Assessment of Rare Cancers and Sarcoma Policy and Sarcoma Drug Approvals in Latin America: A Report From the LACOG Sarcoma Group.

Purpose: The availability of drugs and national public policies for patients with rare cancers, including sarcomas, varies in different parts of the world.

Methods: In this manuscript, we have conducted a comprehensive analysis to evaluate rare cancer policies in Latin American countries' national policy documents. Additionally, we have reviewed the approvals for sarcoma drugs in selected Latin American countries and compared them with US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approvals.

Challenges and opportunities for sarcoma care and research in Latin America: a position paper from the LACOG sarcoma group.

As a developing region, Latin America faces unique cancer control and prevention challenges, which are intensified when considering rare cancers, including sarcomas. Sarcomas are a group of malignancies that arise in the connective tissues of the body-such as muscle, fat, nerves, blood vessels, and bones-accounting for a diverse range of tumours that, although rare, require specialized attention. Sarcoma care and research in Latin America require a comprehensive approach that includes deeper epidemiologic knowledge, diagnostic capacity building, access to innovative treatments, increased patient advocacy, and strengthening of clinical research capacity.

Addressing the unmet needs of patients with BRAF-mutated melanoma in Latin America: Expert perspective.

Melanoma represents an increasing public health burden with extensive unmet needs in Latin America (LA). A mutation in the gene is present in approximately 50% of all melanomas in White populations and is a target of precision medicine, with the potential to dramatically improve patient outcomes. Thus, increased access to testing and therapy is LA must be explored.

Merkel cell carcinoma in Latin America: a contribution from an expanded access program for avelumab to address issues from experts' recommendations.

Background: Merkel cell carcinoma (MCC) is an aggressive malignancy, associated with poor outcomes in patients with metastatic disease (mMCC). Management has been dramatically altered as a result of incorporating immune checkpoint blockade agents. MCC data from Latin America (LATAM) come from case-series or individual records.

Demographic, Clinical, and Pathologic Features of Patients With Cutaneous Melanoma: Final Analysis of the Brazilian Melanoma Group Database.

Purpose: National epidemiologic data on melanoma are scarce in Brazil. The current work presents final demographic, clinical, and pathologic results from the Brazilian Melanoma Group database to detail how patients with melanoma present at diagnosis.

Methods: The online database includes patients diagnosed between 1982 and 2015 and evaluated at their centers of origin between 2001 and 2016.

Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas.

Introduction: Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines.

Methods: This consensus addresses the treatment of STSs in the extremities.

Analysis of the Abscopal Effect With Anti-PD1 Therapy in Patients With Metastatic Solid Tumors.

Abscopal effect is a rare phenomenon characterized by tumor regression of untreated metastatic lesions after a local therapy (eg, radiotherapy). We studied the probability of abscopal effect with radiotherapy associated with anti-programmed death cell 1 (PD1) therapy after progression on anti-PD1. This study is a retrospective analysis of patients treated with nivolumab or pembrolizumab for melanoma, non-small cell lung cancer (NSCLC) and renal cancer at Antônio Ermírio de Moraes Oncology Center, Brazil.

Toxicity of checkpoint inhibitors.

Immunologic checkpoint inhibitor is a new class of antineoplastic drugs which mechanism of action depends on the interaction with the immune system. The first in class was ipilimumab, anti-CTLA4, and soon the anti-PD1 (Programmed Death 1) and anti-PDL1 are expected to be available. Although the profile of adverse events is unique, they are predictable and, by complying with the guidelines available, the management of these drugs is safe in the great majority of patients.

Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma.

Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome.

Multiple metastases of malignant melanoma in the head and neck: a case report and literature review.

Malignant melanoma (MM) with multiple metastases (including the oral mucosa) is an extremely rare condition that is difficult to manage due to its complexity. This article presents the case of a 27-year-old man who first developed MM on the scalp, which subsequently metastasized to the mandible, parotid gland, infratemporal fossa, and the cervical regions of the larynx, kidneys, liver, and lungs. The findings of the present case report are compared with 31 other cases published in the English literature.

Workflow in clinical trial sites & its association with near miss events for data quality: ethnographic, workflow & systems simulation.

Background: With the exponential expansion of clinical trials conducted in (Brazil, Russia, India, and China) and VISTA (Vietnam, Indonesia, South Africa, Turkey, and Argentina) countries, corresponding gains in cost and enrolment efficiency quickly outpace the consonant metrics in traditional countries in North America and European Union. However, questions still remain regarding the quality of data being collected in these countries. We used ethnographic, mapping and computer simulation studies to identify/address areas of threat to near miss events for data quality in two cancer trial sites in Brazil.

Cutaneous melanoma in Latin America: the need for more data.

Objective: To identify the scientific literature on cutaneous melanoma in Latin America and compile all available epidemiologic data to demonstrate the need for reliable regional and country-specific data on incidence and mortality estimates.

Methods: Literature searches were conducted in PubMed, Embase, LILACS, and Google Scholar databases for epidemiologic studies from 1 January 2000 to 31 October 2010 related to melanoma in Argentina, Brazil, Colombia, Mexico, Puerto Rico, and Venezuela. A final search on melanoma cases was carried out using country-specific population-based cancer registries.

High-dose interleukin-2 in patients with metastatic melanoma whose disease progressed after biochemotherapy.

The objective of this study was to report our experience with 38 consecutive patients with metastatic melanoma treated with high-dose (HD) bolus interleukin (IL)-2 after disease progression on or after biochemotherapy as the only earlier treatment for metastatic disease. We conducted a retrospective review of all patients with metastatic melanoma treated with HD IL-2 at the Oncology Center of Hospital Sirio-Libanes between October 2000 and December 2009. The treatment consisted of IL-2, of 600,000 U/kg every 8 h for up to 14 doses, followed by 1-week rest and readmission for the second cycle.