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The 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO-GU) reported several advancements in the field of urothelial carcinoma. Multiple new treatment options for non-muscle invasive bladder cancer (NMIBC) were introduced, providing more choices for bladder preservation in BCG-resistant/failed NMIBC cases. In muscle invasive bladder cancer (MIBC) perioperative treatment, the updated 3-year follow-up data from the CheckMate 274 study demonstrated a clear advantage in disease-free survival for the nivolumab monotherapy adjuvant treatment group. For metastatic urothelial carcinoma (mUC), the final overall survival (OS) report from the IMvigor130 study was published, prompting further considerations for future first-line treatment options in mUC. Additionally, the conference highlighted research progress in upper tract urothelial carcinoma (UTUC).
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The ASCO-GU 23 conference was held offline as scheduled after the pandemic. A total of 167 abstracts in the field of renal cell carcinoma has been posted during the conference, covering the first PET/CT diagnostic technology targeting tumors in renal cell carcinoma, risk stratified interpretation of the previous clinical trial results, and exploring the value of tumor and serum biomarkers for precise classification therapy, as well as providing evidence for the therapeutic scheme sequencing.
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In 2022, ASCO genitourinary cancer symposium reported the latest progress in the diagnosis and treatment of urothelial carcinoma. Perioperative treatment progress include prediction of the effect of neoadjuvant chemotherapy for muscle invasive bladder cancer (MIBC) and upper urinary tract epithelial carcinoma (UTUC). The matched cohort study of bladder-sparing treatment showed that the effect of trimodality therapy (TMT) and radical cystectomy was equivalent in oncologic outcome. Immunotherapy showed promising effects in the circumstance of advanced urothelial carcinoma, neoadjuvant therapy and non muscle invasive bladder cancer (NMIBC) treatment. Poly-adenosine diphosphate ribose polymerase (PARP) inhibitors and antibody coupled drugs (ADC) show antitumor activity in the treatment of advanced urothelial carcinoma. The meeting also reported a series of progress in biomarkers related to the prediction of curative effect of urothelial carcinoma.
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Surgery is so far the most effective treatment for early-stage non-small cell lung cancer (NSCLC). Since the 1990s, the pathology spectrum of early-stage lung cancer has gradually changed because of the increased detection of ground-glass opacity (GGO). The findings from preoperative thin-section computed tomography are strong predictors for the invasiveness and lymph node involvement of GGO, and limited surgery is believed to be implemented safely for radiological less invasive lesions, which calls into question the dominance of lobectomy. After the JCOG0201 trial establishing the radiologic criteria of pathological noninvasiveness for lung adenocarcinoma, the Japan Clinical Oncology Group (JCOG) and the West Japan Oncology Group (WJOG) have successively carried out a series of prospective imaging-guided trials to investigate the optimal surgical procedure for early-stage lung cancer. JCOG0804, was a single-arm, non-randomized, confirmatory trial to evaluate the efficacy and safety of sublobar resection (wedge resection and segmentectomy) for GGO dominant peripheral lung cancer. The primary end point was 5-year relapse-free survival. JCOG0802/WJOG4607L, was a multicentre, open-label, phase 3, randomized, controlled, non-inferiority trial to investigate if segmentectomy was non-inferior to lobectomy in patients with small-sized peripheral NSCLC. The primary endpoint was 5-year overall survival. JCOG1211 was also a non-randomized confirmatory trial to confirm the efficacy of a segmentectomy for clinical T1N0 lung cancer with dominant GGO. The primary endpoint was 5-year relapse-free survival. The findings of JCOG0804 and JCOG0802, and the primary analysis results of JCOG1211 have been officially published. This article systematically reviewed and interpreted the results of the JCOG lung cancer surgery trial series.
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Humans , Carcinoma, Non-Small-Cell Lung/surgery , Clinical Trials as Topic , Clinical Trials, Phase III as Topic , Japan , Lung Neoplasms/surgery , Multicenter Studies as Topic , Prospective Studies , Randomized Controlled Trials as TopicABSTRACT
Las urgencias oncológicas son un reto para el clínico. El síndrome de vena cava superior es una emergencia hemato-oncológica en pediatría, el cual se define como la obstrucción intrínseca o extrínseca de la vena cava superior. La clínica más frecuente en pediatría es la aparición de circulación colateral, edema en esclavina y cianosis facial. El diagnóstico es clínico y debe hacerse lo menos invasivamente posible y de una manera rápida, para iniciar cuanto antes su manejo. Los linfomas, el uso prolongado de catéter venoso central y la cirugía cardiovascular en cardiopatías congénitas, son las principales etiologías. En algunas ocasiones, puede ser necesario un tratamiento empírico para salvar la vida del paciente, mediante el uso de esteroides y radioterapia. El objetivo del presente artículo es revisar y actualizar los aspectos más importantes sobre la etiología, las manifestaciones clínicas, el diagnóstico y el tratamiento del síndrome de vena cava superior en pediatría
Oncological emergencies are a challenge for the clinician. The superior vena cava syndrome is a hemato-oncological emergency in pediatrics; it is defined as an intrinsic or extrinsic obstruction of the superior vena cava. The most frequent clinical manifestations in children are the appearance of collateral circulation, edema in the body and facial cyanosis. The diagnosis is clinical and should been done as little invasively as possible and without delay to start its management as soon as possible. Lymphomas, prolonged use of a central venous catheter, and cardiovascular surgery in congenital heart disease are the main etiologies. In some cases, empirical treatment may be necessary to save the patient's life, through the use of steroids and radiotherapy. The aim of this article is to review and update the most important aspects of the etiology, clinical manifestations, diagnosis and treatment of the superior vena cava syndrome in pediatrics
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Superior Vena Cava Syndrome , Pediatrics , Critical Care , Lymphoma , Medical Oncology , NeoplasmsABSTRACT
Owing to the developments in cell biology and other related disciplines, basic oncological research has progressed. There has been a gradual increase in the quantity and quality of research applications for oncology. This paper provided an overview of the applications and fundings (General Program, Youth Program and Regional Program) for clinical oncology of the National Natural Science Foundation of China in 2019, analyzed the research directions of the General Program from different perspectives and discussed representative research directions including non- coding RNA, immunotherapy, microenvironment, metabolism, as well as frontiers such as lymphangiogenesis, pyroptosis and ferroptosis, lysosome and mitochondrion in the field of clinical oncology.
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Peritoneal seeding is one of the three primary forms of cancer metastasis. Significant adverse events are observed in such cases due to inadequate understanding and knowledge of peritoneal cancer. Over the past 30 years, the establishment, improvement, and promotion of surgery-based integrated diagnostic and treatment strategy for peritoneal metastasis have led to an increase in basic, translational, and clinical research. This has resulted in the formation of a new discipline, peritoneal surface oncology. Based on an in-depth understanding of the biological basis, characteristics, and mechanisms of peritoneal metastasis, core clinical diagnostic and therapeutic techniques have been established and improved. From this, the "Ten Milestones" of high-level evidence-based treatment progress has been established. In 2012, the Chinese Journal of Clinical Oncology first launched the "Special Column on Peritoneal Metastasis," urging Chinese clinical oncologists to improve the diagnostic and therapeutic strategies for peritoneal carcinomatosis. Over the past 8 years, with full support from the China Anti-Cancer Association and from oncologists across the country, a comprehensive diagnostic and treatment system for peritoneal metastasis with Chinese characteristics has been established. The publication of the first monograph on this topic in Chinese and the formation of two expert consensuses have led to developments in discipline theory, research platform construction, clinical practice guidelines, and other aspects regarding peritoneal surface oncology in China. Once again, entrusted by the Chinese Journal of Clinical Oncology, we organized the special column "Highlights in Peritoneal Carcinomatosis" aiming to systematically summarize the latest achievements in the field of peritoneal cancer in China, promote the developments in clinical oncology, and provide an overview of the discipline of peritoneal surface oncology.
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Because clinical oncology course for undergraduates is related to many clinical specialties, traditional teaching of this course is likely to lead to repetition and contradiction of knowledge. Clinical medical college carried out integrated curriculum in clinical oncology for three years during the implementation of teaching reform to overcome the above-mentioned disadvantages. Teaching and research sections related to clinical oncology were horizontally integrated under the guidance of teaching affairs office; On the premise of meeting the requirements of teaching outlines, the clinical oncology in internal medicine, surgery and gynecology was systematically improved in accordance with cognitive laws. Following the previous year, PBL teaching program in clinical oncology still focused on the integration of theoretical course and probation course. After integration, the sub-specialty teacher team was gradually shaped, the teaching quality was significantly improved and the clinical thinking of medical students was enhanced.
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Endocrine therapy is the main treatment of hormone receptor-positive advanced breast cancer.How to reverse the endocrine resistance and the new endocrine therapy have become the focus of attention in the tumor community.The study of cyclin dependent kinase (CDKs) has developed rapidly,and the selective cdk4/6 inhibitors can significantly extend the progression-free survival of patients with endocrine resistance to breast cancer,which has been approved for standard treatment for advanced breast cancer.
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The 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, which took place May 31-June 4 in Chicago, drew more than 32,000 oncology specialists from around the world. The theme of 2019 ASCO conference was “Caring for Every Patient, Learning from Every Patient”. Among the topics of interest covered were new approaches to surmount limited access to cancer care and the latest advances in targeted therapies for pancreatic, prostate cancers and soft tissue sarcomas. In the field of head and neck cancer, 8 oral abstracts and 75 poster abstracts were presented at this meeting. In this review, we are going to summarize the eight studies that have been presented orally. The topics are recurrent and/or metastatic head and neck squamous cell carcinoma for two abstracts (#6000, #6002), salivary duct carcinoma for one abstract (#6001), locally advanced nasopharyngeal carcinoma for two abstracts (#6003, #6004), oropharyngeal carcinoma for two abstracts (#6006, #6008), and oral cavity cancer for one abstract (#6007).
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Humans , Carcinoma, Squamous Cell , Head , Head and Neck Neoplasms , Learning , Medical Oncology , Mouth , Neck , Prostatic Neoplasms , Salivary Ducts , Sarcoma , SpecializationABSTRACT
Because clinical oncology course for undergraduates is related to many clinical specialties , traditional teaching of this course is likely to lead to repetition and contradiction of knowledge. Clinical medical college carried out integrated curriculum in clinical oncology for three years during the implementation of teaching reform to overcome the above-mentioned disadvantages. Teaching and research sections related to clinical oncology were horizontally integrated under the guidance of teaching affairs office; On the premise of meeting the requirements of teaching outlines, the clinical oncology in internal medicine, surgery and gynecology was systematically improved in accordance with cognitive laws. Following the previous year, PBL teaching program in clinical oncology still focused on the integration of theoretical course and probation course. After integration, the sub-specialty teacher team was gradually shaped, the teaching quality was significantly improved and the clinical thinking of medical students was enhanced.
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Chemotherapy induced thrombocytopenia (CIT) is a common side-effect of chemotherapy in cancer patients, which lead to dose and cycle reduction or chemotherapy delay, or even the need of platelet transfusion. Therefore, CIT significantly increases the cost of treatment, reduces the efficacy of chemotherapy and the quality of life, and shortens the survival time of patients. The main treatments of CIT include transfusion of platelets, recombinant human thrombopoietin (rhTPO), and recombinant human interleukin-11 (rhIL-11). RhIL-11 is the first approved thrombocytopoietic cytokine. Interleukin-11 has been shown to be effective in the treatment of thrombocytopenia. RhTPO is a recombinant full-length glycosylated thrombopoietin, which is a ligand for c-Mpl protein. Several observations indicated that administration of rhTPO before and after chemotherapy might be beneficial to patients, which enhances platelet recovery and reduces thrombocytopenia after moderately myelosuppressive regimens. In recent years, the application of rhTPO in CIT treatment has dramatically changed the management and treatment plan of CIT. The China Society of Clinical Oncology (CSCO) published a consensus on CIT in 2014. Based on this, the expert committee updated "Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China (2018)" according to the recent literature and clinical research. The new evidence-based practice consensus for CIT aims to provide more reasonable diagnosis, treatment of prevention regimens for CIT patients to maintain the normal platelet counts.
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Humans , Antineoplastic Agents , Blood Platelets , China , Consensus , Interleukin-11 , Therapeutic Uses , Neoplasms , Drug Therapy , Platelet Count , Platelet Transfusion , Quality of Life , Receptors, Thrombopoietin , Recombinant Proteins , Therapeutic Uses , Thrombocytopenia , Diagnosis , Drug Therapy , Mortality , Thrombopoietin , Therapeutic UsesABSTRACT
Chemotherapy induced thrombocytopenia (CIT) is a common side-effect of chemotherapy in cancer patients, which lead to dose and cycle reduction or chemotherapy delay, or even the need of platelet transfusion. Therefore, CIT significantly increases the cost of treatment, reduces the efficacy of chemotherapy and the quality of life, and shortens the survival time of patients. The main treatments of CIT include transfusion of platelets, recombinant human thrombopoietin (rhTPO), and recombinant human interleukin-11 (rhIL-11). RhIL-11 is the first approved thrombocytopoietic cytokine. Interleukin-11 has been shown to be effective in the treatment of thrombocytopenia. RhTPO is a recombinant full-length glycosylated thrombopoietin, which is a ligand for c-Mpl protein. Several observations indicated that administration of rhTPO before and after chemotherapy might be beneficial to patients, which enhances platelet recovery and reduces thrombocytopenia after moderately myelosuppressive regimens. In recent years, the application of rhTPO in CIT treatment has dramatically changed the management and treatment plan of CIT. The China Society of Clinical Oncology (CSCO) published a consensus on CIT in 2014. Based on this, the expert committee updated "Consensus on clinical diagnosis, treatment and prevention management of chemotherapy induced thrombocytopenia in China (2018)" according to the recent literature and clinical research. The new evidence-based practice consensus for CIT aims to provide more reasonable diagnosis, treatment of prevention regimens for CIT patients to maintain the normal platelet counts.
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Objetivos: Considerar el diagnóstico de sarcoidosis y reacción sarcoid-like en pacientes oncológicos controlados por tomografía computada por emisión de positrones (PET/TC), que presentan adenopatías hiliomediastinales hipercaptantes, para evitar errores diagnósticos. Materiales y métodos: Se analizaron retrospectivamente 18 estudios PET/TC realizados durante 3 anos a pacientes con tumores sólidos y linfoma, que presentaron adenopatías hiliomediastinales hipermetabólicas. El patrón morfológico, la distribución y, en algunos casos, la asociación con nódulos pulmonares permitieron plantear como diagnóstico diferencial la sarcoidosis. Resultados: Las enfermedades oncológicas correspondieron a mama (n = 4), próstata (n = 3), ovario (n = 2) y otros (n = 9). En 9 pacientes se obtuvo la confirmación histopatológica. En 7 de los 18 pacientes, las adenopatías fueron catalogadas como benignas por confirmación histológica de sarcoidosis, antracosis o reacción sarcoid-like. En 5 el comportamiento evolutivo fue compatible con benignidad, en 2 la biopsia mostró secundarismo y en los 4 restantes la evolución demostró malignidad. El total de lesiones benignas fue de 12 (66%). Discusión: El hallazgo de adenopatías hiliomediastinales hipermetabólicas con patrón morfológico y de distribución que orientan a sarcoidosis lleva a plantear esta entidad. En pacientes oncológicos, se requiere biopsia para descartar recaída. El uso de nuevos marcadores PET/TC para un diagnóstico diferencial representa un desafío. Los trazadores de síntesis de aminoácidos, como la 18F-fluorotimidina (FLT) y 18F-fluorometiltirosina (FMT), han demostrado ser útiles en la diferenciación entre malignidad y enfermedades granulomatosas. Conclusión: En estudios PET/TC de pacientes oncológicos, la presencia de adenopatías hiliomediastinales bilaterales y simétricas debe plantear sarcoidosis como diagnóstico diferencial.
Purposes: To describe the radiological findings of sarcoidosis or sarcoid-like reactions in cancer patients being monitored by positron emission computed tomography (PET/CT). Materials and methods: A retrospective analysis was performed on 18 PET/CT studies performed over 3 years in patients with lymphomas and solid tumours who presented with hypermetabolic hiliar-mediastinal adenopathies. The morphological pattern of these adenopathies, the distribution, and in some cases the association with pulmonary nodules, might suggest sarcoidosis as a differential diagnosis. Results: Oncological diseases corresponded to breast (4), prostate (3), ovary (2), and others (9). The adenopathies were classified in 7 of the 18 patients as benign after histological confirmation of sarcoidosis, anthracosis or sarcoid-like reaction. The evolutionary behaviour in 5 patients was compatible with benign lesions. The biopsy of 2 patients indicated secondary lesions and malignancy was confirmed by the evolution of the 4 remaining cases. There was a total of 12 (66%) benign lesions. Discussion: Sarcoidosis must be suspected in the presence of hypermetabolic hiliar-mediastinal adenopathies with a characteristic morphological pattern and pulmonary changes. However, biopsy is required to rule out oncological recurrence. The use of new PET/CT markers for differential diagnosis represents a challenge. Aminoacid synthesis tracers such as 18F-fluorothymidine (FLT) and 18F-fluoromethyltyrosine (FMT) are useful in the differentiation between malignancy and granulomatous diseases in oncologic patients. Conclusion: The differential diagnosis of sarcoidosis should be considered in the presence of bilateral symmetric mediastinal hilum lymphadenopathies.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sarcoidosis/diagnostic imaging , Neoplasms/pathology , Retrospective Studies , Lymphadenopathy/diagnostic imaging , Positron Emission Tomography Computed Tomography , Medical OncologyABSTRACT
It is plentiful about the 289 abstracts for the colorectal cancer (CRC) in the 2017 annual meeting of the American Society of Clinical Oncology (ASCO),which include:(1) comparison between long and short courses of postoperative adjuvant chemotherapy for stage Ⅲ CRC in the early diseases,applications of the full course of neoadjuvant therapy for locally advanced rectal cancer and laparoscopic total mesorectal excision for rectal cancer.(2) The use of Vitamin D3 and selective interstitial radiotherapy for metastatic CRC in the advanced diseases showed an encouraging efficacy.Patients with BRAF mutation and poor prognosis underwent a combination therapy of BRAF inhibitor and epidermal growth factor receptor (EGFR),which has created a new situation for precision therapy.And China's domestically designed Fruquintinib (small-molecule kinase inhibitor) and EGFR CMABO09 have showed better clinical efficacies in the second-line therapy.(3) On the precision medicine and translational researches,clinical value of consensus of molecular subtypes is being revealed and liquid biopsy is advantageous to predict postoperative tumor recurrence.These new therapies and researches would impact the clinical practices,promote clinical development and benefit the patients.
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The 53rd annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago,United States between June 2 and 6,2017.The latest advances in biliary tract cancer research from this meeting were summarized and analyzed in this paper.The adjuvant therapy in biliary tract cancer made a breakthrough in this meeting,the findings could provide the basis for a new standard of changing the current management model in the disease.The precision medicine and targeted therapy will be the development direction in the future.Doctors should attach great importance to the adjuvant and comprehensive therapy in biliary tract cancer and initiate high level multi-center clinical trials to improve the overall the diagnostic and treatment levels of biliary tract cancer.
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The 2017 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held on June 2-6,2017 in Chicago,United States.And the academic event showed the frontier researches in the field of oncology.Survival prediction in patients treated by FOLFIRI regimen and bevacizumab for metastatic colorectal cancer using radiomics approach was made in Abstract 3601.Authors aim to summarize the application and development of radiomics in digestive system tumors.
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Objective To explore the value of an innovative teaching model which combined problem based learning (PBL) method with case based learning (CBL) method in clinical oncology Teaching.Methods 68 students were divided into the combinational teaching group (30 cases) and the LBL group (38 cases).The combinational teaching group was taught by PBL method combined with CBL method, and this dual track teaching was based on cases and problems.The traditional teaching group was taught by LBL method.The teaching effect was evaluated by students' questionnaire survey and test score.SPSS 13.0 was used to two groups to do t test for statistical analysis in test score and x2 test for degree of satisfaction.Results In the final examination, the score of non-case test of combinational teaching group was similar to that of traditional teaching group (50.30 ± 7.19 vs.52.04 ± 8.01, P=0.358).The combinational teaching group had significant improvement in case analysis test (35.76 ± 5.28 vs.31.80 ± 5.16), and the difference was statistically significant (P=-0.003).In the course of teaching satisfaction survey, the dual track teaching group, compared with the conventional teaching group, has a better effect on self study ability, communication skills, communication skills, and higher satisfaction for teaching, and more willing to continue to carry out teaching (P＜0.05).Conclusion The PBL+CBL combinational teaching model can make a great contribution to improving the teaching quality and satisfaction, and worthy of being popularized and applied.
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Nowadays,the lack of medical humane education is an important reason for the increasingly tense relationship between doctors and patients.Cancer-related pain is a common symptom and self-feeling of patients with malignant tumor,leading to extreme agony.Good pain management will control patients' cancer-pain and greatly improve their life quality.It also needs doctors' good communication with patients,their guidance and cooperation,which highlight the medical humanism,and embody the medical humanistic care.Recent strategies of good pain management advocated by the Ministry of Health will help to improve the humanity character education of clinical oncology teaching.
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Objective Explore the effect of case method on clinical teaching of Medical Oncology. Methods The case method was taken in the teaching of Clinical Oncology for trial group,and the traditional method teaching was taken for contrast group of our university. At the end of term, we made a questionnaire and statistics examination records. Results (1) It was conducive to good learning ability. Case method teaching in Clinical Oncology could cultivate student's ability to study independently. (2) Comparing examination records of the two groups, it also showed a significant difference ( <0.05) . Conclusion (1) Case method teaching has good teaching effect, and it can cultivate student's ability to study independently. (2) Application of case teaching method in Clinical Oncology received a very good teaching result, but the assessment system should be established and improved.