PI3K/AKT/mTOR inhibitors for advanced or recurrent endometrial cancer. Endometrial cancer is one of the most common gynaecological cancers in developed countries. Treatment of advanced endometrial cancer usually involves radiotherapy, chemotherapy, endocrine therapy or a combination of these. However, survival outcomes are poor in advanced or metastatic disease. Better systemic treatment options are needed to improve survival and safety outcomes for these women. The PI3K/AKT/mTOR pathway (...) is a frequently altered signalling pathway in endometrial cancer. Single-arm studies have reported some encouraging results of the PI3K/AKT/mTOR inhibition in advanced or recurrent endometrial cancer.To assess the efficacy and safety of PI3K/AKT/mTOR inhibitor-containing regimens in women with locally-advanced, metastatic or recurrent endometrial cancer.We searched the Cochrane Central Register of Controlled Trials, MEDLINE and Embase to 16 January 2019; and the World Health Organization's International

Efficacy and safety of first line treatments for patients with advanced epidermal growth factor receptor mutated, non-small cell lung cancer: systematic review and network meta-analysis. To compare the efficacy and safety of first line treatments for patients with advanced epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC).Systematic review and network meta-analysis.PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and several

Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Most patients with small-cell lung cancer (SCLC) have extensive-stage disease at presentation, and prognosis remains poor. Recently, immunotherapy has demonstrated clinical activity in extensive-stage SCLC (ES-SCLC). The CASPIAN trial assessed durvalumab, with or without tremelimumab, in combination

Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a microsimulation modelling study. To estimate benefits and harms of different colorectal cancer screening strategies, stratified by (baseline) 15-year colorectal cancer risk.Microsimulation modelling study using MIcrosimulation SCreening ANalysis-Colon (MISCAN-Colon).A parallel guideline committee (BMJ Rapid Recommendations) defined the time frame and screening interventions, including selection (...) of outcome measures.Norwegian men and women aged 50-79 years with varying 15-year colorectal cancer risk (1-7%).Four screening strategies were compared with no screening: biennial or annual faecal immunochemical test (FIT) or single sigmoidoscopy or colonoscopy at 100% adherence.Colorectal cancer mortality and incidence, burdens, and harms over 15 years of follow-up. The certainty of the evidence was assessed using the GRADE approach.Over 15 years of follow-up, screening individuals aged 50-79 at 3% risk

Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline. Recent 15-year updates of sigmoidoscopy screening trials provide new evidence on the effectiveness of colorectal cancer screening. Prompted by the new evidence, we asked: "Does colorectal cancer screening make an important difference to health outcomes in individuals initiating screening at age 50 to 79? And which screening option is best?"Numerous guidelines recommend (...) screening, but vary on recommended test, age and screening frequency. This guideline looks at the evidence and makes recommendations on screening for four screening options: faecal immunochemical test (FIT) every year, FIT every two years, a single sigmoidoscopy, or a single colonoscopy.These recommendations apply to adults aged 50-79 years with no prior screening, no symptoms of colorectal cancer, and a life expectancy of at least 15 years. For individuals with an estimated 15-year colorectal cancer

Quantitative Image Analysis of HER2 Immunohistochemistry for Breast Cancer CAP Laboratory Improvement Programs Quantitative Image Analysis of Human Epidermal Growth Factor Receptor 2 Immunohistochemistry for Breast Cancer Guideline From the College of American Pathologists Marilyn M. Bui, MD, PhD; Michael W. Riben, MD; Kimberly H. Allison, MD; Elizabeth Chlipala, BS, HTL(ASCP)QIHC; Carol Colasacco, MLIS, SCT(ASCP); Andrea G. Kahn, MD; Christina Lacchetti, MHSc; Anant Madabhushi, PhD; Liron (...) ) immunohistochemistry (IHC) for breast cancer where QIA is used. Design.—The College of American Pathologists (CAP) convened a panel of pathologists, histotechnologists, and computer scientists with expertise in image analysis, immunohistochemistry, quality management, and breast pathology to develop recommendations for QIA of HER2 IHC in breast cancer. A systematic review of the literature was conducted to address 5 key questions. Final recom- mendations were derived from strength of evidence, open comment

Systemic Therapy for Advanced or Recurrent Endometrial Cancer and Advanced or Recurrent Uterine Papillary Serous Carcinoma Evidence-Based Series 4-8 Version 4 A Quality Initiative of the Program in Evidence-based Care (PEBC), Cancer Care Ontario (CCO) Systemic Therapy for Advanced or Recurrent Endometrial Cancer, and Advanced or Recurrent Uterine Papillary Serous Carcinoma Members of the Expert Panel on Endometrial Cancer or Uterine Papillary Serous Carcinoma Guideline 4-8 Version 4 (...) was reviewed in 2019 and ENDORSED by the Expert Panel. See Section 2: Document Assessment and Review for details. EBS 4-8 Version 4 is comprised of 2 sections. You can access the summary and full report here: https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/501 Section 1: Clinical Practice Guideline (ENDORSED) Section 2: Document Assessment and Review July 23, 2019 For information about the PEBC and the most current version of all reports, please visit the CCO website at http

Management of Cancer Medication-Related Infusion Reactions Management of Cancer Medication- Related Infusion Reactions Care has been taken in the preparation of the information contained in this report. Nonetheless, any person seeking to apply or consult the report is expected to use independent medical judgment in the context of individual clinical circumstances or seek out the supervision of a qualified clinician. Cancer Care Ontario makes no representation or guarantees of any kind (...) whatsoever regarding the report content or use or application and disclaims any responsibility for its application or use in any way Management of Cancer Medication-Related Infusion Reactions 2 ACKNOWLEDGEMENTS Working Group Members Dr. Leta Forbes, Medical Oncologist, Provincial Head, Systemic Treatment Program, Cancer Care Ontario, Co-chair Andrea Crespo, Sr. Pharmacist, Systemic Treatment Program, Cancer Care Ontario, Co-chair Daniela Gallo-Hershberg, Pharmacist, Group Manager, Systemic Treatment

Somatic Cancer Panel Reporting in Ontario Sept 2019 Somatic Cancer Panel Reporting in Ontario Introduction As the use of panel testing for molecular oncology expands in Ontario clinical labs, there is an opportunity to develop a standardized approach for the generation of clear, concise reports to reduce variation in report content and format. This standardization will support clinical management decisions by providing clear summaries of genomic findings that can be easily understood by experts (...) and non-experts. This report outlines the recommended components to be included in any somatic cancer panel report, as well as additional items to be considered moving forward to improve / standardize cancer panel reporting across the province. To support this initiative, the Somatic Cancer Panel Reporting Working Group (Working Group) was established. The Working Group was comprised of laboratory geneticists, pathologists with experience in massively parallel sequencing as well as staff from Cancer

Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection Guideline 2-29 Version 3 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection Members of the Gastrointestinal Cancer Disease Site Group Guideline 2-29 was reviewed in 2019 and ENDORSED by the Gastrointestinal Cancer Disease Site Group (See Section 6: Document Assessment (...) and Review for details) Guideline 2-29 Version 3 is comprised of 6 sections. You can access the summary and full report here: https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/231 Section 1: Recommendations Summary (ENDORSED) Section 2: Guideline Section 3: Section 4: Section 5: Section 6: Guideline Methods Overview Evidence Review Internal & External Review Document Assessment and Review September 25, 2019 For information about this document, please contact Dr. Brandon Meyers

Complex surgery and perioperative systemic therapy for genitourinary cancer of the retroperitoneum Guideline 3-20 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Complex surgery and perioperative systemic therapy for genitourinary cancer of the retroperitoneum A. Finelli, N. Coakley, J. Chin, T. Flood, A. Loblaw, C. Morash, R. Shayegan, R. Siemens, and the Genitourinary Cancer Guideline Development Group Report Date: August 8, 2019 For information (...) , et al. Complex surgery and perioperative systemic therapy for genitourinary cancer of the retroperitoneum. Toronto (ON): Cancer Care Ontario; 2019 August 8. Program in Evidence-Based Care Guideline No.: 3-20. Copyright This report is copyrighted by Cancer Care Ontario; the report and the illustrations herein may not be reproduced without the express written permission of Cancer Care Ontario. Cancer Care Ontario reserves the right at any time, and at its sole discretion, to change or revoke

Post-Treatment Follow-up and Active Surveillance of Clinically Localized Renal Cell Cancer. American College of Radiology End User License Agreement ACR Appropriateness Criteria is a registered trademark of the American College of Radiology. By accessing the ACR Appropriateness Criteria®, you expressly agree and consent to the terms and conditions as described at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/TermsandConditions.pdf Personal use of material is permitted for research (...) abdomen and pelvis without and with IV contrast 8 This procedure is equivalent to CT. O CT abdomen and pelvis without and with IV contrast 6 This procedure is particularly appropriate if the patient is postablation or has a hereditary renal cancer syndrome. The noncontrast scan is not needed in the pelvis. ???? CT chest with IV contrast 6 This procedure is particularly appropriate if patients are considered at high risk for metastatic disease. ??? CT chest without IV contrast 5 This procedure

Post-Treatment Surveillance of Bladder Cancer. Date of origin: 1996 Last review date: 2014 ACR Appropriateness Criteria ® 1 Surveillance Imaging of Bladder Cancer American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Post-Treatment Surveillance of Bladder Cancer Variant 1: Superficial TCC; no invasion or risk factors. Radiologic Procedure Rating Comments RRL* CT abdomen and pelvis without and with IV contrast 3 Consider this procedure if metastatic disease (...) with IV contrast 1 ??? CT chest without IV contrast 1 ??? CT chest without and with IV contrast 1 ??? CT abdomen and pelvis with IV contrast 1 ???? CT abdomen and pelvis without IV contrast 1 ???? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Post-Treatment Surveillance of Bladder Cancer Clinical Condition: Post-Treatment Surveillance of Bladder Cancer Variant 2: Superficial TCC; no invasion

Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women. American College of Radiology End User License Agreement ACR Appropriateness Criteria is a registered trademark of the American College of Radiology. By accessing the ACR Appropriateness Criteria®, you expressly agree and consent to the terms and conditions as described at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/TermsandConditions.pdf Personal use of material (...) Cancer American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women Variant 1: Newly diagnosed. Initial workup. Rule out bone metastases. Radiologic Procedure Rating Comments RRL* FDG-PET/CT whole body 2 ???? Tc-99m bone scan whole body 1 ??? X-ray skeletal survey 1 ??? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually

Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Smaller Quantity Opioid Prescribing for Chronic Non-Cancer Pain: Clinical Effectiveness and Guidelines Last updated: June 28, 2019 Project Number (...) : RA1041-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the clinical effectiveness of prescribing opioids in smaller quantities for patients with chronic non-cancer pain? What are the evidence-based guidelines associated with opioid prescribing for patients with chronic non-cancer pain? Key Message One non-randomized study and three evidence-based guidelines were identified regarding short-term prescribing of opioids for patient with chronic non

Digital Tomosynthesis for the Screening and Diagnosis of Breast Cancer: Diagnostic Accuracy, Cost-Effectiveness, and Guidelines Digital Tomosynthesis for the Screening and Diagnosis of Breast Cancer: Diagnostic Accuracy, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Digital Tomosynthesis for the Screening and Diagnosis of Breast Cancer: Diagnostic Accuracy, Cost-Effectiveness, and Guidelines Digital Tomosynthesis for the Screening and Diagnosis of Breast Cancer (...) : Diagnostic Accuracy, Cost-Effectiveness, and Guidelines Last updated: June 11, 2019 Project Number: RB1351-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of 3D digital tomosynthesis with or without 2D mammography compared with 2D mammography alone for breast cancer diagnosis? What is the diagnostic accuracy of 3D digital tomosynthesis with or without 2D mammography compared with 2D mammography alone

Prostate-Specific Antigen Testing for Prostate Cancer: Clinical Utility and Guidelines Prostate-Specific Antigen Testing for Prostate Cancer: Clinical Utility and Guidelines | CADTH.ca Find the information you need Prostate-Specific Antigen Testing for Prostate Cancer: Clinical Utility and Guidelines Prostate-Specific Antigen Testing for Prostate Cancer: Clinical Utility and Guidelines Last updated: August 22, 2019 Project Number: RA1060-000 Product Line: Research Type: Devices and Systems (...) Report Type: Reference List Result type: Report Question What is the clinical utility of prostate-specific antigen testing for prostate cancer? What are the evidence-based guidelines on the use of prostate-specific antigen testing for prostate cancer screening? Key Message Two systematic reviews were identified regarding the clinical utility of prostate-specific antigen testing for prostate cancer. In addition, five evidence-based guidelines were identified regarding the use of prostate-specific

Urinary Dipstick Testing for Bladder Cancer Screening: Diagnostic Accuracy, Clinical Effectiveness and Guidelines Urinary Dipstick Testing for Bladder Cancer Screening: Diagnostic Accuracy, Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Urinary Dipstick Testing for Bladder Cancer Screening: Diagnostic Accuracy, Clinical Effectiveness and Guidelines Urinary Dipstick Testing for Bladder Cancer Screening: Diagnostic Accuracy, Clinical Effectiveness and Guidelines (...) Last updated: April 1, 2019 Project Number: RB1320-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the diagnostic accuracy of urinary dipstick testing for bladder cancer screening in asymptomatic adult patients with microscopic hematuria? What is the clinical effectiveness of urinary dipstick testing for bladder cancer screening in asymptomatic adult patients? What are the evidence-based guidelines regarding the use

Preoperative Seed Placement for Breast Cancer Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Preoperative Seed Placement for Breast Cancer Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Preoperative Seed Placement for Breast Cancer Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Preoperative Seed Placement for Breast Cancer Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines (...) Last updated: April 1, 2019 Project Number: RB1319-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of preoperative seed placement for patients undergoing surgery for breast cancer? What is the cost-effectiveness of preoperative seed placement for patients undergoing surgery for breast cancer? What are the evidence-based guidelines regarding methods of preoperative tumor localization for patient

Occult Blood Detection Testing for Non-Colorectal Cancer Related Medical Conditions: Clinical Effectiveness Occult Blood Detection Testing for Non-Colorectal Cancer Related Medical Conditions: Clinical Effectiveness | CADTH.ca Find the information you need Occult Blood Detection Testing for Non-Colorectal Cancer Related Medical Conditions: Clinical Effectiveness Occult Blood Detection Testing for Non-Colorectal Cancer Related Medical Conditions: Clinical Effectiveness Last updated: April 15 (...) , 2019 Project Number: RA1026-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical effectiveness of the fecal immunochemical test in detecting medical conditions other than colorectal cancer where occult blood detection is needed? What is the clinical effectiveness of the guaiac fecal blood occult test in detecting medical conditions other than colorectal cancer where occult blood detection is needed? Key Message