scholarly journals Melanoma: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

2021 ◽  
Vol 12 (6) ◽  
Author(s):  
Lisa Kottschade, APRN, MSN, CNP
Keyword(s):  
Annual Meeting ◽  
Mayo Clinic ◽  
Immune Therapy ◽  
Advanced Practitioner

With coverage from The ASCO Post, Lisa Kottschade, APRN, MSN, CNP, of Mayo Clinic, reviews data on immune therapy after surgery, the combination of the anti–LAG-3 antibody relatlimab and nivolumab, and a 6.5-year update of combination nivolumab and ipilimumab.

scholarly journals Issues in Oncology: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

2021 ◽  
Vol 12 (6) ◽  
Author(s):  
Josh Epworth, ARNP
Keyword(s):  
Annual Meeting ◽  
Medical Center ◽  
University Of Washington ◽  
Patients With Cancer ◽  
Advanced Practitioner ◽  
Improve Access

Josh Epworth, ARNP, of University of Washington Medical Center, considers the findings of three important abstracts from the 2021 ASCO Annual Meeting and reflects on how advanced practitioners can improve access and care for their patients with cancer. Meeting coverage is provided by The ASCO Post.

scholarly journals Thoracic Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

2021 ◽  
Vol 12 (6) ◽  
Author(s):  
Elizabeth S. Waxman, RN, MSN, AOCN, ANP-BC
Keyword(s):  
Annual Meeting ◽  
Early Stage ◽  
Cancer Center ◽  
Important Research ◽  
Early Stage Lung Cancer ◽  
Advanced Practitioner ◽  
Thoracic Cancer ◽  
Md Anderson ◽  
Doublet Chemotherapy ◽  
Stage Lung Cancer

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC, of MD Anderson Cancer Center, reviews important research in thoracic cancers presented at the 2021 ASCO Annual Meeting, including atezolizumab in early-stage lung cancer, the addition of doublet chemotherapy to doublet immunotherapy in advanced-stage NSCLC, the first-in-class KRAS G12C inhibitor sotorasib, and the combination of amivantamab and lazertinib. Coverage provided by The ASCO Post.

scholarly journals Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

2021 ◽  
Vol 12 (6) ◽  
Author(s):  
Morgane C. Diven, PharmD, BCOP
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Combination Therapy ◽  
Annual Meeting ◽  
Small Molecule ◽  
Metastatic Prostate Cancer ◽  
De Novo ◽  
Advanced Practitioner ◽  
Hormone Sensitive ◽  
Va Health Care System

Morgane C. Diven, PharmD, BCOP, of Phoenix VA Health Care System, evaluates research on an investigational radiolabeled small molecule, combination therapy in the treatment of de novo metastatic prostate cancer, and a CYP17-lyase inhibitor in metastatic hormone-sensitive prostate cancer. Coverage provided by The ASCO Post.

Outcome of mismatch repair deficient metastatic colorectal cancer (CRC): The Mayo Clinic Experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15030-e15030
Author(s):  
Zhaohui Jin ◽  
Cristobal T. Sanhueza ◽  
Benny Johnson ◽  
Thomas C. Smyrk ◽  
David W. Larson ◽  
...  
Keyword(s):  
Mismatch Repair ◽  
Metastatic Disease ◽  
Mayo Clinic ◽  
Proportional Hazards ◽  
Immune Therapy ◽  
Univariate Analysis ◽  
Disease Diagnosis ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Primary Tumors

e15030 Background: Deficiencies in the DNA mismatch repair (dMMR) system cause errors during DNA replication, which in turn give rise to microsatellite instability (MSI-H). MSI-H in mCRC is rare and its prognostic and predictive impact on outcome is unclear. This cohort study aims to investigate the prognostic and predictive value of MSI-H in metastatic CRC prior to the immune therapy era. Methods: 75 MSI-H mCRC patients (pts) and 75 matched (age, gender, disease sidedness, metachronous) MSS mCRC pts were identified from 1268 mCRC who had MSI/MMR test results at Mayo Clinic Rochester between 1/1992 and 7/2016. A retrospective review was conducted by using data from electronic medical records (EMR). Statistical analyses utilized Kaplan-Meier method, Log-rank test, and Cox proportional hazards models. Results: In the MSI-H group, there were 39 male (52%) and 36 female (48%) pts. Median age at metastatic disease diagnosis was 54.7 years. 35 patients presented with stage IV CRC. Primary tumors location: 38 right side, 11 transverse colon, 15 left side, 11 rectum. The MSS group was well matched (3 mismatches for gender and 1 mismatch for metachronous metastatic disease). Median overall survivals (OS) were 28.1 and 37.4 months for MSI-H and MSS pts, respectively ( p= 0.098). 98.7% MSS pts and 94.7% MSI-H pts had Fluoropyrimidine-based chemotherapy for metastatic disease and there was no median OS difference between these two groups (37.4 vs. 32.3 months p= 0.91). 43 MSI-H and 39 MSS pts had metastasectomy including ablation ( p= 0.51) with longer median OS (82.0 and 69.9 months, p= 0.90) compared to pts without metastasectomy (13.9 and 19.7 months, p= 0.15). Age < 65, metastasectomy, asymptomatic metastatic lesions, BRAF wild type, and multiple metastasectomy were associated with better survival in univariate analysis. Only metastasectomy remained statistically significant in multivariate analysis ( p< 0.0001). Conclusions: MSI-H mCRC do not appear to have improved prognosis compared with MSS cancers, in fact, there is a trend toward inferior outcome. In both groups, metastasectomy including multiple metastasectomy should be considered to optimize OS.

scholarly journals Autoimmune Encephalitis Post-SARS-CoV-2 Infection: Case Frequency, Findings, and Outcomes

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012931
Author(s):  
Cristina Valencia Sanchez ◽  
Elitza Theel ◽  
Matthew Binnicker ◽  
Michel Toledano ◽  
Andrew McKeon
Keyword(s):  
Diagnostic Criteria ◽  
Mayo Clinic ◽  
Immune Therapy ◽  
Case Series ◽  
Autoimmune Encephalitis ◽  
Systemic Infection ◽  
Diagnostic Features ◽  
Metabolic Encephalopathy ◽  
Memory Problems ◽  
Clinical Records

Background and objectives:Autoimmune encephalitis (AE) cases post-SARS-CoV-2 infection have been reported, but the frequency is unknown. We aimed to determine the frequency and diagnostic features of COVID-19 related AE.Methods:Residual sera from 556 consecutive Mayo Clinic Rochester patients (laboratory cohort) who underwent autoimmune encephalopathy neural IgG evaluation were tested for total antibodies against the SARS-CoV-2 spike glycoprotein using an FDA-authorized chemiluminescence assay (October 2019-December 2020). Clinical records from patients with a positive SARS-CoV-2 antibody result and available research consent were reviewed. This laboratory cohort was cross-referenced with the Department of Neurology’s COVID-related consultative experience (encephalopathy cohort, n=31).Results:Eighteen of the laboratory cohort (3%) were SARS-CoV-2 antibody positive (April-December 2020). Diagnoses were: AE, 2; post-acute sequelae of SARS CoV-2 infection [PASC], 3; toxic-metabolic encephalopathy during COVID-19 pneumonia, 2; diverse non-COVID-19 relatable neurological diagnoses, 9; unavailable, 2. Five of the encephalopathy cohort had AE (16%, including the 2 laboratory cohort cases which overlapped) representing 0.05% of 10,384 patients diagnosed and cared for with any COVID-19 illness at Mayo Clinic Rochester in 2020. The 5 patients met definite (n=1), probable (n=1), or possible (n=3) AE diagnostic criteria; median symptom onset age was 61 years (range, 46-63), 3 were women. All 5 were neural IgG negative and 4 tested were SARS-CoV-2 PCR/IgG index negative in CSF. Phenotypes (and accompanying MRI and EEG findings) were diverse (delirium [n=5], seizures [n=2], rhombencephalitis [n=1], aphasia [n=1], and ataxia [n=1]). No ADEM cases were encountered. The 3 patients with possible AE had spontaneously resolving syndromes. One with definite limbic encephalitis was immune therapy responsive but had residual mood and memory problems. One patient with probable autoimmune rhombencephalitis died despite immune therapy. The remaining 26 encephalopathy cohort patients had toxic-metabolic diagnoses.Discussion:We encountered occasional cases of AE in our 2020 COVID-19 experience. Consistent with sporadic reports and small case series during the COVID-19 pandemic, and prior experience of postinfectious AE, our cases had diverse clinical presentations and were neural IgG and CSF viral particle negative. Application of diagnostic criteria assists in differentiation of AE from toxic-metabolic causes arising in the setting of systemic infection.

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