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Christopher A. Barker and April K. Salama

also noted that immunotherapies that are robust in the advanced disease setting are now proving their worth as adjuvant treatment. Several effective options are now approved for adjuvant therapy besides observation. Nivolumab is now preferred over

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Michael D. Green and James A. Hayman

the primary site . JAMA Dermatol 2016 ; 152 : 1001 – 1007 . 21. Fields RC Busam KJ Chou JF . Recurrence after complete resection and selective use of adjuvant therapy for stage I through III Merkel cell carcinoma . Cancer 2012 ; 118

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Robert W. Carlson, Susan Moench, Arti Hurria, Lodovico Balducci, Harold J. Burstein, Lori J. Goldstein, William J. Gradishar, Kevin S. Hughes, Mohammad Jahanzeb, Stuart M. Lichtman, Lawrence B. Marks, Joan S. McClure, Beryl McCormick, Lisle M. Nabell, Lori J. Pierce, Mary Lou Smith, Neal S. Topham, Tiffany A. Traina, John H. Ward, and Eric P. Winer

threshold for adjuvant therapy in older breast cancer patients? J Clin Oncol 2000;18:1709–1717. Breast Cancer Mortality Figure 3 shows age-specific breast cancer incidence rates in the United States from the SEER database for 1975 to 2003 for women aged 40

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E. Gabriela Chiorean, Marco Del Chiaro, Margaret A. Tempero, Mokenge P. Malafa, Al B. Benson III, Dana B. Cardin, Jared A. Christensen, Vincent Chung, Brian Czito, Mary Dillhoff, Timothy R. Donahue, Efrat Dotan, Christos Fountzilas, Evan S. Glazer, Jeffrey Hardacre, William G. Hawkins, Kelsey Klute, Andrew H. Ko, John W. Kunstman, Noelle LoConte, Andrew M. Lowy, Ashiq Masood, Cassadie Moravek, Eric K. Nakakura, Amol K. Narang, Lorenzo Nardo, Jorge Obando, Patricio M. Polanco, Sushanth Reddy, Marsha Reyngold, Courtney Scaife, Jeanne Shen, Mark J. Truty, Charles Vollmer Jr, Robert A. Wolff, Brian M. Wolpin, Beth McCullough RN, Senem Lubin, and Susan D. Darlow

(albeit used more rarely compared with pancreatic cancer), adjuvant therapy, and first-line or subsequent-line therapy for locally advanced, metastatic, and recurrent disease. Data for systemic therapy in ampullary cancer are very limited; the only phase

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Amy Jamieson and Jessica N. McAlpine

, and administer the best adjuvant therapies to improve their outcomes remains the greatest challenge in this disease site. Historical risk stratification systems are based on histomorphologic features, such as grade and histotype, both of which have

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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

– 14 Thus, in these high-risk patients, it would seem reasonable to offer SLNB to help define prognostically homogeneous groups for participation in clinical trials of adjuvant therapy. NCCN Guidelines Insights : Metastatic Colon Cancer, Version

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Stephanie L. Lee

Effects of 131 I Therapy RAI therapy is given either as remnant ablation (the most common use), adjuvant therapy, or treatment of metastatic disease. Remnant ablation uses RAI to destroy normal residual functioning thyroid tissues with the goals

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William J. Gradishar, Benjamin O. Anderson, Ron Balassanian, Sarah L. Blair, Harold J. Burstein, Amy Cyr, Anthony D. Elias, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Matthew Goetz, Lori J. Goldstein, Clifford A. Hudis, Steven J. Isakoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Meena Moran, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Kilian E. Salerno, Lee S. Schwartzberg, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, George Somlo, Melinda Telli, John H. Ward, Dorothy A. Shead, and Rashmi Kumar

Biol Endocrinol 2011 ; 9 : 93 . 9. Eggemann H Ignatov A Smith BJ . Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients . Breast Cancer Res Treat 2013 ; 137 : 465 – 470 . 10

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Deborah K. Armstrong, Ronald D. Alvarez, Jamie N. Bakkum-Gamez, Lisa Barroilhet, Kian Behbakht, Andrew Berchuck, Lee-may Chen, Mihaela Cristea, Maria DeRosa, Eric L. Eisenhauer, David M. Gershenson, Heidi J. Gray, Rachel Grisham, Ardeshir Hakam, Angela Jain, Amer Karam, Gottfried E. Konecny, Charles A. Leath III, Joyce Liu, Haider Mahdi, Lainie Martin, Daniela Matei, Michael McHale, Karen McLean, David S. Miller, David M. O’Malley, Sanja Percac-Lima, Elena Ratner, Steven W. Remmenga, Roberto Vargas, Theresa L. Werner, Emese Zsiros, Jennifer L. Burns, and Anita M. Engh

and 193). 1 – 5 However, for some patients with early-stage disease, surgery alone (followed by observation) may be sufficient as primary treatment. In addition, for certain histologic subtypes, adjuvant therapy with hormonal agents are options that

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Lindsey M. Charo, Adam M. Burgoyne, Paul T. Fanta, Hitendra Patel, Juliann Chmielecki, Jason K. Sicklick, and Michael T. McHale

are generally managed surgically, and patients with tumors harboring high-risk features are recommended to receive adjuvant therapy with imatinib, a tyrosine kinase inhibitor that targets the KIT and PDGFRA oncoproteins, but not BRAF, NTRK3, or FGFR1