Articles related to Oncology, Surgical

This article analyzes the state of current treatment options and highlights recent advancements in illness diagnosis and staging, developing disease biomarkers, and relapse/refractory disease treatment. Clinical professionals should use testis cancer treatment algorithms carefully in order to maximize long-term survival and quality of life as well as short-term, disease-related results.

A recent guideline update published in the Journal of Clinical Oncology offers updated recommendations for managing noncastrate advanced, recurrent, or metastatic prostate cancer. The authors recommend five separate standards of care, including docetaxel, abiraterone, enzalutamide, apalutamide, or darolutamide, all administered with androgen deprivation therapy (ADT). Triplet therapy is superior to doublet therapy, and there are no recommendations for the use of any of these agents in any other combination or series apart from the triplet therapies of docetaxel plus abiraterone plus ADT and docetaxel plus darolutamide plus ADT. Docetaxel plus ADT should be offered to patients with metastatic noncastrate prostate cancer with high-volume disease who are unwilling or unable to receive triplet therapy. Triplet therapy should be offered to patients with de novo metastatic noncastrate prostate cancer with high-volume disease who are being offered ADT plus docetaxel chemotherapy, with significant overall survival and radiographic progression-free survival benefits. Overall, patients should be informed that doublet therapy (docetaxel plus ADT) has been proven inferior to triplet therapy such as abiraterone and prednisone plus docetaxel plus ADT.

The Organ Transplant and Procurement Network (OTPN) is set to undergo modernization and improvement after being criticized for lack of transparency, long waits, mishandling of organs, and the number of people who die on the waitlist each year. The Health Resources and Services Administration (HRSA) has launched the OTPN modernization project, which will focus on accountability. The current system is outdated and has been responsible for 70 deaths between 2010 and 2020, according to a 2022 senate report. The HRSA plans to take steps, such as creating a new dashboard, to provide transparency and better serve patients and their families. Additional modernization will focus on overhauling the operations of the OTPN system to ensure higher compliance and a greater focus on patient safety. Organ transplants and the OTPN disproportionately affect the Black community in the US. About 30% of the ONTP waitlist is Black Americans, and about 90% are waiting for kidney transplants. The HRSA’s plan hopes to address the inequality by improving accountability, transparency, and systems of organ retrieval and matching. The changes will benefit patients, and physicians might be able to see more of their patients receive the life-saving transplants they need.

The FDA’s Oncologic Drugs Advisory Committee (ODAC) has voted to support the use of polatuzumab vedotin-piiq (Polivy) in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola+R-CHP) for the first-line treatment of patients with previously untreated large B-cell lymphoma (LBCL). The committee voted 11-2 in favour of the drug following the confirmatory POLARIX trial, a double-blind, placebo-controlled, phase 3 study, which enrolled 879 patients with LBCL, including diffuse large B-cell lymphoma (DLBC), not otherwise specified (NOS). Although concerns were raised about modest benefits in progression-free survival (PFS) and similar overall survival (OS) between Pola+R-CHP and the standard treatment R-CHOP, ODAC member Neil Vasan, MD, PhD, said that the benefits outweighed the risks and Pola+R-CHP should be an option for first-time treatment of DLBCL with curative intent, as it could spare patients from more toxic and complicated salvage therapies.

At the 2023 National Comprehensive Cancer Network (NCCN) Annual Conference, a panel of experts discussed solutions to address staff shortages and retain workers in cancer care. The suggestions ranged from offering work-from-home opportunities to gifting small gestures like cookies and wine, with the aim of improving employee retention. The value of flexible working options and compensation were recurring themes, along with the importance of employee recognition programs and discussing career advancement opportunities. Exacerbated by the pandemic, burnout, and early retirements, the shortage of nurses and doctors in cancer centers has become more pressing as Americans grow older and require more oncology services. The panelists emphasized that having visible management, offering flexible working options, and providing employee recognition programs are important steps to retain staff in cancer care. They also discussed the significance of discussing career advancement opportunities and avoiding the use of temporary travel staff to retain employees.

The National Comprehensive Cancer Network (NCCN) Guidelines are continuously updated to reflect the latest advances in cancer treatment. New agents and combinations are introduced all the time, and NCCN guidelines are refreshed regularly to include new technologies, drugs, and approaches. The guidelines are developed and maintained by panels of experts who review the latest science, including new publications, FDA approvals, and information presented at scientific meetings. The goal is to include new information that has been sufficiently validated to provide clinical utility and benefit to patients. In-person interactions at the NCCN conference are essential to the exchange of ideas and the creation of relationships that lead to shared learning and collaboration. The NCCN plans to continue evolving and adapting to the changing landscape of cancer care by keeping up with the latest data and by focusing on inclusiveness, equity, and access. The organization aims to expand access to traditionally marginalized and underserved populations and to reach out to communities through their trusted sources. The NCCN is committed to learning from patients and communities to ensure that everyone benefits from advances in cancer treatment.