RESUMEN
The NCCN Guidelines for Hematopoietic Growth Factors provide recommendations for the appropriate use of growth factors in the clinical management of febrile neutropenia (FN), chemotherapy-induced thrombocytopenia (CIT), and chemotherapy-induced anemia (CIA). Management and prevention of these sequelae are an integral part of supportive care for many patients undergoing cancer treatment. The purpose of these guidelines is to operationalize the evaluation, prevention, and treatment of FN, CIT, and CIA in adult patients with nonmyeloid malignancies and to enable the patient and clinician to assess management options for FN, CIT, and CIA in the context of an individual patient's condition. These NCCN Guidelines Insights provide a summary of the important recent updates to the NCCN Guidelines for Hematopoietic Growth Factors, with particular emphasis on the incorporation of a newly developed section on CIT.
Asunto(s)
Anemia , Antineoplásicos , Neoplasias , Adulto , Anemia/inducido químicamente , Anemia/tratamiento farmacológico , Antineoplásicos/efectos adversos , Factores de Crecimiento de Célula Hematopoyética/uso terapéutico , Humanos , Neoplasias/tratamiento farmacológicoRESUMEN
Management of febrile neutropenia (FN) is an integral part of supportive care for patients undergoing cancer treatment. The NCCN Guidelines for Hematopoietic Growth Factors provide suggestions for appropriate evaluation, risk determination, prophylaxis, and management of FN. These NCCN Guidelines are intended to guide clinicians in the appropriate use of growth factors for select patients undergoing treatment of nonmyeloid malignancies. These NCCN Guidelines Insights highlight important updates to the NCCN Guidelines regarding the incorporation of newly FDA-approved granulocyte-colony stimulating factor biosimilars for the prevention and treatment of FN.
Asunto(s)
Biosimilares Farmacéuticos/uso terapéutico , Neutropenia Febril Inducida por Quimioterapia/tratamiento farmacológico , Factores de Crecimiento de Célula Hematopoyética/uso terapéutico , Neoplasias/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Biosimilares Farmacéuticos/economía , Biosimilares Farmacéuticos/normas , Neutropenia Febril Inducida por Quimioterapia/etiología , Aprobación de Drogas , Costos de los Medicamentos , Educación Médica Continua , Factores de Crecimiento de Célula Hematopoyética/economía , Factores de Crecimiento de Célula Hematopoyética/normas , Humanos , Oncología Médica/educación , Oncología Médica/normas , Neoplasias/sangre , Oncólogos/educación , Organizaciones sin Fines de Lucro/normas , Factores de Riesgo , Estados Unidos , United States Food and Drug Administration/legislación & jurisprudenciaRESUMEN
The NCCN Guidelines for Neuroendocrine and Adrenal Tumors provide recommendations for the management of adult patients with neuroendocrine tumors (NETs), adrenal gland tumors, pheochromocytomas, and paragangliomas. Management of NETs relies heavily on the site of the primary NET. These NCCN Guidelines Insights summarize the management options and the 2018 updates to the guidelines for locoregional advanced disease, and/or distant metastasis originating from gastrointestinal tract, bronchopulmonary, and thymus primary NETs.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/terapia , Prestación Integrada de Atención de Salud/normas , Oncología Médica/normas , Tumores Neuroendocrinos/terapia , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Adulto , Humanos , Tumores Neuroendocrinos/diagnóstico , Sociedades Médicas/normas , Estados UnidosRESUMEN
Metastatic primary cutaneous extramammary Paget disease (EMPD) is a rare clinical entity with a 5-year survival <10% and no standard therapy. We report the first case to our knowledge of metastatic EMPD with treatment response to checkpoint inhibitor immunotherapy. The patient had diffusely metastatic disease and previously progressed on cytotoxic chemotherapy and a molecularly targeted agent. Treatment with four cycles of ipilimumab 1 mg/kg plus nivolumab 3 mg/kg resulted in a durable partial response lasting 7 months. Analysis of metastatic tumor tissue failed to identify known predictors of treatment response to immune checkpoint inhibitors, such as high PD-L1 expression, high tumor mutation burden, or microsatellite instability. These findings support further investigation of immune checkpoint inhibition for the management of metastatic EMPD, which currently has an abysmal prognosis and no standard therapies.