Latest news with #NationalComprehensiveCancerNetwork
Medscape
04-06-2025
- Health
- Medscape
Fast Five Quiz: B-Cell Acute Lymphoblastic Leukemia
Though more common in pediatric populations, B-cell acute lymphoblastic leukemia (B-ALL) affects both children and adults, and it has several genetic subtypes that significantly affect prognosis and treatment decisions. Despite advances in treatment protocols, resistance mechanisms remain a significant challenge. However, some genetic subtypes are associated with more favorable prognosis, and the nuances of this disease are evident in the cascading treatment algorithm recommended by the National Comprehensive Cancer Network (NCCN) for pediatric and adult cases. What do you know about B-ALL? Check your knowledge with this quick quiz. The treatment of B-ALL involves a complex and intensive series of steps. In the induction phase, glucocorticoids are typically used to reduce tumor burden by clearing leukemic cells from the bone marrow. However, point mutations in the NR3C1 gene generally cause resistance to glucocorticoid therapy, which can significantly affect prognosis. Mutations in the CREBBP gene also cause resistance to glucocorticoids DHFR , FPGS , and TYMS genes have been shown to generally cause resistance to methotrexate, not glucocorticoids. Learn more about corticosteroids in B-ALL. In risk stratification for B-ALL, the NCCN notes that having a white blood cell count of > 30 x 109/L is considered a high-risk feature. This is consistent with European guidelines. The NCCN also states that age over 35 years is another high-risk feature for B-ALL. ETP phenotype is a high-risk feature for T-cell acute lymphoblastic leukemia rather than the B-ALL subtype. Hyperdiploidy (a molecular subtype of B-ALL with 51-65 chromosomes) is considered standard risk by the NCCN; data have shown better prognosis for pediatric patients with this subtype. Learn more about risk stratification for B-ALL. TKIs are an important component of induction, consolidation, and maintenance treatment for Ph+ B-ALL. They are recommended by the NCCN for use in conjunction with other drugs, such as corticosteroids, blinatumomab, and inotuzumab ozogamicin (depending on treatment phase and disease severity) and as a treatment post-HCT. They recommend continuing TKI therapy for at least 2 years after HCT, although they note that the 'optimal duration' is unknown for this population. A recent review, however, notes that despite their success in patients with Ph+ B-ALL, approximately 25% of cases will develop resistance to TKIs. Given this possibility, the NCCN notes that clinicians should consider prior TKI intolerance, dose used, BCR::ABL1 mutations, and disease-related features when choosing a specific TKI; they specifically recommend bosutinib, dasatinib, imatinib, nilotinib, or ponatinib as options for TKI therapy. Learn more about Ph+ B-ALL treatments. The DUX4-rearranged subtype of B-ALL is considered to have a favorable prognosis in adolescents and young adults, compared with MEF2D-rearranged, CDX2/UBTF, and IDH1/2; these subtypes generally have inferior prognosis in the same populations (although MEF2D-rearranged has intermediate prognosis in adults). Specifically, DUX4-rearranged B-ALL has been associated with 93% event-free survival and overall survival in pediatric patients, and adolescent and young-adult patients also see longer disease-free survival after complete remission is achieved. Learn more about B-ALL genomics. Several genetic subtypes of B-ALL are associated with varying prognoses, and the outcomes differences seen between pediatric and adult patients can be partly explained by the different subtypes expressed by these populations. Further, new therapies have enabled high survival rates among pediatric patients with B-ALL, with long-term survival of up to 90% in this population. Prognosis for B-ALL in adolescents and adults is comparatively poor. For example, a population-based study reported the following declining survival rates with age: 74% for patients 15-19 years old, 59% for patients 20-39 years old, and 43% for those 40-59 years old. However, the researchers explained that these percentages still demonstrate improvements, as survival rates were overall lower in the 1980s and 1990s. Learn more about B-ALL prognosis.
Medscape
04-06-2025
- Health
- Medscape
Rapid Review Quiz: Ovarian Cancer Screening and Prevention
Reliably screening for ovarian cancer in the general population remains a challenge. Common tools such as CA-125 testing and transvaginal ultrasound have shown limited sensitivity and specificity, leading to unnecessary surgeries and false reassurance. However, advances in genetic testing and molecular pathology have reshaped prevention strategies, particularly in individuals at elevated hereditary risk such as BRCA mutation carriers. Risk-reducing salpingo-oophorectomy remains the cornerstone of prevention for high-risk patients, while oral contraceptives offer a risk-reducing effect in the general population. Additionally, genetic counseling has become an essential step in identifying at-risk individuals who may benefit from tailored interventions. How much do you know about recent developments in ovarian cancer screening and prevention? Test your knowledge with this updated review. Despite significant research efforts, no screening strategy has yet demonstrated a mortality benefit in average-risk female patients. As noted in the National Comprehensive Cancer Network (NCCN) guidelines, landmark clinical trials — including the PLCO (Prostate, Lung, Colorectal, and Ovarian) cancer screening trial — failed to show a survival benefit from annual CA-125 testing or transvaginal ultrasound alone or in combination. The risk of ovarian cancer algorithm (ROCA) — which evaluates CA-125 trends over time — did improve early-stage detection rates but did not ultimately reduce mortality. As a result, current guidelines from the United States Preventive Services Task Force and other expert bodies, including the NCCN, recommend against routine screening for ovarian cancer in asymptomatic, average-risk females. Instead, attention has shifted toward identifying and managing high-risk individuals through genetic counseling and risk-reducing strategies. Routine screening in the general population is considered ineffective and may result in harms from false-positive tests and unnecessary surgical interventions. Learn more about the workup for ovarian cancer. Risk-reducing salpingo-oophorectomy (RRSO) remains the most effective strategy for preventing ovarian and fallopian tube cancer in individuals with BRCA1 or BRCA2 mutations. Guidelines recommend RRSO typically between ages 35 and 45, depending on the specific mutation and family history. This surgery significantly lowers the risk of high-grade serous carcinoma, the most common and aggressive subtype. Studies have shown that RRSO can reduce ovarian cancer risk significantly also confer a survival benefit, particularly in BRCA1 carriers. While oral contraceptives also reduce risk, they do not offer the same degree of protection as surgical removal of at-risk tissue. Annual pelvic exams and imaging have not demonstrated efficacy in early detection or mortality reduction in this population. Patients considering RRSO should be counseled about surgical menopause and may require hormone therapy depending on age and symptom burden. The procedure is essential in the preventive care of high-risk individuals. Learn more more about ovarian cancer deterrence and prevention. Emerging evidence over the past decade suggests that the fallopian tube epithelium — not the ovary — is the origin of many high-grade serous ovarian carcinomas. As a result, the practice of opportunistic salpingectomy — removing the fallopian tubes during hysterectomy or tubal sterilization procedures — has gained traction as a preventive strategy, even in females at average risk. Major gynecologic societies now endorse this practice as a safe and effective risk-reducing option during pelvic surgery for benign indications. The rationale is grounded in the theory of serous tubal intraepithelial carcinoma as a precursor lesion to high-grade serous cancer. Unlike endometrial cancer, whose origin lies in the uterine lining, salpingectomy directly targets the tissue where most serous carcinomas are thought to begin. Learn more about ovarian cancer and surgical considerations. Current guidelines recommend genetic counseling and consideration of BRCA and multigene panel testing in females with a personal or strong family history of breast, ovarian, fallopian tube, or peritoneal cancer. Identifying carriers of pathogenic variants enables implementation of life-saving risk-reducing strategies, including salpingo-oophorectomy or enhanced surveillance. Importantly, such testing is also offered to individuals with male relatives who have had breast cancer, early-onset cancers, or known mutations in cancer susceptibility genes. Genetic testing should ideally be preceded by counseling to interpret results accurately and discuss implications for family members. Patients with unrelated gynecologic conditions like endometriosis or abnormal uterine bleeding, and those without relevant family history, are not routinely offered genetic testing unless other risk factors emerge. Early identification of mutation carriers is essential for tailored management, timely preventive interventions, and cascade testing of at-risk relatives. Learn more about risk assessment and genetic counseling in ovarian cancer. Multiple large observational studies and meta-analyses have consistently demonstrated a protective effect of combined oral contraceptives (COCs) against ovarian cancer. The reduction in risk is observed with long-term use, typically over 5 years, and persists for decades after discontinuation. The proposed mechanism involves suppression of ovulation, thereby reducing the repetitive trauma and repair cycles to the ovarian epithelium, which may underlie carcinogenesis. The protective effect spans multiple histologic subtypes, including high-grade serous, endometrioid, and clear cell carcinomas. While other agents such as NSAIDs have been evaluated, their protective role is less well established and not considered standard for chemoprevention. Aromatase inhibitors and bisphosphonates are not used for ovarian cancer prevention. As with any medication, the decision to use oral contraceptives must consider individual risk profiles, including thromboembolic and cardiovascular risks, and be guided by patient preferences and shared decision-making. Learn more about ovarian cancer and the impact of oral contraceptives.
Yahoo
29-05-2025
- Business
- Yahoo
Helix releases pharmacogenomics tests for use in neurology and oncology
US-based genomics company Helix has released a new suite of pharmacogenomics (PGx) tests, widening its portfolio to offer personalised patient care in neurology and oncology. The suite includes a PGx Fluoropyrimidines DPYD test to detect individuals with dihydropyrimidine dehydrogenase (DPYD) gene variants at risk for side effects from certain chemotherapies, aligning with the recent guidelines from the National Comprehensive Cancer Network. The DPYD test provides insights into a patient's metabolism of cancer treatments. It targets therapies used in treating breast, pancreatic, head and neck, colorectal, and oesophageal cancers. Additionally, the suite includes the PGx APOE test to evaluate the status of apolipoprotein E (APOE) relevant to Alzheimer's drugs. It assesses the risk of serious adverse effects such as amyloid-related imaging abnormalities (ARIA) for individuals treated with Leqembi or Kisunla. These drugs have US Food and Drug Administration (FDA) boxed warnings for individuals with two copies of the APOE ε4 allele. With these tests, Helix now covers all neurology and oncology-associated PGx haplotypes cited in the agency's warnings. The company noted that its PGx tests offer accuracy across varied populations, utilising its Exome+ assay and comprehensive star allele caller. Its Sequence Once, Query Often model allows for exomes to be sequenced just once, with subsequent genetic tests not requiring additional samples. This facilitates rapid results, enabling genetic insights at the point of care. Helix's latest PGx tests encompass medications for cancer, cardiovascular diseases, pain management, gastrointestinal conditions, and anaesthesia guidance. These tests add to the company's existing PGx offerings for blood clotting, mental health, and immune suppression treatments. In addition, Helix has also developed the Helix Research Network in collaboration with its partners. This precision clinical research network comprises health systems focused on integrating genomics into routine care and advancing human health through genomics research. It also creates real-world evidence to support a wide range of initiatives, including studies showing the genomics' clinical use. Helix chief science officer Will Lee said: 'By focusing on patients with neurodegenerative conditions and cancer, and actively identifying those at higher risk for adverse outcomes, we can help providers treat vulnerable patients more precisely and effectively.' "Helix releases pharmacogenomics tests for use in neurology and oncology" was originally created and published by Medical Device Network, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Time of India
28-05-2025
- Health
- Time of India
Why it's tough to detect prostate cancer
Former US president 's health was a matter of intense focus while he was in office due to his episodes of forgetfulness and verbal slip-ups. But amid the speculation over his alleged cognitive decline, a far more serious illness was silently progressing inside his body. Tired of too many ads? go ad free now Biden, 82, was diagnosed with prostate cancer last week, and the disease has already metastasised to his bones. His condition has been characterised by a Gleason score of 9, near the top of the 6-10 scale used to grade prostate cancer severity. 'While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management,' his office said. Usual, But Unexpected Delayed diagnosis, experts say, is common in people who skip regular health check-ups or overlook clear signs of the disease. However, they add that late detection in someone as high-profile as Biden, who was president of the US until Jan this year and, therefore, was regularly monitored by a team of doctors, is unexpected and concerning. While some have questioned whether Biden's cancer could have been detected earlier, experts stress that his doctors were likely following standard protocol. Specialists note that prostate cancer is usually easy to detect early through a simple blood test — Serum PSA (Prostate-Specific Antigen). 'Early detection is possible in 99% of cases through PSA testing,' said Dr Amrendra Pathak, senior urologist at Sir Ganga Ram Hospital, Delhi. However, PSA screening isn't routinely recommended for men over 70, as the risk of overdiagnosis and unnecessary treatment may outweigh the benefits, according to reports on Medium, the online publishing platform. Leading medical bodies — including the US Preventive Services Task Force and the National Comprehensive Cancer Network — recommend discontinuing routine PSA testing after a certain age, unless the patient is in exceptionally good health. Tired of too many ads? go ad free now Given Biden's age and prior treatment for an enlarged prostate, the absence of a PSA test during his 2024 physical appears to be in line with the guidelines. A Tricky Customer Even with regular screening, however, prostate cancer can evade early detection. In some cases, the disease is metastatic from the outset, leaving no window for early diagnosis. In others, it may progress rapidly between PSA tests or fail to trigger elevated PSA levels at all. Studies also show that roughly 15% of men with prostate cancer may have normal PSA levels, especially since what is considered a 'normal' range increases with age. Dr Manav Suryavanshi, senior consultant and head of the urology division at Amrita Institute of Medical Sciences, Faridabad added: 'PSA is a critical marker, and in men who are predisposed to prostate cancer — due to family history, genetic mutations like BRCA1/2, or ethnicity — stricter and more frequent screening protocols are essential. In most clinical cases, if these protocols are followed rigorously, prostate cancer is usually detected at an early, localised stage where treatment is not only effective but also potentially curative. ' In early stages, when the disease is localised to the prostate, it can be cured by surgically removing the gland. But doctors say if it reaches a locally advanced stage, that is, if it spreads outside of the prostate gland into nearby tissues, multimodal therapy including surgery, radiotherapy, and hormonal treatment is required. Prostate cancer in India is on the rise, with nearly five lakh new cases being reported every year, said Dr Harit Chaturvedi, chairman, Max Institute of Cancer Care. The burden is expected to rise further due to population growth, increasing life expectancy, and an aging male population in the country.
Yahoo
14-05-2025
- Health
- Yahoo
NCCN Joins Global Cancer Organizations for First-Ever International Training/Mentoring Meeting on Cancer Control Plans
The United States-based National Comprehensive Cancer Network is among groups from up to 75 countries taking part in the Cancer Planners Forum in Geneva, Switzerland. GENEVA, May 14, 2025 /PRNewswire/ -- The National Comprehensive Cancer Network® (NCCN®)—a not-for-profit alliance of leading cancer centers in the United States that publishes evidence-based expert consensus-driven guidelines—is joining global organizations for the first-ever Cancer Planners Forum in Geneva, Switzerland on May 14-16. "We strive every day to improve access to high-quality, high-value, patient-centered cancer care for all people globally," said Crystal S. Denlinger, MD, Chief Executive Officer, NCCN. "We are proud to not only attend but also sponsor this important meeting as part of our commitment to international collaboration against cancer. It is crucial that every country or region has access to cancer plans based on the best available evidence to optimize care for people touched by cancer everywhere." The Cancer Planners Forum is the first meeting of its kind dedicated to training, mentoring and supporting individuals responsible for developing and implementing National Cancer Control Plans (NCCPs). It is organized and led by The Union for International Cancer Control (UICC)—of which NCCN is a member—with the partnership support of World Health Organization (WHO), the International Agency for Research on Cancer (IARC), the International Atomic Energy Agency (IAEA), and the International Cancer Control Partnership (ICCP). A recent study published in Lancet Oncology focused on a global review of NCCPs. The study involved more than 70 international experts—including from NCCN—analyzing 98 NCCPs and 58 non-communicable disease (NCD) plans from countries across all resource levels. While results show progress in overall national cancer strategies, there continue to be persistent gaps in funding, access, and integration of evidence-based interventions within NCCPs. The Cancer Planners Forum aims to address these gaps by fostering collaboration, promoting data-driven decision-making, and ensuring that cancer control plans are comprehensive, well-funded, and effectively implemented. Some topics that will be addressed include: Best practices in developing and implementing NCCPs The investment case for national cancer control planning Case studies on successful national cancer responses The role of cancer registries and data-driven decision-making The impact of law and policy on cancer control "This landmark forum is happening in an important year where NCDs, like cancer, are a focus for the global health agenda," said Katy Winckworth-Prejsnar, MPH, Director of NCCN's Global Program. "Critical upcoming global future meetings this year include the World Health Assembly (WHA) and the Fourth High-level Meeting of the UN General Assembly on the prevention and control of NCDs (HLM4). We hope that the learnings from this forum can be utilized by member states when advocating for NCCPs in the context of achieving Universal Health Coverage (UHC), NCD Global Action Plan targets, and Sustainable Development Goals (SDGs)." NCCN is well-positioned to contribute to this mission. Nearly half of the two million registered users for the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) are located outside the United States, representing more than 190 different countries. NCCN's Global program frequently collaborates with local and regional experts to create cancer control guidelines and resources tailored for the specific needs of that population. This includes International Adaptations of the NCCN Guidelines®, NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework™), and Translations of NCCN Guidelines and NCCN Guidelines for Patients®. All of NCCN's global cancer resources are available for free at or via the Virtual Library of NCCN Guidelines App. Visit to learn more. About the National Comprehensive Cancer NetworkThe National Comprehensive Cancer Network® (NCCN®) is marking 30 years as a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to defining and advancing quality, effective, equitable, and accessible cancer care and prevention so all people can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus-driven recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit for more information. Media Contact:Rachel Darwin267-622-6624darwin@ View original content to download multimedia: SOURCE National Comprehensive Cancer Network
