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NCCN Guidelines Insights: Kidney Cancer, Version 2.2020

Featured Updates to the NCCN Guidelines

Robert J. Motzer, Eric Jonasch, M. Dror Michaelson, Lakshminarayanan Nandagopal, John L. Gore, Saby George, Ajjai Alva, Naomi Haas, Michael R. Harrison, Elizabeth R. Plimack, Jeffrey Sosman, Neeraj Agarwal, Sam Bhayani, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Thomas H. Gallagher, Steven L. Hancock, Christos Kyriakopoulos, Chad LaGrange, Elaine T. Lam, Clayton Lau, Bryan Lewis, Brandon Manley, Brittany McCreery, Andrew McDonald, Amir Mortazavi, Phillip M. Pierorazio, Lee Ponsky, Bruce G. Redman, Bradley Somer, Geoffrey Wile, Mary A. Dwyer, CGC, Lydia J. Hammond, and Griselda Zuccarino-Catania

-presenting cells, including immune cells and tumor cells). Ipilimumab is an antibody that selectively blocks the interaction between the negative regulator CTLA-4 (expressed early on activated T cells) and its ligands CD80/CD86 (expressed on antigen

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Yuefeng Wang, Xinhua Yu, Nan Zhao, Jiajing Wang, Chi Lin, Enrique W. Izaguirre, Michael Farmer, Gary Tian, Bradley Somer, Nilesh Dubal, David L. Schwartz, Matthew T. Ballo, and Noam A. VanderWalde

improve responses to anti-CTLA-4 treatment . Vaccine 2015 ; 33 : 7415 – 7422 . 32. Golden EB Chhabra A Chachoua A . Local radiotherapy and granulocyte-macrophage colony-stimulating factor to generate abscopal responses in patients with

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NCCN Guidelines® Insights: Melanoma: Cutaneous, Version 2.2021

Featured Updates to the NCCN Guidelines

Susan M. Swetter, John A. Thompson, Mark R. Albertini, Christopher A. Barker, Joel Baumgartner, Genevieve Boland, Bartosz Chmielowski, Dominick DiMaio, Alison Durham, Ryan C. Fields, Martin D. Fleming, Anjela Galan, Brian Gastman, Kenneth Grossmann, Samantha Guild, Ashley Holder, Douglas Johnson, Richard W. Joseph, Giorgos Karakousis, Kari Kendra, Julie R. Lange, Ryan Lanning, Kim Margolin, Anthony J. Olszanski, Patrick A. Ott, Merrick I. Ross, April K. Salama, Rohit Sharma, Joseph Skitzki, Jeffrey Sosman, Evan Wuthrick, Nicole R. McMillian, and Anita M. Engh

.org). Treatment of Unresectable Stage III or Distant Metastatic Disease (Stage IV): Updates to Systemic Therapy Options Anti–PD-1/Anti–CTLA-4 Combinations For several years, combination therapy with nivolumab/ipilimumab has been a recommended option for

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Jacalyn Rosenblatt and David Avigan

cells, and plasmacytoid dendritic cells (DCs), contributes to an immunosuppressive microenvironment that promotes tumor growth. Negative costimulatory molecules, including CTLA4 and PD-L1, play a vital role in promoting T-cell exhaustion and anergy in

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Benjamin Levy, Ashish Saxena, and Bryan J. Schneider

apoptotic and hedgehog pathways, respectively. The insulin-like growth factor 1 receptor (IGF-1R) pathway may be deregulated in SCLC, and studies with the monoclonal antibody cixutumumab (IGF-1R antagonist) are underway. 65 The anti-CTLA-4 antibody

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Melanoma, Version 2.2013

Featured Updates to the NCCN Guidelines

Daniel G. Coit, Robert Andtbacka, Christopher J. Anker, Christopher K. Bichakjian, William E. Carson III, Adil Daud, Dominick DiMaio, Martin D. Fleming, Valerie Guild, Allan C. Halpern, F. Stephen Hodi Jr., Mark C. Kelley, Nikhil I. Khushalani, Ragini R. Kudchadkar, Julie R. Lange, Anne Lind, Mary C. Martini, Anthony J. Olszanski, Scott K. Pruitt, Merrick I. Ross, Susan M. Swetter, Kenneth K. Tanabe, John A. Thompson, Vijay Trisal, Marshall M. Urist, Nicole McMillian, and Maria Ho

-modulating receptor cytotoxic T lymphocyte antigen-4 (CTLA-4), received FDA approval for treatment of metastatic melanoma in 2011. Approval was based on results of a randomized phase III trial of 676 patients with unresectable metastatic disease that had progressed

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Harish N. Vasudevan and Sue S. Yom

Checkpoint inhibitors include agents such as durvalumab, which blocks interactions between host T lymphocytes and PD-L1 expressed on host antigen-presenting cells as well as tumors, and pembrolizumab and nivolumab, which block interactions with PD-1. CTLA-4

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Daniel C. McFarland, Devika R. Jutagir, Andrew H. Miller, William Breitbart, Christian Nelson, and Barry Rosenfeld

2015 ; 348 : 124 – 128 . 10.1126/science.aaa1348 25765070 18. Snyder A , Makarov V , Merghoub T , . Genetic basis for clinical response to CTLA-4 blockade in melanoma . N Engl J Med 2014 ; 371 : 2189 – 2199 . 10.1056/NEJMoa1406498 25409260

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Daniel G. Coit, John A. Thompson, Alain Algazi, Robert Andtbacka, Christopher K. Bichakjian, William E. Carson III, Gregory A. Daniels, Dominick DiMaio, Marc Ernstoff, Ryan C. Fields, Martin D. Fleming, Rene Gonzalez, Valerie Guild, Allan C. Halpern, F. Stephen Hodi Jr, Richard W. Joseph, Julie R. Lange, Mary C. Martini, Miguel A. Materin, Anthony J. Olszanski, Merrick I. Ross, April K. Salama, Joseph Skitzki, Jeff Sosman, Susan M. Swetter, Kenneth K. Tanabe, Javier F. Torres-Roca, Vijay Trisal, Marshall M. Urist, Nicole McMillian, and Anita Engh

-cell activation to promote immune responses needed to fight cancer. Ipilimumab, a monoclonal antibody directed to the immune checkpoint receptor CTLA-4, has been shown to significantly improve progression-free survival and OS in patients with unresectable or

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Manisha H. Shah, Whitney S. Goldner, Al B. Benson III, Emily Bergsland, Lawrence S. Blaszkowsky, Pamela Brock, Jennifer Chan, Satya Das, Paxton V. Dickson, Paul Fanta, Thomas Giordano, Thorvardur R. Halfdanarson, Daniel Halperin, Jin He, Anthony Heaney, Martin J. Heslin, Fouad Kandeel, Arash Kardan, Sajid A. Khan, Boris W. Kuvshinoff II, Christopher Lieu, Kimberly Miller, Venu G. Pillarisetty, Diane Reidy, Sarimar Agosto Salgado, Shagufta Shaheen, Heloisa P. Soares, Michael C. Soulen, Jonathan R. Strosberg, Craig R. Sussman, Nikolaos A. Trikalinos, Nataliya A. Uboha, Namrata Vijayvergia, Terence Wong, Beth Lynn, and Cindy Hochstetler

, Othus M , Chae YK , A phase II basket trial of dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors (DART SWOG 1609) in patients with nonpancreatic neuroendocrine tumors . Clin Cancer Res 2020 ; 26 : 2290 – 2296 . 10.1158/1078-0432.CCR-19