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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

Staging and Treatment of Cutaneous Melanoma Cutaneous melanomas are categorized as follows: localized disease with no evidence of regional or distant metastases (stages 0–II), regional nodal/in-transit disease (stage III), and distant metastatic disease

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Zeynep Eroglu, Odicie Fielder, and George Somlo

with higher numbers noted in those with multiple bone metastases. 28 In a retrospective analysis of 151 patients with metastatic breast cancer, baseline CTC levels of 5 or greater CTCs per 7.5 mL of blood using CellSearch were prognostic for decreased

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Elio Mazzone, Sophie Knipper, Francesco A. Mistretta, Carlotta Palumbo, Zhe Tian, Andrea Gallina, Derya Tilki, Shahrokh F. Shariat, Francesco Montorsi, Fred Saad, Alberto Briganti, and Pierre I. Karakiewicz

teaching hospitals (68.1% vs 57.4%; P =.005), and to patients with liver metastases (20.4% vs 10.0%; P <.001). According to principal diagnosis at admission, IPC services were more frequently used in patients admitted for infections (23.0% vs 11.9%; P

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Darren Sigal, Marie Tartar, Marin Xavier, Fei Bao, Patrick Foley, David Luo, Jason Christiansen, Zachary Hornby, Edna Chow Maneval, and Pratik Multani

distribution of disease, demonstrating the extensive skeletal metastases and bulky pelvic lymphadenopathy. (B) Octreoscan (ant and post, planar) after 6 cycles of entrectinib shows significant burden of disease, including in the liver, bones, and pelvis, but

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Lirong Liu, Fangfang Hou, Yufeng Liu, Wenzhu Li, and Haibo Zhang

hypermetabolic nodules in left hilar suggestive of lung cancer with obstructive pneumonia and bone and right adrenal metastases. (B1–B3) CT after 2 cycles of carboplatin/pemetrexed with bevacizumab shows left lower lobe atelectasis aggravated with a large

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Richard S. Matulewicz, Brendan T. Frainey, Daniel T. Oberlin, and Joshua J. Meeks

performed in 89.3% of patients, with 12.7% having pathology-confirmed nodal metastases. Pathologic T upstaging occurred in 41.0% of patients (n=644); NMIBC was found in 50.5% of patients with clinical T1HG bladder cancer (n=794); only 3.6% patients (n=56

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Timothy Gilligan, Daniel W. Lin, Rahul Aggarwal, David Chism, Nicholas Cost, Ithaar H. Derweesh, Hamid Emamekhoo, Darren R. Feldman, Daniel M. Geynisman, Steven L. Hancock, Chad LaGrange, Ellis G. Levine, Thomas Longo, Will Lowrance, Bradley McGregor, Paul Monk, Joel Picus, Phillip Pierorazio, Soroush Rais-Bahrami, Philip Saylor, Kanishka Sircar, David C. Smith, Katherine Tzou, Daniel Vaena, David Vaughn, Kosj Yamoah, Jonathan Yamzon, Alyse Johnson-Chilla, Jennifer Keller, and Lenora A. Pluchino

experienced in the management of these patients should also be considered. Additionally, patients with postorchiectomy beta-hCG levels >5,000 IU/L should undergo brain MRI because they are at an increased risk of having brain metastases. Further workup should

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Robert J. Besaw, Adrienne R. Terra, Grace L. Malvar, Tobias R. Chapman, Lauren M. Hertan, and Benjamin L. Schlechter

UCOGC of the pancreas with a high tumor mutation burden (TMB) identified during next-generation sequencing (NGS). Third-line pembrolizumab monotherapy markedly reduced the primary pancreatic tumor and metastases in the lung and brain. Despite recent

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Charles P. Borden, Charles L. Shapiro, Maria Teresa Ramirez, Linda Kotur, and William Farrar

the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. The cancer program at OSUCCC uses a variety of tools for process

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Michael Karass, Rohan Bareja, Ethan Shelkey, Panagiotis J. Vlachostergios, Brian D. Robinson, Francesca Khani, Juan Miguel Mosquera, Douglas S. Scherr, Andrea Sboner, Scott T. Tagawa, Ana M. Molina, Olivier Elemento, David M. Nanus, and Bishoy M. Faltas

metastases were prospectively collected. Somatic DNA from tumor samples and germline DNA from peripheral blood mononuclear cells were submitted for WES as previously described. 3 RNA was extracted from tumor samples and submitted for RNA-seq. Whole