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The Pancreatic Cancer Early Detection (PRECEDE) Study is a Global Effort to Drive Early Detection: Baseline Imaging Findings in High-Risk Individuals

George Zogopoulos, Ido Haimi, Shenin A. Sanoba, Jessica N. Everett, Yifan Wang, Bryson W. Katona, James J. Farrell, Aaron J. Grossberg, Salvatore Paiella, Kelsey A. Klute, Yan Bi, Michael B. Wallace, Richard S. Kwon, Elena M. Stoffel, Raymond C. Wadlow, Daniel A. Sussman, Nipun B. Merchant, Jennifer B. Permuth, Talia Golan, Maria Raitses-Gurevich, Andrew M. Lowy, Joy Liau, Joanne M. Jeter, James M. Lindberg, Daniel C. Chung, Julie Earl, Teresa A. Brentnall, Kasmintan A. Schrader, Vivek Kaul, Chenchan Huang, Hersh Chandarana, Caroline Smerdon, John J. Graff, Fay Kastrinos, Sonia S. Kupfer, Aimee L. Lucas, Rosalie C. Sears, Randall E. Brand, Giovanni Parmigiani, Diane M. Simeone, and on behalf of the PRECEDE Consortium

Background: Pancreatic adenocarcinoma (PC) is a highly lethal malignancy with a survival rate of only 12%. Surveillance is recommended for high-risk individuals (HRIs), but it is not widely adopted. To address this unmet clinical need and drive early diagnosis research, we established the Pancreatic Cancer Early Detection (PRECEDE) Consortium. Methods: PRECEDE is a multi-institutional international collaboration that has undertaken an observational prospective cohort study. Individuals (aged 18–90 years) are enrolled into 1 of 7 cohorts based on family history and pathogenic germline variant (PGV) status. From April 1, 2020, to November 21, 2022, a total of 3,402 participants were enrolled in 1 of 7 study cohorts, with 1,759 (51.7%) meeting criteria for the highest-risk cohort (Cohort 1). Cohort 1 HRIs underwent germline testing and pancreas imaging by MRI/MR-cholangiopancreatography or endoscopic ultrasound. Results: A total of 1,400 participants in Cohort 1 (79.6%) had completed baseline imaging and were subclassified into 3 groups based on familial PC (FPC; n=670), a PGV and FPC (PGV+/FPC+; n=115), and a PGV with a pedigree that does not meet FPC criteria (PGV+/FPC–; n=615). One HRI was diagnosed with stage IIB PC on study entry, and 35.1% of HRIs harbored pancreatic cysts. Increasing age (odds ratio, 1.05; P<.001) and FPC group assignment (odds ratio, 1.57; P<.001; relative to PGV+/FPC–) were independent predictors of harboring a pancreatic cyst. Conclusions: PRECEDE provides infrastructure support to increase access to clinical surveillance for HRIs worldwide, while aiming to drive early PC detection advancements through longitudinal standardized clinical data, imaging, and biospecimen captures. Increased cyst prevalence in HRIs with FPC suggests that FPC may infer distinct biological processes. To enable the development of PC surveillance approaches better tailored to risk category, we recommend adoption of subclassification of HRIs into FPC, PGV+/FPC+, and PGV+/FPC– risk groups by surveillance protocols.

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Prostate Cancer, Version 3.2024

Featured Updates to the NCCN Guidelines

Edward M. Schaeffer, Sandy Srinivas, Nabil Adra, Yi An, Rhonda Bitting, Brian Chapin, Heather H. Cheng, Anthony Victor D’Amico, Neil Desai, Tanya Dorff, James A. Eastham, Thomas A. Farrington, Xin Gao, Shilpa Gupta, Thomas Guzzo, Joseph E. Ippolito, R. Jeffrey Karnes, Michael R. Kuettel, Joshua M. Lang, Tamara Lotan, Rana R. McKay, Todd Morgan, Julio M. Pow-Sang, Robert Reiter, Mack Roach III, Tyler Robin, Stan Rosenfeld, Ahmad Shabsigh, Daniel Spratt, Russell Szmulewitz, Benjamin A. Teply, Jonathan Tward, Richard Valicenti, Jessica Karen Wong, Jenna Snedeker, and Deborah A. Freedman-Cass

The NCCN Guidelines for Prostate Cancer include recommendations for staging and risk assessment after a prostate cancer diagnosis and for the care of patients with localized, regional, recurrent, and metastatic disease. These NCCN Guidelines Insights summarize the panel's discussions for the 2024 update to the guidelines with regard to initial risk stratification, initial management of very-low-risk disease, and the treatment of nonmetastatic recurrence.

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Volume 22 (2024): Issue 2.5 (Apr 2024): Abstracts from the NCCN 2024 Annual Conference

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BIO24-030: Unifying Multimodal Data, Time Series Analytics, and Contextual Medical Memory: Introducing MINDS as an Oncology-Centric Cloud-Based Platform

Aakash Tripathi, Asim Waqas, and Ghulam Rasool

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BIO24-031: Hierarchical Multimodal Learning on Pan-Squamous Cell Carcinomas for Improved Survival Outcomes

Asim Waqas, Aakash Tripathi, Ashwin Mukund, Paul Stewart, Mia Naeini, and Ghulam Rasool

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BIO24-032: Early Diagnosis of Cancer Cachexia Using Body Composition Index as the Radiographic Biomarker

Sabeen Ahmed, Nathan Parker, and Ghulam Rasool

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BPI24-008: Pumping Iron in the Preoperative Period: Is It Beneficial in Reducing Blood Transfusions?

Carla Patel, Danielle Fournier, Susan Knippel, Cheryl Fraser, TaCharra Laury, Hue Cao, Mini George, and Arlene Correa

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BPI24-009: Improving Adherence to Safe Handling of Oral Hazardous Drugs and Contaminated Wastes Guidelines

Eliane Vieira, Grace Allen, and Sadeeka Al-Majid

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BPI24-010: Temporary Toilet Lids Minimize Contamination of Bathroom Surfaces With Hazardous Drugs

Eliane Vieira, Grace Allen, and Sadeeka Al-Majid