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Tarek Safi, Pascale Salameh, Lea Aoude, Mirna Waked, FCCP and Bassim Kobrossy

), progesterone receptor (PR), and epidermal growth factor 2 (HER-2). We compared the age distribution to U.S. population as well as other Arab populations. In addition we compared these and other characteristics with respect to the laterality of the breast cancer

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scientific peer-review process and are overseen by the ORP. Several NCCN-sponsored studies funded through the grant mechanism are highlighted below. A Phase I/II Trial of Temsirolimus Plus Neratinib for Patients With Metastatic HER2-Amplified or

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Angela Jain, Paula D. Ryan and Michael V. Seiden

12 and 13 mutations), epidermal growth factor receptor (EGFR) exon 18–21 mutation screen (wild-type), and HER2 tested with immunohistochemistry (3+). Because of wild-type KRAS tumor status with a mucinous phenotype, 5-FU, leucovorin, and irinotecan

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Rachana Yendala, Kyaw Thein, Sriman Swarup, Anita Sultan, Somedeb Ball, Miguel Quirch, Myo H. Zaw, Yin M. Myat and Catherine Jones

Background: Pain, fatigue, hot flushes, and rash significantly contribute to quality of life in breast cancer patients undergoing chemotherapy. Hormone receptor-positive breast cancer is a common entity among women worldwide. In cancer cells, CDK4/6 activity is over expressed, which can lead to amplification or overexpression of the genes encoding for CDK 4/6 or the cyclin D, ultimately leading to endocrine therapy resistance. We undertook a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of health-related quality of life (HRQOL) events associated with CDK 4/6 inhibitors. Methods: We conducted a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts from inception through September 2018. RTCs that mention HRQOL events as adverse effects were incorporated in the analysis. Mantel-Haenszel (MH) method was used to calculate the estimated pooled risk ratio (RR) with 95%CI. Random effects model was applied. Results: 8 RCTs (7 phase III and 1 phase II) with a total of 4,557 patients were eligible. The study arms used palbociclib/ribociclib/abemaciclib with letrozole or anastrozole or fulvestrant or other hormonal agent while the control arms utilized placebo in combination with letrozole or anastrozole or fulvestrant or other hormonal agent. The RR of all-grade side effects were as follows: fatigue, 1.226 (95% CI: 1.079–1.393; P=.002); back pain, 0.971 (95% CI: 0.844–1.117; P=.681); arthralgia, 0.978 (95% CI: 0.830–1.152; P=.790); headache, 1.046 (95% CI: 0.928–1.179; P=.459); alopecia, 2.635 (95% CI: 1.966–3.533; P<.001); hot flushes, 0.901 (95% CI: 0.766–1.060; P=.210); and rash, 2.068 (95% CI: 1.604–2.666; P<.001). The RR of high-grade side effects were as follows: fatigue, 3.487 (95% CI: 1.765–6.889; P<.001); back pain, 1.364 (95% CI: 0.695–2.679; P=.367); arthralgia, 1.148 (95% CI: 0.509–2.593; P=.740); headache, 0.807 (95% CI: 0.303–2.147; P=.667); and rash, 3.018(95% CI: 0.954–9.554; P=.060). Conclusions: Our study showed that the risk of developing all grades of fatigue and any-grade alopecia and rash was significantly with CDK 4/6 inhibitors. Prompt intervention with good supportive care is required.

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NCCN Guidelines Insights: Rectal Cancer, Version 6.2020

Featured Updates to the NCCN Guidelines

Al B. Benson III, Alan P. Venook, Mahmoud M. Al-Hawary, Mustafa A. Arain, Yi-Jen Chen, Kristen K. Ciombor, Stacey Cohen, Harry S. Cooper, Dustin Deming, Ignacio Garrido-Laguna, Jean L. Grem, Andrew Gunn, Sarah Hoffe, Joleen Hubbard, Steven Hunt, Natalie Kirilcuk, Smitha Krishnamurthi, Wells A. Messersmith, Jeffrey Meyerhardt, Eric D. Miller, Mary F. Mulcahy, Steven Nurkin, Michael J. Overman, Aparna Parikh, Hitendra Patel, Katrina Pedersen, Leonard Saltz, Charles Schneider, David Shibata, John M. Skibber, Constantinos T. Sofocleous, Elena M. Stoffel, Eden Stotsky-Himelfarb, Christopher G. Willett, Alyse Johnson-Chilla and Lisa A. Gurski

rectum and differentiating the rectum from the sigmoid colon; the total neoadjuvant therapy (TNT) approach for localized rectal cancer; and biomarker-targeted therapy for mCRC, with a focus on new treatment options for patients with BRAF V600E– or HER2

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Christos Vaklavas, John R. Ross, Lisle M. Nabell, Andres Forero, Martin J. Heslin and Tina E. Wood

and progesterone receptors on immunohistochemistry; Her2 was nonamplified. In addition to the different histologic appearances of the gastric and breast biopsies, the absence of staining for mammaglobin, and estrogen and progesterone receptors on the

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Gabrielle B. Rocque, Courtney P. Williams, Bradford E. Jackson, Stacey A. Ingram, Karian I. Halilova, Maria Pisu, Kelly M. Kenzik, Andres Azuero, Andres Forero and Smita Bhatia

Regimens and Guideline Concordance Characterizing Treatment Regimens: Hormonal medications, chemotherapy, and HER2-targeted therapy were identified from Medicare claims using National Drug Codes (NDCs), the Healthcare Common Procedure Coding System

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Dung T. Le and Elizabeth M. Jaffee

; DC, dendritic cell; EGFR, epidermal growth factor receptor; GM-CSF, granulocyte-macrophage colony-stimulation factor; HER2, human epidermal growth factor receptor-2; IL, interleukin; PD-1, programmed death-1; VEGF, vascular endothelial growth factor

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Alan P. Venook, Maria E. Arcila, Al B. Benson III, Donald A. Berry, David Ross Camidge, Robert W. Carlson, Toni K. Choueiri, Valerie Guild, Gregory P. Kalemkerian, Razelle Kurzrock, Christine M. Lovly, Amy E. McKee, Robert J. Morgan, Anthony J. Olszanski, Mary W. Redman, Vered Stearns, Joan McClure and Marian L. Birkeland

disease is now standard. This treatment has been shown to be superior to chemotherapy in this population in terms of response rate and progression-free survival (PFS). 7 , 8 Similarly, ERBB2(HER2) expression/amplification in breast cancer informs both

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William Gradishar and Kilian E. Salerno

neoadjuvant, adjuvant, and metastatic settings; the benefit of ovarian suppression; preoperative HER2-directed therapy; and fertility preservation. Dr. Salerno presented updates in locoregional treatment and emphasized the benefits of hypofractionated whole