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study to evaluate the efficacy of combination sorafenib and temsirolimus in patients with thyroid cancer of follicular cell origin (e.g., papillary, follicular, Hürthle cell, anaplastic). Primary Outcome Measures: Determine the objective response

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Maurie Markman

of residual disease after primary surgical cytoreduction, and, in the case of advanced disease, morphologic subtype (e.g., mucinous vs. papillary serous). Importantly, however, even if this prognostic information helps patients and physicians make

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Tatjana Gavrancic and Yeun-Hee Anna Park

prognosis. It is defined as an alpha fetoprotein (AFP)–producing primary lung carcinoma with pathologic findings of acinar and papillary adenocarcinoma resembling hepatocellular carcinoma (HCC). Globally, only 24 cases have been reported. This report

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Mary B. Daly, Robert Pilarski, Jennifer E. Axilbund, Saundra S. Buys, Beth Crawford, Susan Friedman, Judy E. Garber, Carolyn Horton, Virginia Kaklamani, Catherine Klein, Wendy Kohlmann, Allison Kurian, Jennifer Litton, Lisa Madlensky, P. Kelly Marcom, Sofia D. Merajver, Kenneth Offit, Tuya Pal, Boris Pasche, Gwen Reiser, Kristen Mahoney Shannon, Elizabeth Swisher, Nicoleta C. Voian, Jeffrey N. Weitzel, Alison Whelan, Georgia L. Wiesner, Mary A. Dwyer, and Rashmi Kumar

individuals with Cowden syndrome, 23 and the lifetime risk of thyroid cancer (follicular or papillary) has been estimated at 3% to 10%. 11 , 24 A higher cumulative lifetime risk of thyroid cancer (21%-38%) was reported in several recent studies in

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NCCN Guidelines Insights: Kidney Cancer, Version 1.2021

Featured Updates to the NCCN Guidelines

Robert J. Motzer, Eric Jonasch, Shawna Boyle, Maria I. Carlo, Brandon Manley, Neeraj Agarwal, Ajjai Alva, Katy Beckermann, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Arpita Desai, Saby George, John L. Gore, Naomi Haas, Steven L. Hancock, Christos Kyriakopoulos, Elaine T. Lam, Clayton Lau, Bryan Lewis, David C. Madoff, Brittany McCreery, M. Dror Michaelson, Amir Mortazavi, Lakshminarayanan Nandagopal, Phillip M. Pierorazio, Elizabeth R. Plimack, Lee Ponsky, Sundhar Ramalingam, Brian Shuch, Zachary L. Smith, Bradley Somer, Jeffrey Sosman, Mary A. Dwyer, and Angela D. Motter

/everolimus. The investigators reported an objective response rate (ORR) of 25.8% (95% CI, 11.9%–44.6%); 8 patients in the trial achieved a partial response (PR; papillary, n=3; chromophobe, n=4; unclassified, n=1) and none had a complete response (CR). At the time

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Robert J. Motzer, Eric Jonasch, Neeraj Agarwal, Sam Bhayani, William P. Bro, Sam S. Chang, Toni K. Choueiri, Brian A. Costello, Ithaar H. Derweesh, Mayer Fishman, Thomas H. Gallagher, John L. Gore, Steven L. Hancock, Michael R. Harrison, Won Kim, Christos Kyriakopoulos, Chad LaGrange, Elaine T. Lam, Clayton Lau, M. Dror Michaelson, Thomas Olencki, Phillip M. Pierorazio, Elizabeth R. Plimack, Bruce G. Redman, Brian Shuch, Brad Somer, Guru Sonpavde, Jeffrey Sosman, Mary Dwyer, and Rashmi Kumar

are RCC, and approximately 80% of these are clear cell tumors. 2 , 3 Other less common cell types include papillary, chromophobe, translocation, and Bellini duct (collecting duct) tumors. Medullary renal carcinoma is a variant of collecting duct renal

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Thomas W. Flaig, Philippe E. Spiess, Neeraj Agarwal, Rick Bangs, Stephen A. Boorjian, Mark K. Buyyounouski, Sam Chang, Tracy M. Downs, Jason A. Efstathiou, Terence Friedlander, Richard E. Greenberg, Khurshid A. Guru, Thomas Guzzo, Harry W. Herr, Jean Hoffman-Censits, Christopher Hoimes, Brant A. Inman, Masahito Jimbo, A. Karim Kader, Subodh M. Lele, Jeff Michalski, Jeffrey S. Montgomery, Lakshminarayanan Nandagopal, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Elizabeth R. Plimack, Kamal S. Pohar, Mark A. Preston, Wade J. Sexton, Arlene O. Siefker-Radtke, Jonathan Tward, Jonathan L. Wright, Lisa A. Gurski, and Alyse Johnson-Chilla

-grade disease. A small fragment of tumor with few muscle fibers is inadequate for assessing the depth of invasion and guiding treatment recommendations. When a large papillary lesion is noted, more than one session may be needed to completely resect the tumor

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Saby George, Roberto Pili, Michael A. Carducci, and Jenny J. Kim

include clear cell RCC (75%), papillary RCC (15%), chromophobe type (5%), and oncocytic type tumors. Furthermore, clear cell RCC, the most common and extensively studied histologic subtype, is characterized in most cases by distinctive features, including

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Eric Jonasch

bevacizumab/everolimus is useful in select patients with advanced papillary RCC, including those with germline mutations for hereditary leiomyomatosis and RCC (HLRCC). “I’ve tried this combination and have observed dramatic responses in patients with HLRCC

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Robert I. Haddad

to better diagnosis. Thyroid cancer deaths, however, are rare, with only about 1800 a year despite the high cancer incidence, Dr. Haddad added. Most cases of thyroid cancer are differentiated thyroid cancers (83% papillary, 11% follicular). The more