Now in its 3rd edition, Tumor Board Review: Evidence-Based Case Reviews and Questions is the most comprehensive clinical case review book in the field. With hands-on input from current fellows and oncologists, this new edition has been enhanced and reformatted for greater efficiency and practicality.
The review covers all disease-site areas in oncology and features a wide variety of board-style questions pivotal in helping fellows and oncologists prepare for both the ABIM medical oncology board exam and maintenance of certification (MOC) assessments. Evidence-based discussions of difficult patient cases offer an in-depth and accurate depiction of what is discussed at tumor boards and foster critical thinking essential for clinical practice. Patient cases also highlight impactful treatment decisions that include newly approved immunotherapies and targeted therapies. Each chapter contains digestible essentials for each case, including a summary of diagnosis, molecular and genomic testing, treatment options, toxicity considerations, follow-up, and survivorship. Each chapter ends with high-yield multiple-choice questions including answers and detailed rationales ensuring readers are well-equipped with the knowledge they need to make well-informed, individualized treatment decisions. Tumor Board Review: Evidence-Based Case Review and Questions is an essential case-based reference for anyone working in oncology.
Key Features:
Describes more than 120 patient cases, including locally advanced and metastatic cases for each major disease site
Contains 300 board-style questions and answers related to case reviews
Includes new advances in diagnosis and therapy, with a greater emphasis on immunotherapies, cancer genomics, and precision-based targeted therapies
Provides essentials for toxicity considerations, follow-up, and survivorship considerations
Author(s): Francis P. Worden, Martha Pritchett Mims, Helen K. Chew
Edition: 3
Publisher: Demos Medical
Year: 2022
Language: English
Tags: Oncology; Cancer; Tumor
Cover
Title
Copyright
Contents
Contributors
Preface
Chapter 1: Head and Neck Cancer
Introduction
Case Summaries
Case 1.1: Locally Advanced Cancer of the Oropharynx
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemoradiotherapy?
What Are Other Treatment Considerations?
General Surveillance Recommendations
Case 1.2: Locally Advanced Nasopharyngeal Cancer
How Is a Diagnosis Established?
What Are the Histological Subclassifications for This Diagnosis?
What Further Molecular or Genomic Testing Is Recommended?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Are the Toxicities Associated With Chemoradiotherapy?
General Surveillance Recommendations19-21
Case 1.3: Metastatic Adenoid Cystic Carcinoma
How Is a Diagnosis Established?
What Is the Appropriate Treatment for Localized Disease?
Is Adjuvant Therapy Indicated?
What Is the Recommended Follow-Up?
What Are the Treatment Options for Metastatic Disease?
Case 1.4: Metastatic Squamous Cell Carcinoma
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Treatment Considerations?
What Are Available First-Line Treatment Options for Unresectable Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma? (Figure 1.1)
What Are Second-Line Treatment Options?
Review Questions
Answers And Rationales
References
Chapter 2: Thyroid Cancer
Introduction
Differentiated Thyroid Cancer
Case Summaries
Case 2.1: Locally Advanced Anaplastic Thyroid Cancer
What Is the Initial Evaluation and Management of Anaplastic Thyroid Carcinoma?
What Is the Management for Locoregionally Advanced Anaplastic Thyroid Carcinoma?
What Is the Management for Locoregionally Advanced, Unresectable, or Metastatic Anaplastic Thyroid Carcinoma?
Case 2.2: Metastatic Medullary Thyroid Cancer
What Is the Initial Evaluation for a Patient Diagnosed With Medullary Thyroid Carcinoma?
What Are the Primary Treatment Options for Medullary Thyroid Cancer?
When Should Systemic Therapy Be Considered?
What Are the Systemic Therapy Options for Medullary Thyroid Cancer?
What Are Other Options for Patients Who Progress on the Approved Tyrosine Kinase Inhibitors?
What Are Some Other Considerations to Offer Best Supportive Care for Patients With Metastatic Medullary Thyroid Cancer?
Case 2.3: Metastatic Radioactive Iodine Refractory Differentiated Thyroid Cancer
What Is the Stage of His Recurrent Thyroid Cancer?
What Further Testing Would You Recommend for Recurrent or Metastatic Radioactive Iodine-Refractory Differentiated Thyroid Cancer?
What Are the Frontline Options for Treatment of Metastatic Radioactive Iodine-Refractory Differentiated Thyroid Cancer?
What Are the Second-Line Therapy Options for Treatment of Metastatic Radioactive Iodine-Refractory Differentiated Thyroid Cancer?
Review Questions
Answers And Rationales
References
Chapter 3: Non-Small Cell Lung Cancer
Introduction
Case Summaries
Case 3.1: Early-Stage Resectable Lung Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Treatment?
What Are Other Treatment Considerations?
Case 3.2: Locally Advanced Unresectable Lung Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemoradiotherapy?
What Are Other Treatment Considerations?
Case 3.3: Metastatic Lung Cancer Without Driver Mutations
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Immunotherapy?
Should the Patient Receive Maintenance Therapy?
Case 3.4: Metastatic Lung Adenocarcinoma With a Targetable Driver Mutation
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Further Molecular or Genomic Testing Is Required? Should Treatment Be Initiated Immediately?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Treatment?
Other Considerations
Case 3.5: Metastatic Non-Small Cell Lung Cancer in the Second Line
What Are Appropriate Second-Line Treatment Options?
Review Questions
Answers and Rationales
References
Chapter 4: Small Cell Lung Cancer
Introduction
Case Summaries
Case 4.1: Newly Diagnosed Extensive-Stage Small Cell Lung Cancer
What Is the Clinical Presentation of Small Cell Lung Cancer?
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Is the Role for Molecular Biomarker Analysis in Treatment Selection for Small Cell Lung Cancer?
What Is the First-Line Treatment for Extensive-Stage Small Cell Lung Cancer?
What Are the Toxicities Associated With the Treatment?
What Surveillance Is Recommended?
What Is the Prognosis of Extensive-Stage Small Cell Lung Cancer?
Case 4.2: Relapsed Small Cell Lung Cancer
How Frequently Does Small Cell Lung Cancer Relapse?
How Is Refractory Disease and Relapse Defined?
What Are the Treatment Options for Refractory and Relapsed Extensive-Stage Small Cell Lung Cancer?
What Is the Duration of Treatment for Relapsed Disease?
What Response Assessment Is Recommended?
Is There Subsequent Therapy If Patients Are Found to Have Recurrent Relapse or Ongoing Progression?
Case 4.3: Limited-Stage Small Cell Lung Cancer and the Role of Prophylactic Cranial Irradiation Versus MRI Brain Surveillance
How Is the Staging of Limited-Stage Small Cell Lung Cancer Different From Extensive-Stage Small Cell Lung Cancer?
How Is Limited-Stage Small Cell Lung Cancer Treated?
What Is the Prognosis for Limited-Stage Small Cell Lung Cancer?
What Is the Role of Prophylactic Cranial Irradiation Versus MRI Brain Surveillance in Small Cell Lung Cancer?
Review Questions
Answers and Rationales
References
Chapter 5: Hormone Receptor-Positive Breast Cancer
Introduction
Case Summaries
Case 5.1: Early-Stage Breast Cancer
How Is a Diagnosis Established?
What Are the Subtypes of Breast Cancer?
What Other Biomarkers Are Important in Hormone Receptor-Positive Breast Cancer?
How Is Breast Cancer Staged?
What Treatment Should You Offer a Premenopausal Woman With Early-Stage Breast Cancer?
What Tools Are Available to Access the Patient’s Response to Neoadjuvant Endocrine Therapy?
What Treatment Should the Patient Receive After Surgery?
Case 5.2: Early-Stage Hormone-Positive Breast Cancer
Invasive Ductal Carcinoma
Staging and Prognosis of Early Breast Cancer?
Treatment of Early-Stage Breast Cancer?
What Treatment Is Given After Surgery in Patients With Early-Stage Hormone Receptor-Positive Breast Cancer?
Are There Adverse Effects Associated With Selective Estrogen Receptor Modulators? And What Are the Adverse Effects With Aromatase Inhibitors?
When Do You Choose Between Selective Estrogen Receptor Modulators and Aromatase Inhibitors?
Case 5.3: Locally Advanced Breast Cancer
What Further Molecular or Genomic Testing Is Recommended?
What Adjuvant Therapy Should Be Offered to High-Risk Patients?
What Adjuvant Therapy Should Be Offered to Patients With a Germline BRCA Mutation?
Conclusions
Case 5.4: Stage IV Breast Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Cyclin-Dependent Kinase 4/6 Inhibitors?
What Are Other Treatment Considerations?
Treatment Duration
Case 5.5: Recurrent Stage IV Breast Cancer
What Further Molecular or Genomic Testing Is Required?
What Is Phosphoinositide 3 Kinase?
What Are Phosphoinositide 3 Kinase Mutations?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Alpelisib?
How Are These Toxicities Managed?
Review Questions
Answers And Rationales
References
Chapter 6: Triple-Negative Breast Cancer
Introduction
Case Summaries
Case 6.1: Localized Triple-Negative Breast Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Other Diagnostic Considerations Are There?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Systemic Chemotherapy?
Other Considerations
Case 6.2: Locally Advanced Triple-Negative Breast Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Other Diagnostic Considerations Are There?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
Post-Therapy Surveillance
case 6.3: Metastatic Triple-Negative Breast Cancer
How Is a Diagnosis Established?
How Is the Tumor Staged?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Systemic Therapies?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 7: Esophageal Cancer
Introduction
Risk Factors
Clinical Presentation
Staging
Case Summaries
Case 7.1: Locally Advanced, Resectable Esophageal Adenocarcinoma
How Is Esophageal Adenocarcinoma Diagnosed?
What Additional Workup Is Needed?
What Is the Patient’s Clinical Stage Per the AJCC Eighth Edition Criteria?
What Is the General Treatment Modality for Locally Advanced Esophageal Adenocarcinoma Defined as Clinical Stage T3-4a or any Regional Node-Positive Disease?
What Surveillance Should the Patient Now Be On?
Case 7.2: Locally Advanced Esophageal Squamous Cell Carcinoma
What Is the General Treatment Approach for Locally Advanced Squamous Cell Carcinoma of the Lower Esophagus?
Case 7.3: Locally Advanced Cervical Esophageal Squamous Cell Carcinoma
How Is Squamous Cell Carcinoma of the Cervical Esophagus Managed?
Case 7.4: Metastatic Esophageal Adenocarcinoma
What Molecular or Genomic Testing Is Required?
What Are the Appropriate Frontline Treatment Options for Metastatic Esophageal Adenocarcinoma?
What Are Toxicities to Consider With Systemic Chemoimmunotherapy in Metastatic Esophageal Adenocarcinoma?
What Are Second-Line Treatment Options for Patients With Metastatic Esophageal Adenocarcinoma Who Progress on Frontline Chemotherapy or Chemoimmunotherapy?
Case 7.5: Human Epidermal Growth Factor Receptor 2-Positive Metastatic Esophageal Cancer
How Is Human Epidermal Growth Factor Receptor 2 Tested for in Esophageal Cancer?
What Are the Frontline Treatment Options for Human Epidermal Growth Factor Receptor 2 Overexpressing Metastatic Esophageal Cancer?
What Are the Second-Line Treatment Options for Patients With Human Epidermal Growth Factor Receptor 2-Positive Metastatic Esophageal Cancer?
Review Questions
Answers and Rationales
References
Chapter 8: Gastric Cancer
Introduction
Case Summaries
Case 8.1: Resectable Gastric Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Goals of Surgical Resection?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 8.2: Unresectable Locally Advanced Gastric Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Further Molecular or Genomic Testing Is Required?
How Do You Manage the Acute Complication of Gastric Outlet Obstruction in Locally Advanced Gastric Cancer?
What Are Appropriate First-Line Treatment Options in This Patient With Unresectable Locally Advanced Gastric Cancer?
Case 8.3: Metastatic Gastric Adenocarcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Therapy?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 9: Pancreatic Cancer
Introduction
Case Summaries
Case 9.1: Resectable Pancreatic Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 9.2: Borderline Resectable Pancreatic Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
Case 9.3: Locally Advanced Pancreatic Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
Case 9.4: Metastatic Pancreatic Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Toxicities Associated With Chemotherapy?
What Encompasses Best Supportive Care?
Future Directions
Review Questions
Answers and Rationales
References
Chapter 10: Neuroendocrine Cancer
Introduction
Case Summaries
Case 10.1: Gastric Neuroendocrine Neoplasm
What Are the Subtypes of Gastric Neuroendocrine Tumors?
How Is This Cancer Staged?2
How Is Diagnosis Established for Gastric Neuroendocrine Neoplasm?4,5
Is Biochemical Testing Required for the Disease?
What Molecular or Genetic Markers Are Used In Current Clinical Practice?
How Do Various Types of Gastric Neuroendocrine Neoplasm Present?
How Is the Type 1 Gastric Neuroendocrine Tumor Managed and What Are Treatment Options?
What Are the Toxicities Associated With Systemic Therapy Options?
How Are Patients Followed Up for Surveillance?
Case 10.2: Pancreatic Neuroendocrine Neoplasm
How Are Pancreatic Neuroendocrine Neoplasms Classified?
What Is the Specific Pathology for Each Disease?
How Is the Disease Diagnosed?
Is Biochemical Testing Required for the Disease?
What Molecular Markers Are Used In Current Clinical Practice for Pancreatic Neuroendocrine Tumors?
Does the Disease Have Specific Germline Mutations to Warrant Genetic Counseling?
How Does the Disease Present?
How Is a Pancreatic Neuroendocrine Tumor Managed and What Are the Treatment Options?
How Are Advanced Unresectable or Metastatic Well-Differentiated G3 Pancreatic Neuroendocrine Tumors Managed?
What Are the Toxicities Associated With Systemic Therapy Options?
What Are the Prognostic Markers and How Do They Impact Treatment and/or Survival?
How Are Patients Followed Up for Surveillance?
Case 10.3: Midgut Neuroendocrine Tumor and Carcinoid Syndrome
What Is the Specific Pathology?
How Is the Disease Diagnosed?
What Biomarkers Are Used in Current Clinical Practice?
What Molecular Markers Are Used Currently in Clinical Practice?
Does the Disease Have Specific Germline Mutations to Warrant Genetic Counseling?
How Does the Disease Present?
How Is a Midgut Neuroendocrine Tumor Managed and What Are Treatment Options?
What Are the Appropriate Treatment Options at This Stage?
What Are the Toxicities Associated With Systemic Therapy Options?
What Are the Prognostic Markers and How Do They Impact Treatment and/or Survival?
What Are the Side Effects of Various Treatments?
How Are Patients Followed Up for Surveillance?
Case 10.4: Poorly Differentiated Neuroendocrine Carcinoma
What Is the Specific Pathology for Each Disease and How Is it Staged?
How Is Pacreatic Neuroendocrine Carcinoma Diagnosed?
Is Biochemical Testing Required for the Disease?
What Molecular Markers Are Used in Current Clinical Practice?
Does the Disease Have Specific Germline Mutations to Warrant Genetic Counseling?
How Does the Disease Present?
How Is Pancreatic Neuroendocrine Carcinoma Managed and What Are the Treatment Options?
What Are the Prognostic Markers and How Do They Impact Treatment and/or Survival?
How Are Patients Followed Up for Surveillance?
Review Questions
Answers and Rationales
References
Chapter 11: Hepatobiliary Cancer
Introduction
Case Summaries
Case 11.1: Metastatic Hepatocellular Carcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
What Are Other Treatment Considerations?
What Is Required for This Patient’s Follow-Up?
Biliary Tract Cancer
Case 11.2: Locally Advanced Cholangiocarcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
What Are Other Treatment Considerations?
Case 11.3: Metastatic Cholangiocarcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 12: Colorectal Cancer
Introduction
Case Summaries
Case 12.1: Locally Advanced Colon Adenocarcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
What Are Other Treatment Considerations?
Case 12.2: Locally Advanced Rectal Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
Case 12.3: Unresectable Metastatic Colon Adenocarcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Chemotherapy?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 13: Anal Cancer
Introduction
Case Summaries
Case 13.1: Locally Advanced Anal Cancer
What Studies Are Needed to Complete Staging?
What Is the Stage of Her Anal Cancer?
What Are Recommended Treatment Modalities for Stage I to III Anal Cancer?
When Is the Response to First-Line Chemoradiotherapy Assessed?
How Should Surveillance Be Conducted Following Primary Treatment?
How Should Locoregional Failure After Primary Chemoradiotherapy Be Managed?
Case 13.2: Very Early-Stage Anal Cancer Requiring Surgery Alone
What Are the Precursor Lesions for Anal Cancer?
How Should Precursor Lesions for Anal Cancer Be Managed?
What Additional Testing Should Be Discussed or Recommended?
Case 13.3: Metastatic Anal Cancer
What Are the Most Common Sites for Distant Metastatic Disease?
What Is the Risk of Metastatic Disease?
What Is the Recommended First-Line Treatment for Metastatic Anal Cancer?
What Are Second-Line Treatment Options for Anal Cancer?
Review Questions
Answers and Rationales
References
Chapter 14: Prostate Cancer
Introduction
Case Summaries
Case 14.1: Localized Prostate Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Radical Prostatectomy?
What Are Other Treatment Considerations?
Case 14.2: Biochemically Recurrent Prostate Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Salvage Radiation Therapy?
Case 14.3: Metastatic Hormone-Sensitive Prostate Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?5
How Is This Tumor Staged?
What Are Appropriate Treatment Options?9
What Are the Toxicities Associated With Chemohormonal Therapy?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 15: Testicular Cancer
Introduction
Case Summaries
Case 15.1: Localized Testicular Cancer—Seminoma
What Are the Initial Steps In Diagnosis of Testicular Cancer?
How Is Testicular Cancer Staged?
What Are Treatment Options for Stage I Seminoma?
What Are Side Effects Associated With These Treatment Regimens?
What Is the Recommended Surveillance Regimen?
Case 15.2: Advanced Testicular Cancer—Seminoma
What Are the Treatment Options for Stage II Seminoma?
What Are the Risk Categories in Metastatic Seminoma?
What Are the Treatment Options for Stage III (and IIC) Seminoma?
What Are Side Effects Associated With Initial Chemotherapy Used in Advanced Seminoma?
What Is Done After Primary Treatment With Chemotherapy in Advanced Seminoma?
What Does Surveillance Entail in Advance Seminoma?
What Are Options in Second-Line Therapy for Seminoma?
What Are Third-Line Options in Seminoma?
Case 15.3: Locally Advanced Nonseminoma Testicular Cancer
What Are the Subtypes of Nonseminomatous Germ Cell Tumor?
What Are the Treatment Options for Stage I Nonseminoma?
What Are the Treatment Options for Stage II Nonseminoma
How Are Patients Followed After Treatment?
Case 15.4: Metastatic Nonseminoma Testicular Cancer
How Is Metastatic Testicular Cancer Risk Stratified?
What Are the Treatment Options for Metastatic Testicular Cancer?
What Follow-Up Is Needed After Treatment?
How Are Brain Metastasis Managed?
What Are Options for Treatment of Relapsed or Refractory Disease?
What Is Required for Follow-Up and Survivorship?
Review Questions
Answers and Rationales
References
Chapter 16: Renal Cancer
Introduction
Case Summaries
Case 16.1: Early-Stage Renal Cell Carcinoma
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 16.2: Metastatic Renal Cell Carcinoma
How Is a Diagnosis Established?
What Are Other Prognostic Factors?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Systemic Therapy?
Case 16.3: Oligometastatic Disease
How Is a Diagnosis Established?
What Is the Patient's Stage and Prognostic Group?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Is Required for This Patient’s Follow-Up and Survivorship?
Review Questions
Answers and Rationales
References
Chapter 17: Bladder Cancer
Introduction
Case Summaries
Case 17.1: Muscle-Invasive Bladder Cancer in a Surgical Candidate
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Is Required for the Patient’s Follow-Up and Survivorship?
Case 17.2: Muscle-Invasive Bladder Cancer in a Nonsurgical Candidate
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Treatment?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 17.3: Metastatic Bladder Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With This Regimen?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 17.4: Platinum-Refractory Metastatic Bladder Cancer
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Treatment?
Review Questions
Answers and Rationales
References
Chapter 18: Cervical Cancer
Introduction
Epidemiology, Risk Factors, and Pathology
Natural History and Prognosis
Case Summaries
Case 18.1: Early Cervical Cancer
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Management Strategies Are Available for Early-Stage Cervical Cancer (Stage IA2, IB1, IB2, and IIA)?
What Route of Surgery Is Recommended for Early-Stage Cervical Cancer?
Following Surgery, Who Should Receive Adjuvant Therapy?
Who Is a Candidate for Fertility Sparing Surgery?
What Is the Management for Patients Who Are Not Surgical Candidates?
How Should Patients Be Surveilled Following Completion of Treatment?
Case 18.2: Locally Advanced Cervical Cancer
What Management Strategies Are Available for Locally Advanced Cervical Cancer (Stage IB3 to IVA)?
What Is the Management of Para-Aortic Lymph Node Metastases?
How Should Patients With Locally Advanced Disease Be Surveilled Following Completion of Treatment?
Case 18.3: Distant Metastatic and Recurrent Cervical Cancer
What Management Options Are Available for Metastatic Cervical Cancer?
What Prognostic Factors May Indicate a Poor Response to Systemic Chemotherapy?
Review Questions
Answers and Rationales
References
Chapter 19: Uterine Cancer
Introduction
Case Summaries
Case 19.1: Type 1 Endometrial Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With the Treatment?
What Are Other Treatment Considerations?
Case 19.2: Advanced Type 2 Endometrial Cancer
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With the Treatment?
What Are Other Treatment Considerations?
Case 19.3: Leiomyosarcoma
What Preoperative Evaluations Are Necessary?
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 20: Ovarian Cancer
Introduction
Case Summaries
Case 20.1: Early Ovarian Cancer
What Is the Utility of Tumor Markers?
What Is the Standard of Care Treatment for Early-Stage Ovarian Cancer?
Which Patients Need Adjuvant Treatment?
Case 20.2: Borderline Ovarian Tumor
What Are the Different Histologies of Borderline Ovarian Tumor?
How Are Borderline Tumors Staged?
What Is the Role of Fertility-Sparing Surgery in Patients With Borderline Tumors?
How Are Invasive Implants Treated?
Should Patients With Borderline Tumors Receive Adjuvant Chemotherapy Postoperatively?
What Is the Prognosis? What Is the Risk of Recurrence for a BOT After an Oophorectomy? After an Ovarian Cystectomy?
Case 20.3: Primary Treatment: Neoadjuvant Treatment Versus Primary Cytoreductive Surgery
Which Patients Should Undergo Primary Cytoreductive Surgery and Which Should Receive Neoadjuvant Chemotherapy?
What Chemotherapy Regimen Would You Recommend for a Patient Receiving Neoadjuvant Chemotherapy? Does This Differ From Patients Who Undergo Primary Debulking Surgery Followed by Adjuvant Chemotherapy?
Is There a Role for Maintenance Therapy After Completion of Primary Treatment of Ovarian Cancer?
Case 20.4: Recurrent Ovarian Cancer
What Are the Definitions of Platinum-Sensitive and Platinum-Resistant Ovarian Cancer? How Does This Impact Treatment Recommendations?
What Are the Appropriate Treatment Options for This Patient?
Case 20.5: Malignant Germ Cell Tumor
What in This Patient’s History Makes You Suspicious of a Germ Cell Tumor?
A Dysgerminoma Is Suspected. What Are the Initial Steps in Management?
Which Patients With Malignant Germ Cell Tumors Require Postoperative Adjuvant Therapy? What Is the Recommended Adjuvant Therapy?
What Is the Most Worrisome Toxicity of the Chemotherapy Regimen?
What Is the Prognosis for Germ Cell Tumors?
Review Questions
Answers and Rationales
References
Chapter 21: Melanoma
Introduction
Case Summaries
Case 21.1: Stage I to II Disease
How Does One Evaluate a Suspicious Skin Lesion?
When Is Further Molecular or Genomic Testing Required?
What Are Appropriate Treatment Options?
What Are Other Treatment Considerations?
What Are the Principles of Staging?
What Follow-up Is Appropriate?
What Is the Role for Systemic Therapy?
Case 21.2: Locally Advanced Stage III With Positive Sentinel Node
What Staging Workup Is Considered for Stage III Melanoma?
What Are the Management Options for a Positive Sentinel Lymph Node?
What Further Molecular or Genomic Testing Is Required?
What Is the Role for Adjuvant Radiation Therapy?
What Are the Adjuvant Systemic Treatment Options for Stage III Melanoma?
What Are the Potential Toxicities Associated With Adjuvant Systemic Therapy?
Case 21.3: Metastatic BRAF V600 Mutation-Positive Disease
How Is the Diagnosis Established?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With This Treatment?
What Are Other Treatment Considerations?
What Is Required for This Patient’s Follow-Up and Survivorship?
Case 21.4: Merkel Cell Carcinoma
What Is Merkel Cell Carcinoma and How Is It Diagnosed?
What Additional Staging Workup Is Recommended?
What Is the Definitive Management of Locoregional Merkel Cell Carcinoma?
What Adjuvant Systemic Treatment Is Available for Stage III Merkel Cell Carcinoma?
What Are the Treatment Options for Metastatic Merkel Cell Carcinoma?
Review Questions
Answers and Rationales
References
Chapter 22: Bone Sarcoma
Introduction
Case Summaries
Case 22.1: Osteosarcoma
How Is a Diagnosis Established?
What Is the Staging System for Bone Cancers?
What Is the Recommended Treatment?
What Are the Common Toxicities of Treatment?
What Is the Recommended Surveillance?
Case 22.2: Ewing Sarcoma
How Is a Diagnosis Established and What Is the Recommended Workup?
What Is the General Course of Treatment?
What Are the Common Toxicities of Treatment?
What Is the Recommended Surveillance?
How Is Metastatic Disease Treated?
Case 22.3: Chondrosarcoma
How Is a Diagnosis Established and What Is the Recommended Workup for Chondrosarcoma?
How Are Chondrosarcomas Staged?
What Is the Recommended Treatment of Localized Disease?
How Is Metastatic Disease Treated?
What Are the Common Toxicities of Treatment?
Review Questions
Answers and Rationales
References
Chapter 23: Soft-Tissue Sarcoma
Introduction
Case Summaries
Case 23.1: Localized Soft-Tissue Sarcoma
How Is a Diagnosis Established?
How Are Soft-Tissue Sarcomas Staged?
What Is the Approach to Treatment?
What Are the Toxicities of Treatment?
What Is the Recommended Surveillance for Soft-Tissue Sarcoma?
Case 23.2: Metastatic Soft-Tissue Sarcoma
How Is a Diagnosis Established?
What Is the Typical Pattern of Metastasis for Soft-Tissue Sarcomas?
How Are Metastatic Soft-Tissue Sarcomas Treated?
Case 23.3: Rhabdomyosarcoma
How Are Head and Neck Sarcomas Staged?
What Are the Types of Rhabdomyosarcoma?
How Is Localized and Metastatic Disease Treated?
What Are the Treatment Toxicities?
Case 23.4: Gastrointestinal Stromal Tumor
How Is a Diagnosis Established?
How Is a Gastrointestinal Stromal Tumor Staged?
Which Patients Should Receive Adjuvant Therapy?
What Are the Treatment Options for Metastatic Disease?
What Are the Treatment Toxicities?
Review Questions
Answers And Rationales
References
Chapter 24: Primary Brain Tumors
Introduction
Case Summaries
Case 24.1: Glioblastoma, IDH Wildtype
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Standard of Care Treatment?
What Are Other Treatment Considerations?
Case 24.2: Astrocytoma, IDH Mutant
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Standard of Care Treatments?
What Are Other Treatment Considerations?
Case 24.3: Oligodendroglioma, IDH Mutant, 1p/19q Co-Deleted
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Standard of Care Treatments?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 25: Cancer of Unknown Primary
Introduction
Case Summaries
Case 25.1: Squamous Cell Carcinoma of the Head and Neck
How Is a Cancer of Unknown Primary of the Head and Neck Diagnosed?
How Do You Establish Regional Lymph Node Involvement?
What Treatment Do You Recommend?
Treatment of Recurrent or Persistent Disease
Case 25.2: Poorly Differentiated Carcinoma of Unknown Primary
What Additional Workup Is Required?
What Is the Role of Molecular Gene Expression Profiling in Poorly Differentiated Carcinoma of Unknown Primary?
What Is Our Patient’s Prognosis?
What Treatment Do You Recommend for This Patient?
If She Was a Treatment Candidate, What Treatment Could Be Offered?
The Patient Presents to Your Clinic Outpatient; What Do You Recommend for Treatment?
Case 25.3: Neuroendocrine Cancer of Unknown Primary
How Is the Diagnosis of Neuroendocrine Cancer of Unknown Primary Confirmed?
How Are Neuroendocrine Cancers of Unknown Primary Classified?
What Other Imaging Should Be Included in the Evaluation of Neuroendocrine Cancers of Unknown Primary?
What Additional Laboratory Testing Should Be Considered?
What Is the Management of Localized Neuroendocrine Cancer of Unknown Primary?
What Is the Management of Metastatic Well-Differentiated Tumors?
What Is the Management of Poorly Differentiated Neuroendocrine Carcinoma?
What Surveillance Is Necessary?
Case 25.4: Adenocarcinoma of Unknown Primary
How Is Adenocarcinoma of Unknown Primary Diagnosed?
What Further Molecular or Genomic Testing Is Required?
What Further Workup Is Necessary for Adenocarcinoma of Unknown Primary?
What Is Appropriate Management for Localized Disease?
What Treatment Could Be Considered for Widely Disseminated or Unresectable Disease?
Review Questions
Answers and Rationales
References
Chapter 26: Hodgkin Lymphoma
Introduction
Case Summaries
Case 26.1: Early-Stage, Favorable Risk Hodgkin Lymphoma
How Is a Diagnosis Established?
What Are the Different Subtypes of Hodgkin Lymphoma?
Which Molecular Feature Is Important in Distinguishing Between Classical Hodgkin Lymphoma and Anaplastic Large-Cell Lymphoma?
Which Age Groups Are Most Likely to Develop Hodgkin Lymphoma?
How Is This Tumor Staged?
What Determines Favorable Versus Unfavorable Risk?
What Are the Possible Treatment Options for Early-Stage Favorable Risk Classical Hodgkin Lymphoma?
What Are the Toxicities Associated With Chemoradiotherapy?
Case 26.2: Early-Stage, Unfavorable Risk Hodgkin Lymphoma
Treatment Options for Early-Stage Unfavorable Risk
What Is Required for This Patient’s Follow-Up?
What Is Required for This Patient’s Survivorship?
Case 26.3: Advanced-Stage Hodgkin Lymphoma
What Is the Patient's Risk?
What Are Other Poor Prognostic Factors?
Treatment Options for Advanced-Stage Classical Hodgkin Lymphoma
What Is Brentuximab Vedotin?
What Is the Role of Radiation?
How Are Interim PET Scans Interpreted?
What Are Treatment Options for Relapsed/Refractory Hodgkin Lymphoma?
Review Questions
Answers and Rationales
References
Chapter 27: Non-Hodgkin Lymphoma
Introduction
Common Issues to Non-Hodgkin Lymphomas
Case Summaries
Case 27.1: Mantle Cell Lymphoma
How Is a Diagnosis Established?
How Is Mantle Cell Lymphoma Staged and Risk-Stratified?
What Are Appropriate Treatment Options?
Follow-Up and Relapsed Disease
Case 27.2: Follicular Lymphoma
How Is a Diagnosis Established?
How Is This Tumor Staged?
Is Prognostic Risk Stratification Available for Follicular Lymphoma?
What Treatment Strategies Are Appropriate for Follicular Lymphoma?
Surveillance and Relapse
What Treatment Options Are Available for Relapsed Follicular Lymphoma?
Case 27.3: Diffuse Large B-Cell Lymphoma
How Is the Diagnosis of Diffuse Large B-Cell Lymphoma Established?
What Additional Genetic Testing Should Be Performed?
How Is Diffuse Large B-Cell Lymphoma Staged?
Does a Prognostic Stratification System Exist for Diffuse Large B-Cell Lymphoma?
What Are the First-Line Treatment Options for Diffuse Large B-Cell Lymphoma?
What Is the Role of Lumbar Puncture and Central Nervous System Prophylaxis?
Surveillance
What Treatment Strategies Are Available on First Relapse?
What Treatment Options Are Available for Multiply-Relapsed Disease?
Case 27.4: Peripheral T-Cell Lymphoma
How Is the Diagnosis of T-Cell Lymphoma Established?
What Additional Genetic Testing Should Be Performed?
How Is Peripheral T-Cell Lymphoma Worked Up and Staged?
Does a Prognostic Stratification System Exist for Peripheral T-Cell Lymphoma?
What Are the First-Line Treatment Options for Peripheral T-Cell Lymphoma?
What Is the Role of Lumbar Puncture and Central Nervous System Prophylaxis?
Surveillance
What Treatment Strategies Are Available on First Relapse?
What Treatment Options Are Available for Multiply-Relapsed Disease?
Case 27.5: Burkitt Lymphoma
How Is the Diagnosis of Burkitt Lymphoma Established?
Does Burkitt Lymphoma Have Subtypes?
How Is Burkitt Lymphoma Staged?
Is There a Prognostic System for Burkitt Lymphoma?
What Is the Front-Line Treatment for Burkitt Lymphoma?
What Is the Role of Lumbar Puncture and Central Nervous System Prophylaxis in Burkitt Lymphoma?
How Do You Treat Relapsed/Refractory Burkitt Lymphoma?
Surveillance
Review Questions
Answers and Rationales
References
Chapter 28: Multiple Myeloma and Plasma Cell Neoplasms
Introduction
Case Summaries
Case 28.1: Precursor Disease (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma)
What Is the Diagnosis?
How Is Monoclonal Gammopathy of Undetermined Significance Risk Stratified and Managed?
How Is Smoldering Multiple Myeloma Risk Stratified and What Is This Patient’s Risk?
How Should Smoldering Multiple Myeloma Be Treated?
Case 28.2: Newly Diagnosed, Transplant-Eligible Multiple Myeloma
What Is the Workup for Multiple Myeloma?
How Is Multiple Myeloma Staged?
How Is Multiple Myeloma Risk Stratified?
What Is the Diagnosis and Treatment?
Case 28.3: Newly Diagnosed, Transplant-Ineligible Multiple Myeloma
What Is the Diagnosis and Treatment?
Case 28.4: Relapsed/Refractory Multiple Myeloma
What Is the Diagnosis and Treatment?
Case 28.5: Amyloid Light Chain Amyloidosis
What Is the Diagnosis and Treatment?
Review Questions
Answers and Rationales
References
Chapter 29: Acute Lymphoblastic Leukemia
Introduction
Case Summaries
Case 29.1: Adolescent and Young Adult Acute Lymphoblastic Leukemia
How Is Acute Lymphoblastic Leukemia Diagnosed?
What Further Workup Should Be Performed at Diagnosis?
What Is the Role of Lumbar Puncture and Intrathecal Chemotherapy?
What Is the Initial Treatment for Acute Lymphoblastic Leukemia in the Adolescent and Young Adult Population?
What Is the Role of Post-Induction Therapy?
What Further Surveillance Is Needed Posttreatment?
What Are Treatment Options in the Adolescent-and-Young-Adult Population in the Event of Relapse?
Case 29.2: Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia
What Is the Significance of the Philadelphia Chromosome in Acute Lymphoblastic Leukemia?
What Are Typical Induction Strategies for Philadelphia+ Acute Lymphoblastic Leukemia?
What Are Options for Post-Induction Therapy for Philadelphia+ Acute Lymphoblastic Leukemia?
What Are the Principles of Surveillance in Philadelphia+ Acute Lymphoblastic Leukemia?
What Treatment Options Are Available in the Relapse/Refractory Setting?
Case 29.3: Pre-B Cell Acute Lymphoblastic Leukemia
How Is Pre-B Cell Acute Lymphoblastic Leukemia Diagnosed?
What Are Important Prognostic and Risk Assessment Variables in Pre-B-Cell Acute Lymphoblastic Leukemia?
What Is the Overall Approach to Treatment?
How Is Response to Treatment Assessed?
What Are Treatment Options in the Setting of Measurable Residual Disease-Positivity or Relapsed/Refractory Disease?
Case 29.4: T-Cell Acute Lymphoblastic Leukemia
How Is T-Cell Acute Lymphoblastic Leukemia Diagnosed?
What Further Workup Should Be Performed?
What Are Favorable Prognostic Features in This Case?
What Treatment Options Are Available in the Relapsed/Refractory Setting?
Review Questions
Answers and Rationales
References
Chapter 30: Acute Myelogenous Leukemia
Introduction
Case Summaries
Case 30.1: Acute Promyelocytic Leukemia
What Is the Diagnosis?
What Are the Types of Acute Promyelocytic Leukemia?
How Is Acute Promyelocytic Leukemia Diagnosed?
How Is Acute Promyelocytic Leukemia Managed?
What Is the Management of Relapsed Acute Promyelocyte Leukemia?
Is Central Nervous System Prophylaxis Routinely Used in Acute Promyelocytic Leukemia?
Case 30.2: Acute Myeloid Leukemia With Favorable Risk in Younger Adults (18 to 60 Years Old)
What Is the Management of Newly Diagnosed Favorable-Risk Acute Myeloid Leukemia?
Case 30.3: Acute Myeloid Leukemia With Intermediate Risk/Unfavorable Risk in Younger Adults
What Is the Management of Intermediate and Unfavorable Risk Acute Myeloid Leukemia in Younger Adults (Younger Than 60 Years)?
Case 30.4: Acute Myeloid Leukemia in the Older Adult (Age Older Than 60 Years)
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Induction Options Are There for Older Patients Who Are Less Fit?
What Targeted Therapies Do We Have for Older, Less-Fit Patients?
What Monitoring Needs to Be Done for This Regimen?
What Is Required for Follow-Up?
Review Questions
Answers and Rationales
References
Chapter 31: Chronic Myeloid Leukemia
Introduction
Case Summaries
Case 31.1: Newly Diagnosed Chronic Myeloid Leukemia
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Tyrosine Kinase Inhibitor Therapy?
What Are Other Treatment Considerations?
Case 31.2: Chronic Myeloid Leukemia With a T315I Mutation
What Further Genomic or Molecular Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Ponatinib?
What Are Other Treatment Considerations?
Case 31.3: Chronic Myeloid Leukemia With Lymphoid Blast Crisis
How Is a Diagnosis Established?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Hyper-CVAD and Allo-HSCT?
What Are Other Treatment Considerations?
Review Questions
Answers and Rationales
References
Chapter 32: Chronic Lymphocytic Leukemia
Introduction
Case Summaries
Case 32.1: Newly Diagnosed Chronic Lymphocytic Leukemia
How Is a Diagnosis Established?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
Case 32.2: Chronic Lymphocytic Leukemia Requiring Treatment
What Further Molecular or Genomic Testing Is Required?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Bruton Tyrosine Kinase Inhibitors?
What Are Other Treatment Considerations?
Case 32.3: Chronic Lymphocytic Leukemia Undergoing Richter’s Transformation
What Are Appropriate Treatment Options?
What Are Important Considerations With BCL2 Inhibitors?
What Diagnostic Tests Should Be Considered for This Patient?
What Are the Treatment Options for Richter’s Transformation?
Review Questions
Answers and Rationales
References
Chapter 33: Myelodysplastic Syndrome
Introduction
Case Summaries
Case 33.1: Myelodysplastic Syndrome With Excess Blasts-1
How Is a Diagnosis Established?
What Further Molecular or Genomic Testing Is Required?
How Is This Tumor Staged?
What Are Appropriate Treatment Options?
What Are the Toxicities Associated With Hypomethylating Agents?
What Are Other Treatment Considerations?
Case 33.2: Myelodysplastic Syndrome With Ring Sideroblasts
What Other Tests Are Required to Complete the Diagnostic Workup?
What Are Treatment Options for Lower-Risk Myelodysplastic Syndrome?
What Are the Toxicities Associated With Erythropoietin, Granulocyte Colony-Stimulating Factor, and Luspatercept?
What Are Other Treatment Considerations?
Case 33.3: Myelodysplastic Syndrome With Isolated Del(5q)
What Further Tests for Diagnosis and Therapy Planning Are Required at This Point?
What Are the Treatment Options and Considerations for MDS With Del(5q)?
What Are the Toxicities Associated With Lenalidomide?
Review Questions
Answers and Rationales
References
Index
