Articles related to GUIDELINES/RECOMMENDATIONS

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 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.

The American Optometric Association (AOA) has released a revised clinical practice guideline to help doctors of optometry provide comprehensive eye and vision exams for adults. The guideline was created due to the significant public and economic impact of increasing visual impairments, blindness, and an aging population in the United States. The guideline recommends annual comprehensive eye exams for adults aged 18-64 to optimize visual function, detect sight-threatening eye and systemic health conditions early, and prevent or reduce vision loss. The guideline emphasizes that early detection of eye and vision problems can improve a patient’s visual function and quality of life.

Key practice-changing points from the latest guidelines: • 1st line therapy is sacubitril plus valsartan, as this combination increases survival and reduces hospitalizations versus ACE inhibitors and ARBs.• ACE inhibitors should be used only in patients who cannot tolerate sacubitril-valsartan, and ARBs used only in those who cannot tolerate either the 1st- or 2nd-line recommended therapies.• Patients whose ejection fraction increases to more than 40% under therapy should continue to receive therapy.

Per the Standards, “diabetes management in older adults requires regular assessment of medical, psychological, functional, and social domains. Older adults with diabetes have higher rates of premature death, functional disability, accelerated muscle loss, and coexisting illnesses … and … are also at greater risk for several common geriatric syndromes, such as polypharmacy, cognitive impairment, depression, urinary incontinence, injurious falls, persistent pain, and frailty. All these can impair their self-management.”

A clear synopsis of the McDonald criteria, including application of the criteria with different manifestations of MS. This overview also provides an FAQ and the features the criteria in tabular and chart formats.