205 results match your criteria: "Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine[Affiliation]"

Multigene panel testing has allowed for the detection of a growing number of inherited pathogenic/likely pathogenic variants in people at high risk of cancer, including endometrial cancer (EC). Hereditary syndromes associated with EC include Lynch syndrome, PTEN hamartoma tumor syndrome, and Peutz-Jeghers syndrome. This manuscript provides the latest recommendations from the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric on the screening and management of EC in patients at high risk for these syndromes, as well as the advantages and limitations of multigene panel testing.

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NCCN Guidelines® Insights: Survivorship, Version 2.2024.

J Natl Compr Canc Netw

December 2024

National Comprehensive Cancer Network.

The NCCN Guidelines for Survivorship include recommendations for screening, evaluation, and treatment of psychosocial and physical problems resulting from adult-onset cancer and its treatment. They also include recommendations to promote healthy behaviors and immunizations in survivors and provide a framework for care coordination. These NCCN Guidelines Insights summarize the panel's current recommendations regarding sexual health and fertility.

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Background: Neoantigen vaccines can induce or enhance highly specific antitumor immune responses with minimal risk of autoimmunity. We have developed a neoantigen DNA vaccine platform capable of efficiently presenting both HLA class I and II epitopes and performed a phase 1 clinical trial in triple-negative breast cancer patients with persistent disease on surgical pathology following neoadjuvant chemotherapy, a patient population at high risk of disease recurrence.

Methods: Expressed somatic mutations were identified by tumor/normal exome sequencing and tumor RNA sequencing.

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  • - The NCCN Guidelines outline a comprehensive approach to diagnosing, staging, and treating ovarian, fallopian tube, and primary peritoneal cancers.
  • - Recent developments in the use of PARP inhibitors, both as maintenance therapy and standalone treatments, have significantly influenced the recommendations in these guidelines.
  • - These insights highlight the collaborative effort among experts to continuously update treatment protocols based on the latest research in ovarian cancer therapies.
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  • - The NCCN Guidelines for acute lymphoblastic leukemia (ALL) offer management recommendations that prioritize classifying ALL subtypes using immunophenotype and cytogenetic/molecular markers.
  • - The guidelines emphasize risk assessment and stratification to tailor therapy for both Ph-positive and Ph-negative ALL, specifically addressing treatment for adolescent, young adult, and adult patients.
  • - This excerpt highlights treatment recommendations specifically for adults newly diagnosed with Ph-negative ALL, grounded in the latest evidence-based research.
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  • - Financial hardship significantly affects Black prostate cancer survivors, who face both direct costs (like out-of-pocket expenses) and indirect costs (such as lost wages and time spent on care) that complicate their treatment decisions.
  • - The study gathered insights from 11 prostate cancer survivors and 11 caregivers through interviews, focusing on how financial factors intersect with material, behavioral, and psychosocial aspects of their lives.
  • - Participants highlighted the burden of treatment costs on their household budgets and emphasized the need for better support in understanding and managing these financial challenges during their treatment journey.
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  • * A multidisciplinary team of experts from various medical fields contributes to these guidelines, ensuring comprehensive care for patients with cancer-associated VTE.
  • * The guidelines provide specific evaluation processes and recommended treatment options tailored to the different types of cancer-associated VTE.
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  • * These guidelines are designed to support physicians in making informed decisions about CRC screening for patients who do not have specific genetic syndromes.
  • * Recent updates include insights on both primary and secondary CRC prevention, particularly addressing when to start screening for average-risk individuals and those with a relevant personal history of cancer.
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NCCN Guidelines® Insights: Rectal Cancer, Version 3.2024.

J Natl Compr Canc Netw

August 2024

National Comprehensive Cancer Network.

Article Synopsis
  • - Determining the best treatment plan for rectal cancer is complicated, involving choices between curative or palliative surgery and considering impact on bowel function and quality of life, especially for distal rectal cancer patients.
  • - Patients with rectal cancer face a higher risk of pelvic recurrence compared to those with colon cancer, making careful patient selection and a multidisciplinary treatment approach essential for better outcomes.
  • - Recent updates to the NCCN Guidelines for Rectal Cancer include new treatment options like endoscopic submucosal dissection for early cases, revisions to the total neoadjuvant therapy strategy, and a nonoperative "watch-and-wait" option for patients who respond well to initial therapy.
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Folate intake and colorectal cancer risk according to genetic subtypes defined by targeted tumor sequencing.

Am J Clin Nutr

September 2024

Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States.

Article Synopsis
  • Folate intake plays a crucial role in genetic and metabolic processes, and low levels are linked to higher cancer risk, specifically colorectal cancer (CRC).
  • The study analyzed dietary and supplemental folate intake among participants with CRC, investigating how this intake relates to specific genetic mutations using advanced sequencing techniques.
  • Results indicated that higher total folate intake generally reduced CRC risk, but the impact varied when considering mutation status in tumors, with a few specific gene mutations showing different associations with folate intake.
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  • Breast cancer treatment involves a team of specialists from surgical, radiation, and medical oncology fields.
  • The NCCN Guidelines provide recommendations for various types of breast cancer, including different stages and specific conditions like Paget's disease and treatment during pregnancy.
  • This issue highlights the management of systemic therapies for nonmetastatic breast cancer, both before and after surgery.
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The NCCN Guidelines for Cutaneous Melanoma (termed Melanoma: Cutaneous) provide multidisciplinary recommendations for diagnostic workup, staging, and treatment of patients. These NCCN Guidelines Insights focus on the update to neoadjuvant systemic therapy options and summarize the new clinical data evaluated by the NCCN panel for the recommended therapies in Version 2.2024 of the NCCN Guidelines for Cutaneous Melanoma.

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  • Colorectal cancer (CRC) ranks as the fourth most common cancer and the second deadliest in the U.S.
  • Treatment for advanced metastatic CRC includes multiple active drugs used alone or in combination, depending on patient-specific factors.
  • The paper reviews the systemic therapy recommendations for metastatic CRC as outlined in the NCCN Guidelines for Colon Cancer.
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  • Vulvar cancer is diagnosed in about 6,470 individuals each year, primarily as squamous cell carcinomas, constituting 5% to 8% of gynecologic cancers.
  • Key risk factors include older age, HPV infection, smoking, inflammatory vulvar conditions, and weakened immune systems.
  • The text reviews NCCN Clinical Practice Guidelines for treatments, surveillance, systemic therapies, and survivorship for those affected by vulvar cancer.
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  • Obesity is linked to various types of colorectal cancer (CRC), but the strength and cause of these links are not fully understood.
  • By using Mendelian randomization, researchers studied how body size traits like BMI, waist circumference, and body fat percentage affect risks for different CRC subtypes.
  • Results showed that higher BMI and body fat significantly increased the risks for serrated and alternate CRC pathways (Jass types 1, 2, and 3), while associations with the traditional pathway (Jass type 4) were weaker.
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BACKGROUND: Indolent systemic mastocytosis (ISM) is a clonal mast-cell disease driven by the KIT D816V mutation. We assessed the efficacy and safety of avapritinib versus placebo, both with best supportive care, in patients with ISM. METHODS: We randomized patients with moderate to severe ISM (total symptom score [TSS] of ≥28; scores range from 0 to 110, with higher numbers indicating more severe symptoms) two to one to avapritinib 25 mg once daily (n=141) or placebo (n=71).

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  • The genotoxin colibactin is linked to a specific mutation signature in colorectal cancer (SBS88), affecting tumor characteristics and possibly influencing risk and survival outcomes.
  • A study involving over 4,300 tumors found that higher fruit intake lowers the risk of SBS88-positive colorectal cancer, and some epidemiological factors like BMI and alcohol consumption show different associations based on the presence of SBS88.
  • While most risk and survival factors were similar regardless of SBS88 status, higher BMI might lead to worse survival outcomes for those with SBS88, suggesting a need for further research with more comprehensive genetic data.
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  • The treatment options for Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) have expanded with new advancements.
  • The NCCN Guidelines offer a structured approach for diagnosing, treating, and evaluating responses in patients with WM/LPL.
  • These guidelines apply to both newly diagnosed and previously treated individuals, ensuring effective follow-up care.
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The NCCN Guidelines for Cervical Cancer provide recommendations for all aspects of management for cervical cancer, including the diagnostic workup, staging, pathology, and treatment. The guidelines also include details on histopathologic classification of cervical cancer regarding diagnostic features, molecular profiles, and clinical outcomes. The treatment landscape of advanced cervical cancer is evolving constantly.

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  • - The treatment landscape for relapsed/refractory multiple myeloma has expanded significantly with new options like second generation proteasome inhibitors, immunomodulators, monoclonal antibodies, and CAR T cells, among others.
  • - Due to the nature of multiple myeloma, many patients will experience multiple relapses and require various combination therapies that consider their specific resistance patterns and individual factors such as age and health conditions.
  • - The NCCN Guidelines for multiple myeloma offer a structured approach to help healthcare providers make informed decisions regarding diagnosis, treatment, and monitoring for patients with relapsed/refractory multiple myeloma.
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mRNA vaccines have attracted widespread research attention with clear advantages in terms of molecular flexibility, rapid development, and potential for personalization. However, current mRNA vaccine platforms have not been optimized for induction of CD4/CD8 T cell responses. In addition, the mucosal administration of mRNA based on lipid nanoparticle technology faces challenges in clinical translation.

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Basal cell carcinoma (BCC) is the most common form of skin cancer in the United States. Due to the high frequency, BCC occurrences are not typically recorded, and annual rates of incidence can only be estimated. Current estimated rates are 2 million Americans affected annually, and this continues to rise.

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  • Novel targeted therapies have transformed how we treat relapsed/refractory B-cell lymphomas, including small molecule inhibitors and antibody-drug conjugates.
  • BTK inhibitors are becoming increasingly important in managing mantle cell lymphoma, whether in initial treatment or after relapse.
  • Anti-CD19 CAR T-cell therapies and bispecific T-cell engagers have emerged as effective options for treating relapsed follicular lymphoma and diffuse large B-cell lymphoma, leading to key updates in the NCCN Guidelines.
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