ABSTRACT
In 2018, cemiplimab-rwlc became the first systemic treatment approved by the US FDA for patients with metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced CSCC who are not candidates for curative surgery or curative radiation. In 2019, conditional approvals were granted by Health Canada and the European Commission for the same indications. Limited data exist pertaining to the clinical characteristics, disease progression and survivorship of patients with advanced CSCC in real-world clinical practice. CemiplimAb-rwlc Survivorship and Epidemiology (CASE) is a prospective Phase IV, noninterventional, survivorship and epidemiology study that will enroll patients with advanced CSCC who have recently initiated or who plan to receive cemiplimab in a real-world setting. Trial registration number: NCT03836105.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/epidemiology , Clinical Protocols , Skin Neoplasms/drug therapy , Skin Neoplasms/epidemiology , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents, Immunological/administration & dosage , Antineoplastic Agents, Immunological/adverse effects , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/mortality , Female , Humans , Male , Molecular Targeted Therapy , Neoplasm Metastasis , Neoplasm Staging , Prognosis , Skin Neoplasms/diagnosis , Skin Neoplasms/mortality , Treatment OutcomeABSTRACT
AIM: To describe treatment changes from 2011 to 2017 and demographic/clinical characteristics of patients with advanced melanoma who received systemic therapy by BRAF status. PATIENTS & METHODS: Treatment patterns were evaluated in adults from the Oncology Services Comprehensive Electronic Records database who received antimelanoma systemic therapy. RESULTS: Checkpoint inhibitors were prevailingly prescribed (66%); usage increased from 2011 (21%) to 2017 (84%). BRAF/MEK inhibitors were the second most common (21%); usage increased from 2011 (6%) to 2012 (18%) and stabilized until 2017 (22%). BRAF/MEK inhibitors (65%) and checkpoint inhibitors (57%) were predominantly used for BRAFMut melanoma. CONCLUSION: Overall, checkpoint inhibitors have supplanted other therapies for advanced melanoma. Treatment shifts have occurred for BRAFMut melanoma, notably increased use of checkpoint inhibitors and BRAF/MEK combinations compared with monotherapies.
ABSTRACT
The induction of the abscopal effect using immunotherapy and radiation is under investigation through case reports and institutional studies. We describe a case of the abscopal effect with a combination of ipilimumab, nivolumab, and palliative radiation, in a patient with metastatic head and neck squamous cell carcinoma (mHNSCC).
Subject(s)
Carcinoma, Basal Cell/drug therapy , DNA, Neoplasm/genetics , Mutation , Pyrimidines/therapeutic use , Skin Neoplasms/drug therapy , Sulfonamides/therapeutic use , Vascular Endothelial Growth Factor Receptor-2/genetics , Carcinoma, Basal Cell/genetics , Carcinoma, Basal Cell/secondary , DNA Mutational Analysis , Humans , Indazoles , Male , Middle Aged , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Vascular Endothelial Growth Factor Receptor-2/metabolismABSTRACT
Merkel cell carcinoma (MCC) is a rare and lethal skin cancer with few known treatment options. Management of this disease is challenging, and oncology nurses must understand the medical, physical, and psychosocial burden that MCC places on the patient and family caregivers. Patients must navigate a complex medical and insurance network that often fails to support patients with rare cancers. Nurses must advocate for these patients to ensure quality comprehensive cancer care.
Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Merkel Cell/drug therapy , Carcinoma, Merkel Cell/nursing , Rare Diseases/drug therapy , Rare Diseases/nursing , Skin Neoplasms/drug therapy , Skin Neoplasms/nursing , Female , Humans , Male , Middle Aged , Prognosis , Treatment OutcomeABSTRACT
CONTEXT: Ultrasonography is a valuable diagnostic tool in the clinical setting. Yet, medical students often have minimal familiarity with this technology. OBJECTIVE: To evaluate the ability of second-year medical students to use ultrasonography for identification of anatomic structures and pathologic conditions. DESIGN: A self-directed approach that reduced facilitator involvement, encouraging learning that mimicked the medical school's problem-based learning pathway program. METHODS: Five students were each given 10 hours of instruction in ultrasonographic techniques by three certified ultrasonographers in outpatient and hospital settings. Each student performed 40 hours of organ-specific ultrasonographic scans on another student in 2-hour sessions during 20 weeks. Images were archived for future evaluation and quality rating. Students took a 35-question posttraining examination with 10 contrived case scenarios. Questions were designed to test student knowledge in three categories: anatomic structure, technical skill, and clinical diagnosis. RESULTS: Posttraining examination results, expressed as the percent of correct answers for all five participants by category, were as follows: anatomic structure, 70%; technical skill, 70%; clinical diagnosis, 68%. Evaluations of the archived images, which were graded for proper anatomic identification and image clarity, yielded the following scores indicating "good" or "fair" quality for each anatomic region: abdominal, 80%; pelvic, 63%; cardiac, 73%. CONCLUSION: Second-year osteopathic medical students can attain a sufficient degree of proficiency in limited ultrasonographic technique.
