 and Child-Pugh class A.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SEOM-GG clinical guidelines for the management of germ-cell testicular cancer (2023). SEOM-GG 生殖细胞睾丸癌治疗临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-03 DOI: 10.1007/s12094-024-03532-2
José Angel Arranz Arija, Xavier García Del Muro, Raquel Luque Caro, María José Méndez-Vidal, Begoña Pérez-Valderrama, Jorge Aparicio, Miguel Ángel Climent Durán, Cristina Caballero Díaz, Ignacio Durán, Enrique González-Billalabeitia

Testicular germ cell tumors are the most common tumors in adolescent and young men. They are curable malignancies that should be treated with curative intent, minimizing acute and long-term side effects. Inguinal orchiectomy is the main diagnostic procedure, and is also curative for most localized tumors, while patients with unfavorable risk factors for recurrence, or those who are unable or unwilling to undergo close follow-up, may require adjuvant treatment. Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classified according to the IGCCCG prognostic classification. BEP is the most recommended chemotherapy, but other schedules such as EP or VIP may be used to avoid bleomycin in some patients. Efforts should be made to avoid unnecessary delays and dose reductions wherever possible. Insufficient marker decline after each cycle is associated with poor prognosis. Management of residual masses after chemotherapy differs between patients with seminoma and non-seminoma tumors. Patients at high risk of relapse, those with refractory tumors, or those who relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers. Salvage treatment for these patients includes conventional-dose chemotherapy (TIP) and/or high-dose chemotherapy, although the best regimen and strategy for each subgroup of patients is not yet well established. In late recurrences, early complete surgical resection should be performed when feasible. Given the high cure rate of TGCT, oncologists should work with patients to prevent and identify potential long-term side effects of the treatment. The above recommendations also apply to extragonadal retroperitoneal and mediastinal tumors.

睾丸生殖细胞瘤是青少年和年轻男性最常见的肿瘤。它们是可治愈的恶性肿瘤,治疗时应以治愈为目的,尽量减少急性和长期副作用。腹股沟睾丸切除术是主要的诊断方法,也是大多数局部肿瘤的根治方法,而有不利复发风险因素的患者,或无法或不愿接受密切随访的患者,可能需要辅助治疗。睾丸切除术后标记物持续存在或确诊时已是晚期的患者应根据 IGCCCG 预后分类进行分期和分类。BEP是最推荐的化疗方案,但也可使用其他方案,如EP或VIP,以避免某些患者使用博莱霉素。应尽可能避免不必要的延迟和剂量减少。每个周期后标记物下降不足与预后不良有关。精原细胞瘤和非精原细胞瘤患者化疗后残留肿块的处理方法有所不同。高复发风险患者、难治性肿瘤患者或化疗后复发的患者应由经验丰富的中心的多学科团队进行管理。对这些患者的挽救性治疗包括常规剂量化疗(TIP)和/或高剂量化疗,但针对每个亚组患者的最佳治疗方案和策略尚未完全确定。对于晚期复发患者,在可行的情况下应尽早进行完整的手术切除。鉴于 TGCT 的高治愈率,肿瘤学家应与患者一起预防和识别治疗可能产生的长期副作用。上述建议同样适用于对角线外腹膜后和纵隔肿瘤。
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引用次数: 0
SEOM-GEMCAD-TTD clinical guideline for the diagnosis and treatment of gastric cancer (2023). SEOM-GEMCAD-TTD 胃癌诊断和治疗临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-18 DOI: 10.1007/s12094-024-03600-7
Fernando Rivera, Federico Longo, Marta Martín Richard, Paula Richart, Maria Alsina, Alberto Carmona, Ana Belén Custodio, Ana Fernández Montes, Javier Gallego, Tania Fleitas Kanonnikoff

Gastric cancer (GC) is the fifth most common cancer worldwide with a varied geographic distribution and an aggressive behavior. In Spain, the incidence is lower and GC represents the tenth most frequent tumor and the seventh cause of cancer mortality. Molecular biology knowledge allowed to better profile patients for a personalized therapeutic approach. In the localized setting, the multidisciplinary team discussion is fundamental for planning the therapeutic approach. Endoscopic resection in very early stage, perioperative chemotherapy in locally advanced tumors, and chemoradiation + surgery + adjuvant immunotherapy for the GEJ are current standards. For the metastatic setting, biomarker profiling including Her2, PD-L1, MSS status is needed. Chemotherapy in combination with checkpoint inhibitors had improved the outcomes for patients with PD-L1 expression. Her2 positive patients should receive antiHer2 therapy added to chemotherapy. We describe the different evidences and recommendations based on the literature.

胃癌(GC)是全球第五大常见癌症,其地理分布各不相同,且具有侵袭性。在西班牙,胃癌的发病率较低,是第十大常见肿瘤和第七大癌症死因。分子生物学知识使我们能够更好地对患者进行特征描述,从而采取个性化的治疗方法。在局部环境中,多学科团队讨论是规划治疗方法的基础。目前的标准是在极早期进行内窥镜切除术,对局部晚期肿瘤进行围手术期化疗,对胃食管癌进行化放疗+手术+辅助免疫治疗。对于转移性肿瘤,需要进行生物标志物分析,包括Her2、PD-L1和MSS状态。化疗联合检查点抑制剂可改善PD-L1表达患者的预后。Her2阳性患者应在化疗的基础上接受抗Her2治疗。我们介绍了基于文献的不同证据和建议。
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引用次数: 0
SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023). SEOM 静脉血栓栓塞症(VTE)与癌症临床指南(2023 年)。
IF 2.8 3区 医学 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-07 DOI: 10.1007/s12094-024-03605-2
Laura Ortega Morán, Francisco José Pelegrín Mateo, Rut Porta Balanyà, Jacobo Rogado Revuelta, Silverio Ros Martínez, José Pablo Berros Fombella, Elena María Brozos Vázquez, Natalia Luque Caro, José Muñoz Langa, Mercedes Salgado Fernández

The Spanish Society of Medical Oncology (SEOM) last published clinical guidelines on venous thromboembolism (VTE) and cancer in 2019, with a partial update in 2020. In this new update to the guidelines, SEOM seeks to incorporate recent evidence, based on a critical review of the literature, to provide practical current recommendations for the prophylactic and therapeutic management of VTE in patients with cancer. Special clinical situations whose management and/or choice of currently recommended therapeutic options (low-molecular-weight heparins [LMWHs] or direct-acting oral anticoagulants [DOACs]) is controversial are included.

西班牙肿瘤内科学会(SEOM)上一次发布静脉血栓栓塞症(VTE)与癌症的临床指南是在2019年,并于2020年进行了部分更新。在此次新的指南更新中,SEOM 在对文献进行严格审查的基础上,力求纳入最新证据,为癌症患者 VTE 的预防和治疗管理提供实用的最新建议。其中包括一些特殊的临床情况,这些情况下的管理和/或对目前推荐的治疗方案(低分子量肝素 [LMWHs] 或直接作用口服抗凝剂 [DOACs])的选择存在争议。
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引用次数: 0
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