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.” Approximately half of patients with metastatic melanoma harbor an activating mutation of BRAF, a signaling kinase. These patients tend to show dramatic responses to vemurafenib. Other updates include expanded recommendations on adjuvant therapy and radiation

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Omalkhair Abulkhair, Nagi Saghir, Lobna Sedky, Ahmed Saadedin, Heba Elzahwary, Neelam Siddiqui, Mervat Al Saleh, Fady Geara, Nuha Birido, Nadia Al-Eissa, Sana Al Sukhun, Huda Abdulkareem, Menar Mohamed Ayoub, Fawaz Deirawan, Salah Fayaz, Alaa Kandil, Sami Khatib, Mufid El-Mistiri, Dorria Salem, El Siah Hassan Sayd, Mohammed Jaloudi, Mohammad Jahanzeb, and William I. Gradishar

studies, adjuvant therapy includes chemotherapy, targeted therapy with trastuzumab, and hormonal therapy. 13 – 15 In countries with limited resources, anthracyclines and taxanes are the most commonly used drugs, either in combination or sequentially

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Benjamin E. Greer and Wui-Jin Koh

extension and N2 as gross disease, Dr. Koh noted. He stated that selecting patients for adjuvant therapy is challenging. Rather than look at the total number of nodes, he suggested using a ratio of the number of positive nodes per side divided by the number

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NCCN Guidelines® Insights: Breast Cancer, Version 4.2021

Featured Updates to the NCCN Guidelines

William J. Gradishar, Meena S. Moran, Jame Abraham, Rebecca Aft, Doreen Agnese, Kimberly H. Allison, Sarah L. Blair, Harold J. Burstein, Chau Dang, Anthony D. Elias, Sharon H. Giordano, Matthew P. Goetz, Lori J. Goldstein, Sara A. Hurvitz, Steven J. Isakoff, Rachel C. Jankowitz, Sara H. Javid, Jairam Krishnamurthy, Marilyn Leitch, Janice Lyons, Jennifer Matro, Ingrid A. Mayer, Joanne Mortimer, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Erica M. Stringer-Reasor, Melinda L. Telli, John H. Ward, Kari B. Wisinski, Jessica S. Young, Jennifer L. Burns, and Rashmi Kumar

Systemic Therapy In patients with early-stage breast cancer, systemic adjuvant therapy is administered to reduce risk of breast cancer recurrence. The decision is often based on individual risk of relapse and predicted sensitivity to treatment (eg

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Sara H. Javid, L. Christine Fang, Larissa Korde, and Benjamin O. Anderson

34%, 1 , 3 a favorable outcome that has been attributed to the combination of increased screening mammography and improved adjuvant therapy. 4 However, despite the steady increase in DCIS detection and treatment in the 1990s, the subsequent

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Ariel Polish and Mary F. Mulcahy

neoadjuvant or adjuvant therapy. One retrospective study focused on 49 patients with adenocarcinoma (90%) or squamous (10%) cancer of the esophagus who were staged as T2,N0,M0 and received neoadjuvant chemoradiation. 14 The study found that the 5-year rates

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Robert W. Carlson and on behalf of the NCCN Breast Cancer Panel

-free and overall survival. 7 The effectiveness of aromatase inhibitors in the treatment of metastatic breast cancer led to a number of trials incorporating them into the adjuvant therapy of postmenopausal women with early-stage hormone receptor

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Sharon H. Giordano, Anthony D. Elias, and William J. Gradishar

for advanced hormone-sensitive breast cancer at the NCCN 23rd Annual Conference. New Adjuvant Therapy Options for Patients With HER2-Positive Cancer Two new adjuvant treatment options for patients with HER2-positive disease are in the 2018 NCCN

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Benjamin E. Greer, Wui-Jin Koh, Nadeem Abu-Rustum, Michael A. Bookman, Robert E. Bristow, Susana M. Campos, Kathleen R. Cho, Larry Copeland, Marta Ann Crispens, Patricia J. Eifel, Warner K. Huh, Wainwright Jaggernauth, Daniel S. Kapp, John J. Kavanagh, John R. Lurain III, Mark Morgan, Robert J. Morgan Jr, C. Bethan Powell, Steven W. Remmenga, R. Kevin Reynolds, Angeles Alvarez Secord, William Small Jr, and Nelson Teng

in endometrial carcinoma: overview of randomised trials . Clin Oncol (R Coll Radiol) 2008 ; 20 : 463 – 469 . 56 Fleming G . Adjuvant therapy for high-risk adenocarcinoma of the uterus . ASCO Educational Book 2008 : 230 – 233

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Marsha Reyngold, Joyce Niland, Anna ter Veer, Dana Milne, Tanios Bekaii-Saab, Steven J. Cohen, Lily Lai, Deborah Schrag, John M. Skibber, William Small Jr, Martin Weiser, Neal Wilkinson, and Karyn A. Goodman

adjuvant therapy data (n=3). A total of 29 patients received postoperative RT and were excluded from the analysis of factors associated with omission of preoperative RT. The minimum follow-up time was 120 days for all patients. Variables Analyzed