Journal of the advanced practitioner in oncology最新文献

{"title":"Retroperitoneal Liposarcoma: An Unusual Presentation of a Rare Cancer","authors":"Jennifer L. Spicer","doi":"10.6004/jadpro.2021.12.8.6","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.8.6","url":null,"abstract":"Abstract Retroperitoneal liposarcomas (RLPS) are rare tumors that have variable clinical behavior and complex treatment strategies based on presentation, histopathology, and genomics. Early identification is critical, and complete surgical resection remains the primary treatment, although chemotherapy and radiation are used on individual bases. Presenting symptoms are often nonspecific; therefore, a high degree of suspicion is essential for early diagnosis. In this report, the management of a 37-year-old otherwise healthy male with a large RLPS causing right groin/testicular pain is presented. After three evaluations in the emergency department, the patient was diagnosed and received two cycles of doxorubicin/ifosfamide/mesna (AIM) neoadjuvant chemotherapy. His physical exam on presentation for second opinion demonstrated a large palpable abdominal mass and fullness around the right spermatic cord. There was no appreciable change in tumor size or distant metastases on repeat scanning. Given some obstructive symptoms, a multidisciplinary team advised neoadjuvant radiation followed by radical resection of RLPS. Final pathology demonstrated a 31-cm grade II well-differentiated (WD) liposarcoma with low-grade dedifferentiation. Scattered foci of microscopic positive WD margins were noted, and the remainder of margins were negative. Genomic evaluation showed amplification of CDK4, MDM2, and FRS2. A concise literature review of common presentations, histopathology, genomics, and treatment information is discussed herein. Thorough physical exams, attention to subtle findings, appropriate medical imaging studies, and a high index of suspicion when evaluating vague symptomatology can lead to earlier diagnosis and treatment of RLPS, and ultimately better patient outcomes.","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"854 - 862"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46157620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Implementation of an Advanced Practitioner–Led Survivorship Clinic for Patients Status Post Allogeneic Transplant","authors":"Linda Baer, Lauren Brister, Susan R. Mazanec","doi":"10.6004/jadpro.2021.12.8.2","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.8.2","url":null,"abstract":"Background: Survivor recovery from hematopoietic cell transplantation (HCT) is long term, with significant physical and psychological morbidities that impact quality of life and reentry into personal and social lives. The optimal timing of when and how to deliver comprehensive HCT survivorship care is not well defined. Purpose: The purpose of this study was to design, implement, and evaluate an advanced practitioner (AP)-led pilot survivorship clinic incorporating an individual and group format for patients post HCT at the 1-year transition period. Methods: A survey assessing physical, social, emotional, and spiritual needs and concerns was mailed to a sample of patients who underwent HCT between 2009 and 2014. This phase 1 survey was utilized in the phase 2 design of an AP-led pilot survivorship clinic for patients post allogeneic HCT. A total of 15 patients were approached, out of which 7 enrolled over a 12-month period in the pilot survivorship clinic. Results: The needs assessment survey noted the most prevalent moderate to high concerns were in the emotional domain, with 52% of respondents identifying fear of cancer returning and new cancer developing. The pilot survivorship clinic incorporating a group visit format with multiple sessions was not feasible for both patients and APs within the context of a small- to medium-sized HCT program. Conclusion: The needs assessment survey underscored the importance of addressing all four quality of life domains in cancer survivors. A hybrid survivorship clinic with one comprehensive group visit may be beneficial for HCT survivors at the 1-year transition for small- to medium-sized HCT programs.","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"775 - 783"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44406852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JADPRO Live Virtual 2021","authors":"Beth Faiman","doi":"10.6004/jadpro.2021.12.8.1","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.8.1","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"773 - 774"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44323678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASH Highlights and Commentary: Additional Topics of Interest","authors":"PhD Aprn Aocn® Sara Tinsley, PhD Anp-C Aocn Sandra E. Kurtin","doi":"10.6004/jadpro.2021.12.3.30","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.3.30","url":null,"abstract":"Dr. Tinsley provides insight for APs on the use of pevonedistat, a new small-molecule inhibitor. Dr. Kurtin considers the use of the CRISPR technique to detect COVID-19 in patients with hematologic malignancies and data from a retrospective observational cohort study describing the disease burden of primary cold agglutinin disease.","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"26 - 32"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48787278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASH Highlights and Commentary: Multiple Myeloma","authors":"B. Faiman, Aprn-Bc, Aocn, Faan","doi":"10.6004/jadpro.2021.12.3.28","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.3.28","url":null,"abstract":"Dr. Faiman considers the use of qualitative interviews to understand the patient perspective on the clinical benefits and tolerability of belamaf. She also highlights the safety profile and noninferiority of subcutaneous daratumumab compared with IV daratumumab, as described in the APOLLO trial. Finally, Dr. Faiman emphasizes the importance of achieving MRD negativity measured by multiparameter flow cytometry and next-generation sequencing.","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"4 - 10"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46742647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASH Highlights and Commentary: Chronic Lymphocytic Leukemia and Lymphomas","authors":"PhD Aprn Aocn® Sara Tinsley, PhD Anp-C Aocn Sandra E. Kurtin","doi":"10.6004/jadpro.2021.12.3.29","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.3.29","url":null,"abstract":"125 Five-Year Analysis of MURANO Study Demonstrates Enduring Undetectable Minimal Residual Disease (uMRD) in a Subset of Relapsed/Refractory Chronic Lymphocytic Leukemia (R/R CLL) Patients (Pts) Following Fixed-Duration Venetoclax-Rituximab (VenR) Therapy (Tx) Arnon P. Kater, MD, PhD, Thomas J. Kipps, MD, PhD, Barbara Eichhorst, MD, Peter Hillmen, MBChB, PhD, FRCP, FRCPath, James D’Rozario, Carolyn Owen, MD, FRCPC, Sarit E Assouline, MD, MSc, Nicole Lamanna, MD, Tadeusz J. Robak, Javier de la Serna, Ulrich Jaeger, Guillaume Cartron, MD, PhD, Marco Montillo, Clemens Mellink, Brenda J. Chyla, Cameron Wilson, Jenny Wu, Yanwen Jiang, Marcus Lefebure, Michelle Boyer, and John F. Seymour Visit https://doi.org/10.1182/blood-2020-136109 for a complete list of contributor affiliations and full graphics. Introduction: The randomized Phase III MURANO study (NCT02005471) compared fixed-duration VenR with standard bendamustine-rituximab (BR) in R/R CLL. Deep responses with uMRD were associated with superior progression-free survival (PFS) of VenR vs BR with 48 months (mo) follow-up (f/u). We now report long-term MRD kinetics and updated efficacy outcomes, including re-exposure to VenR (to be presented), with a 5 year (yr) median follow-up (clinical cutoff date May 8, 2020). Methods: As published, pts were randomized to VenR (Ven 400 mg daily for 2 yrs + standard dose R for the first 6 mo) or B (70 mg/m2)R (6 mo). A sub-study was introduced in 2018, allowing pts who developed progressive disease (PD) following Tx with BR or VenR to receive the MURANO VenR regimen. PFS was based on investigator assessment. Peripheral blood MRD was analyzed centrally by allele-specific oligonucleotide polymerase chain reaction and/or flow cytometry. Pts were categorized by MRD status as previously reported, using <10-4 threshold for uMRD. MRD conversion was defined as 2 consecutive assays detecting MRD or PD in pts who previously had uMRD. Genomic complexity (GC) and del(17p) status were assessed by array comparative genomic hybridization. GC was defined as ≥3 copy number variations (CNV). All p-values are descriptive. Results: 389 pts were enrolled (VenR, n=194; BR, n=195). With a median f/u of 59.2 (range, 0-71.5) mo, the PFS benefit with VenR over BR was sustained (HR, 0.19 [95% CI: 0.15-0.26]; p<0.0001). Median PFS was 53.6 (95% CI: 48.4-57.0) mo for VenR and 17.0 (95% CI: 15.5-21.7) mo for BR. For pts who completed the full 2 yrs of Ven Tx (n=130), PFS estimates 36 mo post-end of treatment (EOT) were ~51.1% (95% CI: 40.2-61.9). Overall survival (OS) benefit was maintained for pts treated with VenR vs BR (HR, 0.40 [95% CI: 0.26-0.62]; p<0.0001), with 5-yr OS estimates of 82.1% (95% CI: 76.4-87.8) for VenR and 62.2% (95% CI: 54.8-69.6) for BR. Improved OS outcome was observed among the VenR pts that reached EOT without PD and had uMRD (83/118) compared with those with MRD (35/118), with 3-yr post-EOT survival estimates of 95.3% (95% CI: 90.0-100.0) vs 85.0% (95% CI: 72.8-97.2","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"11 - 17"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48114187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Status of Chemotherapy in Metastatic Breast Cancer: Insights for the Advanced Practitioner","authors":"K. Hanna, Kelley D. Mayden","doi":"10.6004/jadpro.2021.12.2.10","DOIUrl":"https://doi.org/10.6004/jadpro.2021.12.2.10","url":null,"abstract":"© 2021 HarborsideTM Breast cancer is the most frequently diagnosed cancer in the United States and ranks second as the most common cause of cancerrelated death among women (Siegel et al., 2020). According to American Cancer Society (ACS) estimates, approximately 276,480 new cases of breast cancer would have been diagnosed in 2020, and greater than 42,000 deaths would be attributed to breast cancer (ACS, 2020). Although only 7% of all cancer-related deaths are from breast cancer every year, it is the leading cause of death among women between the ages of 40 and 49 years (Siegel et al., 2020). The death rate associated with breast cancer, however, has decreased by 1.3% annually from 2013 to 2017. While improvements in treatment and management coupled with early detection have accounted for the decreased death rate, as of January 2020, there were more than 3.5 million women with a history of breast cancer in the United States (ACS, 2020). Indeed, a vast majority of women with newly diagnosed breast cancer have localized or regional disease that is associated with almost 99% to 85.7% 5-year survival rates, respectively (ACS, 2020). The primary treatment goal for patients with early-stage disease is to reduce the probability of recurrence and spread with primary surgery (lumpectomy or mastectomy) of the breast and regional nodes, with or without radiation therapy and/or in conjunction with neoadjuvant and adjuvant systemic therapy. Despite the successes of these approaches, up to 30% of women with early-stage, nonmetastatic breast cancer will eventually develop distant metastatic disease, and almost 6% of newly diagnosed women have metastatic breast cancer (MBC) at diagnosis (ACS, 2020; Early Breast Cancer Trialists’ Collaborative Group, 2005). It has been estimated that more than 150,000 women are living with MBC, among whom 3 in 4 patients were initially diagnosed with earlier stage disease (Mariotto et al., 2017). Unfortunately for these women, MBC is not curable, and while meaningful improvements have been reported due to the introducJ Adv Pract Oncol 2021;12(suppl 2):3–5 Th is ar tic le is dis tri bu te d u nd er th e t er m s o f t he Cr ea tiv e C om m on s A ttr ibu tio n N on -C om m er cia l N on -D er iva tiv e L ice ns e, wh ich pe rm its un re str ict ed","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"12 1","pages":"3 - 5"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49390027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budd-Chiari Syndrome as Initial Manifestation of Polycythemia Vera: Complexities in the Management of Younger Patients","authors":"Pamela Lyle, PA Lindsey E. Kalhagen","doi":"10.6004/jadpro.2020.11.7.12","DOIUrl":"https://doi.org/10.6004/jadpro.2020.11.7.12","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47489218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Thrombosis in Polycythemia Vera: The Advanced Practitioner Perspective","authors":"L. Lyle, Pa-C","doi":"10.6004/jadpro.2020.11.7.11","DOIUrl":"https://doi.org/10.6004/jadpro.2020.11.7.11","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41823993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Treatment Strategies in Patients With Polycythemia Vera Who Develop a Thrombotic Event on Frontline Therapy","authors":"Pamela L. Lyle, PA Julie Huynh-Lu","doi":"10.6004/jadpro.2020.11.7.13","DOIUrl":"https://doi.org/10.6004/jadpro.2020.11.7.13","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42561608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}