Pub Date : 2024-11-01DOI: 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.
{"title":"Prospective study of the real impact of fusion centered genomic assays in patient management in a national collaborative group: the GETHI-XX-16 study.","authors":"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","doi":"10.1007/s12094-024-03745-5","DOIUrl":"https://doi.org/10.1007/s12094-024-03745-5","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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 Pharos<sup>TM</sup> and Archer FusionPlex Solid Tumor<sup>TM</sup>). A central committee evaluated the actionability of genetic alterations and reported the findings to attending physicians, who made the final clinical management decisions.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-07-15DOI: 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.
{"title":"SEOM-GEICO clinical guideline on epithelial ovarian cancer (2023).","authors":"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","doi":"10.1007/s12094-024-03531-3","DOIUrl":"10.1007/s12094-024-03531-3","url":null,"abstract":"<p><p>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.</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/PMC11467069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617509","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}
Pub Date : 2024-11-01Epub Date: 2024-04-25DOI: 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.
{"title":"SEOM-GEINO clinical guidelines for grade 2 gliomas (2023).","authors":"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","doi":"10.1007/s12094-024-03456-x","DOIUrl":"10.1007/s12094-024-03456-x","url":null,"abstract":"<p><p>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.</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/PMC11467015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871669","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}
Pub Date : 2024-11-01Epub Date: 2024-09-26DOI: 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.
{"title":"SEOM-GETNE-TTCC Clinical guideline thyroid cancer (2023).","authors":"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","doi":"10.1007/s12094-024-03736-6","DOIUrl":"10.1007/s12094-024-03736-6","url":null,"abstract":"<p><p>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.</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/PMC11467120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331763","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}
Pub Date : 2024-11-01Epub Date: 2024-06-01DOI: 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.
{"title":"SEOM clinical guidelines for cancer anorexia-cachexia syndrome (2023).","authors":"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","doi":"10.1007/s12094-024-03502-8","DOIUrl":"10.1007/s12094-024-03502-8","url":null,"abstract":"<p><p>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.</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/PMC11466990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187131","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}
Pub Date : 2024-11-01Epub Date: 2024-05-15DOI: 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.
{"title":"SEOM-GEM clinical guidelines for cutaneous melanoma (2023).","authors":"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","doi":"10.1007/s12094-024-03497-2","DOIUrl":"10.1007/s12094-024-03497-2","url":null,"abstract":"<p><p>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.</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/PMC11467041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923893","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}
Pub Date : 2024-11-01Epub Date: 2024-06-24DOI: 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}
Pub Date : 2024-11-01Epub Date: 2024-07-03DOI: 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.
{"title":"SEOM-GG clinical guidelines for the management of germ-cell testicular cancer (2023).","authors":"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","doi":"10.1007/s12094-024-03532-2","DOIUrl":"10.1007/s12094-024-03532-2","url":null,"abstract":"<p><p>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.</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/PMC11467073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494140","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}
Pub Date : 2024-11-01Epub Date: 2024-07-18DOI: 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.
{"title":"SEOM-GEMCAD-TTD clinical guideline for the diagnosis and treatment of gastric cancer (2023).","authors":"Fernando Rivera, Federico Longo, Marta Martín Richard, Paula Richart, Maria Alsina, Alberto Carmona, Ana Belén Custodio, Ana Fernández Montes, Javier Gallego, Tania Fleitas Kanonnikoff","doi":"10.1007/s12094-024-03600-7","DOIUrl":"10.1007/s12094-024-03600-7","url":null,"abstract":"<p><p>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.</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/PMC11467061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635590","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}
Pub Date : 2024-11-01Epub Date: 2024-08-07DOI: 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.
{"title":"SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023).","authors":"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","doi":"10.1007/s12094-024-03605-2","DOIUrl":"10.1007/s12094-024-03605-2","url":null,"abstract":"<p><p>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.</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/PMC11467034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898843","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}