Abstract
The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) thanks to contribution of 64 ESMO-appointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to provide state-of-the-art cancer care to all patients wherever they live. Recent progress in the field of cancer research has indeed resulted in diagnostic and therapeutic innovations such as targeted therapies as a standard therapeutic approach or personalised cancer medicine apart from the revival of immunotherapy, requiring specialised training for medical oncology trainees. Thus, several new chapters on technical contents such as molecular pathology, translational research or molecular imaging and on conceptual attitudes towards human principles like genetic counselling or survivorship have been integrated in the GC. The GC edition 2016 consists of 12 sections with 17 subsections, 44 chapters and 35 subchapters, respectively. Besides renewal in its contents, the GC underwent a principal formal change taking into consideration modern didactic principles. It is presented in a template-based format that subcategorises the detailed outcome requirements into learning objectives, awareness, knowledge and skills. Consecutive steps will be those of harmonising and implementing teaching and assessment strategies.
Keywords: Global curriculum, clinical training, medical oncology, didactic principles, learning objectives
ESMO/ASCO Global Curriculum Working Group
Chair
Christian Dittrich, MD, Professor of Medicine
Head of 3rd Medical Department—Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
Members
Emilio Alba Conejo, MD
Director of UGCI Oncology Intercentros, Hospital Universitario Virgen de la Victoria y Regional de Malaga, Malaga, Spain
Rossana Berardi, MD, Professor of Medical Oncology
Head of Department of Medical Oncology, Università Politecnica delle Marche, Ospedali Riuniti Ancona, Ancona, Italy
Jonas Bergh, MD, PhD, FRCP (London, UK), Professor of Oncology (Mimi Althainz’ donation)
Director, The Strategic Research Programme in Cancer, Karolinska Institutet and University Hospital, Stockholm, Sweden
Nagi El-Saghir, MD, FACP, Professor of Clinical Medicine
Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
Jacek Jassem, MD, PhD, Professor of Clinical Oncology and Radiotherapy
Head of the Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
Michael Kosty, MD, FACP, FASCO
Director, Scripps Green Cancer Center, Division of Hematology/Oncology, Scripps Clinic, La Jolla, California, USA
Roberto Ivan Lopez, MD
Centro Oncologico Punta Pacifica, Medical Oncology, Panama, Panama
Jean-Pierre Lotz, MD, Professor
Head of the Department of Medical Oncology and Cellular Therapy, Medical Oncology Department, Tenon Assistance Publique—Hôpitaux de Paris, Paris, France
Pia Österlund, MD, PhD, Docent
Department of Oncology, HUCH Helsinki University Central Hospital, Helsinki, Finland and Clinicum, University of Helsinki, Helsinki, Finland
Nicholas Pavlidis, MD, PhD, FRCP Edin(Hon), Professor of Medical Oncology
Head of the Department of Medical Oncology, Ioannina University Hospital, Ioannina, Greece
Gunta Purkalne, MD, Associate Professor
Clinic of Oncology, Pauls Stradins Clinical University Hospital, Riga, Latvia
Editorial Board
Jonas Bergh, MD, PhD, FRCP (London, UK), Professor of Oncology (Mimi Althainz’ donation)
Director, The Strategic Research Programme in Cancer, Karolinska Institutet and University Hospital, Stockholm, Sweden
Hetty Carraway, MD, Associate Professor
Director of Hematology/Oncology Fellowship Program, Physician, Department of Hematology Oncology, Cleveland Clinic, Cleveland, Ohio, USA
Julia Lee Close, MD, FACP, Assistant Professor
UF Department of Medicine Division of Hematology/Oncology; Director, UF Hematology/Oncology Fellowship Program; Assistant Chief, Medical Service, Malcom Randall VA Medical Center, Gainesville, Florida, USA
Christian Dittrich, MD, Professor of Medicine
Head of 3rd Medical Department—Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
Jill Gilbert, MD, Associate Professor of Medicine
Vanderbilt University School of Medicine, Nashville, Tennessee, USA
Michael Kosty, MD, FACP, FASCO
Director, Scripps Green Cancer Center, Division of Hematology/Oncology, Scripps Clinic, La Jolla, California, USA
Gunta Purkalne, MD, Associate Professor
Clinic of Oncology, Pauls Stradins Clinical University Hospital, Riga, Latvia
Ex Officio:
Svetlana Jezdic, MD, MSc
Staff Medical Oncologist, Medical Affairs, European Society for Medical Oncology (ESMO), Lugano, Switzerland
Doug Pyle, MBA
Vice President, International Affairs, American Society of Clinical Oncology (ASCO), Alexandria, Virginia, USA
Review Board
Carsten Bokemeyer, MD, PhD, Professor of Medicine
Director of the Department, Oncology, Hematology and BMT with Section Pneumology, University Medical Centre, Universitaetsklinik Hamburg, Hamburg, Germany
Andrés Cervantes, MD, PhD, Professor of Medicine
Head of Department, Medical Oncology Department, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
Julia Lee Close, MD, FACP, Assistant Professor
UF Department of Medicine Division of Hematology/Oncology; Director, UF Hematology/Oncology Fellowship Program; Assistant Chief, Medical Service, Malcom Randall VA Medical Center, Gainesville, Florida, USA
Christian Dittrich, MD, Professor of Medicine
Head of 3rd Medical Department—Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
Nagi El-Saghir, MD, FACP, Professor of Clinical Medicine
Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
Jill Gilbert, MD, Associate Professor of Medicine
Vanderbilt University School of Medicine, Nashville, Tennessee, USA
Michael Kosty, MD, FACP, FASCO
Director, Scripps Green Cancer Center, Division of Hematology/Oncology, Scripps Clinic, La Jolla, California, USA
Yuichiro Ohe, MD, PhD
Deputy Director of the Hospital, Chief, Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
Miklos Pless, MD, Professor
Head of Medical Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
1. INTRODUCTION | 6 |
2. STANDARD REQUIREMENTS FOR TRAINING IN MEDICAL ONCOLOGY | 7 |
3. SPECIAL REQUIREMENTS | 7 |
3.1 Programme Leader/Director of Medical Oncology Training Programme | 7 |
3.2. Faculty | 8 |
3.2.1 Faculty members | 8 |
3.2.2 Faculty standards | 8 |
3.3 Educational Programme | 8 |
3.3.1 Educational environment | 8 |
3.3.2 Professionalism | 8 |
3.3.3 Responsibility | 8 |
3.3.4 Update of skills and knowledge | 8 |
3.3.5 Perception of other specialties | 8 |
3.3.6 Institutional requirements | 8 |
3.3.6.a Clinical setting | 8 |
3.3.6.b Hospital facilities | 8 |
3.3.7 Facilities | 9 |
4. COMPETENCIES REQUIRED IN THE CURRICULUM | 9 |
4.1 Basic Scientific Principles | 9 |
4.1.1 Cancer biology | 9 |
4.1.2 Tumour immunology | 10 |
4.1.3 Aetiology, epidemiology, screening and prevention | 11 |
4.1.4 Clinical research | 12 |
4.1.5 Statistics | 13 |
4.2 Basic Principles in the Management and Treatment of Malignant Diseases | 14 |
4.2.1 Pathology | 14 |
4.2.2 Molecular pathology | 15 |
4.2.3 Laboratory medicine | 17 |
4.2.4 Translational research | 18 |
4.2.5 Principles of personalised cancer medicine | 19 |
4.2.6 Staging procedures (clinical staging) | 20 |
4.2.7 Imaging | 21 |
4.2.8 Molecular imaging | 22 |
4.2.9 RECIST | 22 |
4.3 Therapy | 23 |
4.3.1 Surgical oncology | 23 |
4.3.2 Radiation oncology | 24 |
4.3.3 Anticancer agents | 25 |
4.3.4 Biological therapy | 26 |
4.3.5 Immunotherapy | 27 |
4.3.6 Complications/Toxicities of treatment | 28 |
4.4 Supportive and Palliative Care | 29 |
4.4.1 Supportive measures | 29 |
4.4.2 Palliative care | 33 |
4.4.3 End-of-life care | 34 |
4.5 Management and Treatment of Specific Cancers | 35 |
4.5.1 Head and neck cancers | 37 |
4.5.2 Thoracic malignancies | 38 |
4.5.2.a Small-cell lung cancer | 38 |
4.5.2.b Non-small-cell lung cancer | 39 |
4.5.2.c Mesothelioma | 40 |
4.5.2.d Thymoma and thymic cancer | 40 |
4.5.3 Gastrointestinal cancers | 41 |
4.5.3.a Oesophageal cancer | 41 |
4.5.3.b Gastric cancer | 42 |
4.5.3.c Colon and rectal cancer | 44 |
4.5.3.d Anal cancer | 45 |
4.5.3.e Hepatobiliary cancers | 46 |
4.5.3.f Pancreatic adenocarcinoma | 47 |
4.5.4 Genitourinary cancers | 48 |
4.5.4.a Renal cell cancer | 48 |
4.5.4.b Urothelial cancer | 49 |
4.5.4.c Penile cancer | 51 |
4.5.4.d Prostate cancer | 52 |
4.5.4.e Germ cell tumours | 53 |
4.5.5 Gynaecological malignancies | 55 |
4.5.5.a Ovarian cancer (including Fallopian tube and primary peritoneal cancer) | 55 |
4.5.5.b Endometrial cancer | 56 |
4.5.5.c Cervical cancer | 57 |
4.5.5.d Vulvar and vaginal cancers | 58 |
4.5.5.e Gestational trophoblastic neoplasia | 59 |
4.5.6 Breast cancer | 59 |
4.5.7 Sarcomas | 61 |
4.5.7.a Bone sarcomas | 61 |
4.5.7.b Soft tissue sarcomas | 62 |
4.5.7.c Gastrointestinal stromal tumour | 63 |
4.5.8 Skin cancers | 63 |
4.5.8.a Melanoma | 63 |
4.5.8.b Basal cell and squamous cell cancers of the skin | 65 |
4.5.9 Endocrine tumours | 66 |
4.5.9.a Thyroid cancer | 66 |
4.5.9.b Neuroendocrine neoplasms | 66 |
4.5.10 Central nervous system malignancies | 67 |
4.5.11 Carcinoma of unknown primary site | 69 |
4.5.12 Haematological malignancies | 70 |
4.5.12.a Leukaemias (including acute and chronic leukaemias of lymphoid and myeloid lineage) | 70 |
4.5.12.b Lymphomas | 71 |
4.5.12.b.1 Hodgkin's lymphoma | 71 |
4.5.12.b.2 Non-Hodgkin's lymphoma | 72 |
4.5.12.c Plasma cell dyscrasias | 73 |
4.5.12.d Myeloproliferative neoplasms | 74 |
4.6 Rare Cancers | 75 |
4.7 AIDS-Associated Malignancies | 76 |
4.8 Special Issues in the Diagnosis and Treatment of Cancers in Adolescents | 77 |
4.9 Special Issues in the Diagnosis and Treatment of Cancers in Young Adults | 78 |
4.10 Cancer and Pregnancy | 79 |
4.11 Geriatric Oncology | 80 |
4.12 Cancer Treatment in Patients with Comorbidities | 81 |
5. PSYCHOSOCIAL ASPECTS OF CANCER | 82 |
6. COMMUNICATION | 84 |
7. GENETIC COUNSELLING | 85 |
8. PATIENT EDUCATION | 85 |
9. SURVIVORSHIP | 86 |
10. BIOETHICAL, LEGAL AND ECONOMIC ISSUES | 88 |
10.1 Bioethical and Legal Issues | 88 |
10.2 Economic Issues of New Cancer Drugs | 89 |
11. CANCER CARE DELIVERY IN LOW RESOURCE ENVIRONMENTS | 90 |
12. SKILLS | 90 |
1 INTRODUCTION
Christian Dittrich
Michael Kosty
With the increasing internationalisation of healthcare as well as the increased exchange of specialists and knowledge across borders, the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) identified more than a decade ago the need for a set of international recommendations for the clinical training of physicians to qualify them as medical oncologist. Patients, wherever they live, should have an equal chance of receiving state-of-the-art treatment from well-trained physicians.
In 2004, a joint ESMO/ASCO Task Force produced the first outline for a Global Core Curriculum (GCC) for training in medical oncology. This outline was subsequently distributed to universities as well as medical oncology societies and was simultaneously published in the Annals of Oncology and the Journal of Clinical Oncology.1 2 The Global Curriculum (GC) Task Force also produced a Log Book as a support tool for medical oncologists in training and their supervisors with the purpose of keeping a record of oncology trainees’ educational programmes and their progress.3 4
Interest in using the GCC outline has increased considerably since its inception, as evidenced by translations in different languages available on the ESMO and ASCO websites.5 6 It is also used as a model for the development of the specialty of medical oncology in several countries around the world. The GCC was updated in 2010.7 8 The corresponding Log Book was updated in 2016 by the Global Curriculum Working Group (GC WG) which evolved from the GC Task Force.9 10
In 2011, the European Commission based its formal recognition of medical oncology as a medical specialty on the recommendations of the ESMO/ASCO GC.11
The Curriculum 2010 covered a broad range of recommendations to be adopted by national educational and health authorities and to be implemented according to the resources and conditions of their countries. Furthermore, it was perceived that the diversity of health and educational systems around the world may have rendered some curriculum recommendations aspirational at the stage of its implementation, even for those systems with well-developed training programmes in medical oncology. Reflecting this aspirational nature of the recommendations, the former GC Task Force had changed the updated Curriculum title from ‘Global Core Curriculum’ to ‘Global Curriculum’.
An analysis of the ESMO GC European Landscape data still identified a high degree of heterogeneity, mainly at the organisational level as well as in the duration and structure of the internal medicine part of the training in medical oncology in Europe.12 This heterogeneity relates to whether or not medical oncology is recognised as separate specialty in each country and to the degree of adoption, adaptation and applicability of the GC recommendations by the different countries in Europe. Despite the unequivocal progress towards the establishment of medical oncology and the harmonisation of its implementation in Europe and beyond, this effort has to be pursued further.
Important advances in medical oncology have been achieved in recent years, notably in the integration of molecular pathology and molecular profiling to determine the presence of biomarkers as a rationale for the appropriate selection of new therapies. The unequivocal demands of personalised medicine and of completely different developments like the constantly increasing survivorship community—to mention two examples of the changes in oncology over the last few years—have let us to prepare a new edition of the GC.
With regard to content, multiple changes and innovations have been taken into account in the GC 2016, such as:
targeted therapies are integrated into the (sub)chapters of the separate tumour entities wherever suitable;
immunotherapy is presented in a new separate chapter to reflect its actual impact;
biological therapy and immunotherapy are now presented in separate chapters;
pathology, molecular pathology, laboratory medicine, translational research and principles of personalised cancer medicine have been transformed into separate chapters due to their importance, accepting therewith even some unavoidable overlap;
tumour immunology has been separated into ‘tumour immunology’ which was kept under ‘basic scientific principles’, and into ‘immunotherapy’ which was shifted as separate chapter to the subsection ‘therapy’;
imaging and molecular imaging have been separated into two chapters and are followed by the additional chapter on ‘RECIST’;
rare cancers have been established as a novel subsection;
cancer treatment in patients with comorbidities is treated in a new subsection;
genetic counselling is given increased attention due to its emerging role in the clinical routine as a separate section;
survivorship with its tremendously increasing impact is presented in a separate section.
There exist general attitudes or conceptions, respectively, which are of importance for several or all tumour entities; therefore, separate (sub)sections have been dedicated to them:
integration of palliative or supportive care measures;
consideration of psychosocial aspects;
consideration of adequate communication;
provision of bioethical, legal or economic issues.
In addition to the integration of novel contents, it seemed necessary to change the format of the GC 2016 according to actually acknowledged pedagogical principles. Therefore, a template-based framework is used that subcategorises the quality of the outcome requirements of detailed learning objectives into awareness, knowledge and skills, where appropriate. As far as applicable, the more general teaching items are also presented in this new format.
References provided in the GC 2016 can be used for the training and the individual information, but the trainees should feel stimulated not only to restrict their learning process to these citations but also to use other sources such as guidelines or e-learning tools offered by the two carrier societies and by other authorities.
Although the GC 2016 is very comprehensive, it does not claim to be a textbook. Moreover, it is the intention of the GC to represent a meticulously structured collection of requirements to be fulfilled in order to qualify as medical oncologist. A corresponding Log Book for the documentation of the assessment of the learning progress according to the GC 2016 will follow.
References
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. Ann Oncol 2004;15:1603–12.
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. J Clin Oncol 2004;22:4616–25.
ESMO/ASCO Global Core Curriculum for training in medical oncology, Log Book, 2008. https://www.esmo.org/content/download/8176/168808/file/The-ESMO-ASCO-Global-Core-Curriculum-for-Training-in-Medical-Oncology-Log-Book.pdf
ESMO/ASCO Global Core Curriculum for training in medical oncology, Log Book, 2008. http://www.asco.org/sites/new-www.asco.org/files/content-files/international-programs/documents/2008-ESMO-ASCO-Log-Book-pdf.pdf
ESMO/ASCO recommendations for a Global Curriculum in medical oncology. http://www.esmo.org/Career-Development/Global-Curriculum-in-Medical-Oncology
ESMO/ASCO recommendations for a Global Curriculum in medical oncology. http://www.asco.org/international-programs/global-curriculum
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 Update. https://www.esmo.org/content/download/8171/168764/file/ESMO-ASCO-Revised-Recommendations-for-a-Global-Curriculum-in-Medical-Oncology.pdf
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 Update. http://www.asco.org/sites/default/files/esmo-asco_revised_recommendations.pdf
ESMO/ASCO Global Curriculum for training in medical oncology, Log Book, second edition, 2016. http://www.esmo.org/content/download/81967/1487517/file/The-ESMO-ASCO-Global-Curriculum-for-Training-in-Medical-Oncology-Log-Book-2016.pdf
ESMO/ASCO Global Curriculum for training in medical oncology, Log Book, second edition, 2016. https://www.asco.org/sites/new-www.asco.org/files/content-files/international-programs/documents/2016-ESMO-ASCO-Log-Book-interactive.pdf
The European Parliament and the Council of the European Union. Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications (text with EEA relevance). OJ 2005;L255:22–142.
Pavlidis N, Alba E, Berardi R, et al. The ESMO/ASCO Global Curriculum and the evolution of medical oncology training in Europe. ESMO Open 2015;1. doi: 10.1136/esmoopen-2015-000004.
2 STANDARD REQUIREMENTS FOR TRAINING IN MEDICAL ONCOLOGY
Michael Kosty
on behalf of the ESMO/ASCO GC Working Group
The standard requirement is for a total training period of at least 5 years, beginning with training in internal medicine for 2–3 years, followed by a training programme in medical oncology for a minimum of 2–3 years.
The training programme in medical oncology must include full-time clinical training in the diagnosis and management of a broad spectrum of neoplastic diseases comprising solid tumours and haematological malignancies. Trainees should have access to a wide variety of general and specialty consultative support, including general surgery and surgical subspecialties, internal medicine and its subspecialties, as well as pathology, laboratory medicine, diagnostic and therapeutic radiology, psychiatry, neurology, physiotherapy and nutrition.
Full-time clinical training means that the trainee's professional time and effort during a standard working week is dedicated to clinical activities (patient care or education). These may include the primary care of patients with cancer, supervision of patients with cancer on the general medical service or in designated medical oncology inpatient units, oncological consultations and consultation rounds, oncology ambulatory and day unit care, scheduled clinical conferences, performance of procedures on patients, review of imaging, pathology and other diagnostic materials, other direct patient care, attending national and international scientific meetings and reading relevant literature. There should be multidisciplinary tumour conferences held on a regular basis, and trainees should be active participants in these conferences.
Clinical activities may also include research involving patient contact, care and treatment. Research activities of a maximum of 6 months may be counted for the total training period of at least 5 years. Research experience of longer duration, including international training, is strongly recommended, especially for oncologists who want to pursue an academic career.
References
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. Ann Oncol 2004;15:1603–12.
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. J Clin Oncol 2004;22: 4616–25.
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. https://www.esmo.org/content/download/8171/168764/file/ESMO-ASCO-Revised-Recommendations-for-a-Global-Curriculum-in-Medical-Oncology.pdf
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. http://www.asco.org/sites/default/files/esmo-asco_revised_recommendations.pdf
3 SPECIAL REQUIREMENTS
Nagi El-Saghir
Jean-Pierre Lotz
on behalf of the ESMO/ASCO GC Working Group
3.1 Programme Leader/Director of Medical Oncology Training Programme
The Medical Oncology Programme Leader (or Director of Medical Oncology Training Programme) must be qualified to supervise and educate trainees in medical oncology. Thus, the leader must be certified in medical oncology or possess equivalent qualifications. The leader will have a major commitment to the training programme and related activities, and must be based at the primary training site of the medical oncology programme.
The trainee will maintain a record of his/her training. The programme leader will countersign it, as appropriate, to confirm the satisfactory fulfilment of the required training experience and the acquisition of the competencies that are gained in the specialty curriculum. The record will remain the property of the trainee and must be signed at the annual reviews by the responsible programme leader/director of medical oncology training programme.
3.2 Faculty
3.2.1 Faculty members
The medical oncology programme faculty must include a minimum of three full-time, qualified teaching faculty members, including the programme leader. All the faculty members must be certified in medical oncology or possess equivalent qualifications and each of them must devote substantial time (at least 10 hours per week) to clinical rounds, teaching and research, with the trainees as well as to the critical evaluation of the performance, progress and competence of the trainees.
3.2.2 Faculty standards
The teaching staff must demonstrate an interest in teaching, and set an example for trainees by documented engagement in the following pursuits: actively sharing the personal experience of working in a medical oncology clinical practice and multidisciplinary team; continuing his/her own medical education; active membership in regional, national and international scientific societies; ideally active participation in research and presentation and publication of scientific studies.
3.3 Educational Programme
The educational programme in medical oncology must be organised to provide training and experience at a level high enough for the trainee to acquire the competency of a specialist in the field. The programme must emphasise scholarship, self-instruction, development of critical analysis of clinical problems and the ability to make appropriate decisions, in addition to active involvement in regularly scheduled conferences and multidisciplinary clinics and/or tumour boards. Appropriate supervision of the trainees must be provided for the duration of their educational experience. The programme should foster all aspects of the roles required of an oncologist, including being an effective communicator with patients, a collaborator in the treatment team, a manager of the healthcare system, a health advocate not just for the patient but for the community and a scholar with lifelong commitment and high professional ethics and standards.
The following principles require special emphasis:
3.3.1 Educational environment
Medical oncology training programmes must provide an intellectual environment for acquisition of the knowledge, skills, clinical judgement and attitudes essential to the practice of medical oncology in the context of multidisciplinary care. This objective can only be achieved when appropriate resources and facilities are available. Service commitments must not compromise the achievement of educational goals and objectives.
3.3.2 Professionalism
Professionalism must be fostered during medical oncology training. In addition to mastering the comprehensive clinical and technical skills of the consultant medical oncologist, trainees are encouraged to participate in the educational activities of professional organisations, community programmes and institutional committees.
3.3.3 Responsibility
Lines of responsibility must be clearly delineated for the trainees in medical oncology.
3.3.4 Update of skills and knowledge
Having obtained certification in medical oncology, the specialist is expected to update the acquired skills and knowledge by participating in Continuing Medical Education programmes such as courses, symposia or self-learning processes on a regular basis.
3.3.5 Perception of other specialties
It is also essential to have the support of oncology nursing, pharmacy, emergency medicine, intensive care, rehabilitation medicine, palliative care medicine, and dietetic and psychosocial services so that the trainee can perceive the role of other specialties in the total care of the patient with cancer.
3.3.6 Institutional requirements
3.3.6.a Clinical setting
The clinical setting must include opportunities to observe and manage patients with a wide variety of neoplastic diseases on an inpatient and outpatient basis. The trainee must be given the opportunity to assume the continuing responsibility for acute and chronically ill patients in order to learn the natural history of cancer, the extent of the effectiveness of the various therapeutic programmes and how to impart information to the patient, including bad news. The scenario should include everything from prevention, treatment, to the long-term follow-up of patients with cancer.
3.3.6.b Hospital facilities
Modern inpatient, ambulatory care and laboratory facilities necessary for the overall educational programme must be available and functioning. Specifically, at the primary site, there must be adequate pathology services, modern diagnostic radiology services, resources for nuclear medicine imaging, blood banking and blood therapy facilities and facilities for clinical pharmacology and tumour immunology/biology. A general surgical service and its support must be available, in addition to access to radiation therapy. The programme must also include a set-up for multidisciplinary tumour conferences, and preferably participation in clinical trials according to guidelines on good clinical practice (GCP).
3.3.7 Facilities
It is the responsibility of the teaching institute to oversee that these facilities are available before a graduate medical education programme is initiated.
References
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. Ann Oncol 2004;15:1603–12.
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. J Clin Oncol 2004;22:4616–25.
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. https://www.esmo.org/content/download/8171/168764/file/ESMO-ASCO-Revised-Recommendations-for-a-Global-Curriculum-in-Medical-Oncology.pdf
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. http://www.asco.org/sites/default/files/esmo-asco_revised_recommendations.pdf
4 COMPETENCIES REQUIRED IN THE CURRICULUM
Julia Lee Close
Michael Kosty
Jill Gilbert
The following curriculum should be considered as the educational framework for the training of physicians in medical oncology. The current version represents an expansion of each topic to now include more specific details on curricular content. Each topic is divided into four areas: Objectives, Awareness, Knowledge and Skills. The ‘Objectives’ section provides an overview of the scope of knowledge a trainee is expected to master in the topic. ‘Awareness’ defines components integral to the topic. ‘Knowledge’ provides a listing of concepts necessary to practice. ‘Skills’ provides the activities included in practicing oncology in the specific area covered.
4.1 Basic scientific principles
Ahmad Awada
As a foundation for managing and treating malignant disease, the trainee should learn and understand the following:
The hallmarks of cancer including the complexity of cancer cell biology and the interaction with the tumour microenvironment (immune system, etc);
The management and treatment of malignant diseases (by organ and/or by biological subtypes);
Specific systemic anticancer therapies (cytotoxics/cytostatics, (anti)hormones, biological agents (interferon, IL-2), targeted agents (small molecules) and immunotherapeutics (monoclonal antibodies));
Supportive measures in relation to all kinds of systemic anticancer therapies;
Palliative measures including end-of-life care;
How to properly conduct and participate in translational and clinical research.
It should be noted that the management and treatment of malignant diseases are continuously evolving fields, in view of the advances in molecular biology and imaging techniques. In addition, a multidisciplinary approach to malignant diseases is the basis for optimal quality of patient care.
4.1.1 Cancer biology
Yosef Yarden
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Alberts B, Johnson A, Lewis J, et al. Molecular biology of the cell. 6th edn. New York: Garland Science, 2015:1465 pp.
DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. 10th edn. Alphen aan den Rijn, the Netherlands: Wolters Kluwer, 2014.
Gelmann EP, Sawyers CL, Rauscher FJ III, eds. Molecular oncology: causes of cancer and targets for treatment. Cambridge: Cambridge University Press, 2014:961 pp.
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell 2011;144:646–74.
Weinberg RA. The biology of cancer. 2nd edn. New York: Garland Science, 2013:960 pp.
Cancer browser that includes mainly TCGA datasets and information, such as copy number variations, mutations and DNA methylation. https://genome-cancer.ucsc.edu/ or http://www.cbioportal.org/data_sets.jsp
Genome browser that includes gene annotations, epigenetic marks, transcription factor binding sites, conservation of genomic regions and also the useful link to ‘Phenotype and Literature’. http://genome-euro.ucsc.edu/cgi-bin/hgGateway
UCSC Genome Bioinformatics browser website containing reference sequences and working draft assemblies for a large collection of genomes. http://genome-euro.ucsc.edu/index.html
4.1.2 Tumour immunology
Priya K Gopalan
Dennie V Jones Jr
Ulrich Keilholz
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Abbas AK, Lichtman AH. Basic immunology: functions and disorders of the immune system. 3rd edn. Philadelphia, PA: Saunders Elsevier, 2008.
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell 2011;144:646–74.
Rosenberg SA, Robbins PF, Restifo NP. Cancer immunotherapy. In: DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. Cancer: principles & practice of oncology. 9th edn. Philadelphia, PA: Lippincott, Williams & Wilkins, 2011:332–44.
4.1.3 Aetiology, epidemiology, screening and prevention
Jennifer Duff
Eva Schernhammer
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Adami HO, Hunter D, Trichopoulos D, eds. Textbook of cancer epidemiology. 2nd edn. New York, NY: Oxford University Press, 2008.
Loprinzi CL, Appelbaum FR, Hensley ML, et al. eds. ASCO-SEP. 4th edn. Alexandria, VA: American Society of Clinical Oncology, 2015.
Schottenfeld D, Fraumeni JF, eds. Cancer epidemiology and prevention. 3rd edn. New York, NY: Oxford University Press, 2006.
4.1.4 Clinical research
Emile Voest
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. the 10th edition. Alphen aan den Rijn, the Netherlands: Wolters Kluwer, 2014.
4.1.5 Statistics
Jan Bogaerts
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Armitage P, Berry G, Matthews JNS. Statistical methods in medical research. 4th edn. Chichester: Wiley-Blackwell, 2001.
Breslow NE, Day NE, eds. Statistical methods in cancer research, Volume I–IV. Lyon CEDEX 08: IARC Publications.
Kelley WK, Halabi S, Schilsky R, eds. Oncology clinical trials: successful design, conduct and analysis. 1st edn. New York: Demos Medical Publishing, 2010.
4.2 Basic Principles in the Management and Treatment of Malignant Diseases
Hans-Joachim Schmoll
The management of malignant diseases requires the expertise of many different medical subspecialties, and the majority of patients with malignant diseases are best managed in a multidisciplinary approach with the integration of the various subspecialties because of the increasing complexity of modern treatment. The trainee should recognise the contributions of each of these subspecialties in making the diagnosis, assessing disease stage and treating the underlying disease and its complications, as well as those derived from its treatment. The trainee should interact with each of these disciplines in order to gain an appreciation of the benefits and limitations of each modality. Participation of the trainee in multidisciplinary meetings is encouraged. The trainee should be capable of assessing the patient’s comorbid medical conditions that may affect the toxicity and efficacy of treatment, in order to formulate a treatment plan and be aware of the special conditions that influence the treatment of the growing population of elderly patients with malignant disorders.
Reference
El Saghir NS, Keating NL, Carlson RW, et al. Tumor boards: optimizing the structure and improving efficiency of multidisciplinary management of patients with cancer worldwide. Am Soc Clin Oncol Educ Book 2014:e461–6. doi:10.14694/EdBook_AM.2014.34.e461
4.2.1 Pathology
Julie Steele
Sarah Coupland
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Hammond MEH, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. Arch Pathol Lab Med 2010;134:907–22.
Kumar V, Abbas AK, Fuaso N, et al. eds. Robbins and cotran pathologic basis of disease. 9th edn. Philadelphia: Elsevier Saunders, 2015.
Lester SC. Manual of surgical pathology. 3rd edn. Philadelphia: Elsevier Saunders, 2010.
Lindeman NI, Cagle PT, Beasley MB, et al. Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors guideline from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology. Arch Pathol Lab Med 2013;137:828–60.
WHO classification of tumours series. Lyon: WHO Press. http://whobluebooks.iarc.fr/
Wolff AC, Hammond ME, Hicks DG, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. Arch Pathol Lab Med 2014;138:241–56.
4.2.2 Molecular pathology
Roberto Salgado
Torsten Nielsen
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Laudadio J, McNeal JL, Boyd SD, et al. Design of a genomics curriculum: competencies for practicing pathologists. Arch Pathol Lab Med 2015;139:894–900.
Manolio TA, Chisholm RL, Ozenberger B, et al. Implementing genomic medicine in the clinic: the future is here. Genet Med 2013;15:258–67.
Manolio TA, Murray MF, Inter-Society Coordinating Committee for Practitioner Education in Genomics. The growing role of professional societies in educating clinicians in genomics. Genet Med 2014;16:571–2.
Robson ME, Bradbury AR, Arun B, et al. American Society of Clinical Oncology policy statement update: genetic and genomic testing for cancer susceptibility. J Clin Oncol 2015;33:3660–7.
Yu PP, Hoffman MA, Hayes DF. Biomarkers and oncology: the path forward to a learning health system. Arch Pathol Lab Med 2015;139:451–6.
4.2.3 Laboratory medicine
Thomas Lion
Krisztian Homicsko
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bhasker CR, Hardiman G. Advances in pharmacogenomics technologies. Pharmacogenomics 2010;11:481–5.
Bremnes RM, Sirera R, Camps C. Circulating tumour-derived DNA and RNA markers in blood: a tool for early detection, diagnostics, and follow-up? Lung Cancer 2005;49:1–12.
Cuenca AG, Jiang H, Hochwald SN, et al. Emerging implications of nanotechnology on cancer diagnostics and therapeutics. Cancer 2006;107:459–66.
Durmaz AA, Karaca E, Demkow U, et al. Evolution of genetic techniques: past, present, and beyond. Biomed Res Int 2015;2015:461524.
Grodzinski P, Silver M, Molnar LK. Nanotechnology for cancer diagnostics: promises and challenges. Expert Rev Mol Diagn 2006;6:307–18.
Iorio MV, Croce CM. MicroRNA dysregulation in cancer: diagnostics, monitoring and therapeutics. A comprehensive review. EMBO Mol Med 2012;4:143–59.
Kalia M. Personalized oncology: recent advances and future challenges. Metabolism 2013;62(Suppl 1):S11–14.
Kumar S, Mohan A, Guleria R. Biomarkers in cancer screening, research and detection: present and future: a review. Biomarkers 2006;11:385–405.
Luthra R, Chen H, Roy-Chowdhuri S, et al. Next-generation sequencing in clinical molecular diagnostics of cancer: advantages and challenges. Cancers (Basel) 2015;7:2023–36.
Tahara H, Sato M, Thurin M, et al. Emerging concepts in biomarker discovery; the US-Japan workshop on immunological molecular markers in oncology. J Transl Med 2009;7:45.
Tainsky MA, Chatterjee M, Levin NK, et al. Multianalyte tests for the early detection of cancer: speedbumps and barriers. Biomark Insights 2007;2:261–7.
Vockley JG, Niederhuber JE. Diagnosis and treatment of cancer using genomics. BMJ 2015;350:h1832.
Xue H, Lu B, Lai M. The cancer secretome: a reservoir of biomarkers. J Transl Med 2008;6:52.
4.2.4 Translational research
Krisztian Homicsko
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Cancer biology
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell 2011;144:646–74.
Hanahan D, Coussens LM. Accessories to the crime: functions of cells recruited to the tumour microenvironment. Cancer Cell 2012;21:309–22.
Tuveson D, Hanahan D. Translational medicine: cancer lessons from mice to humans. Nature 2011;471:316–17.
Weinberg RA. The biology of cancer. Oxon: Garland Science, 2013.
Molecular assays
eMICE: electronic Models Information, Communication, and Education. http://emice.nci.nih.gov/
Ignatiadis M, Lee M, Jeffrey SS. Circulating tumor cells and circulating tumor DNA: challenges and opportunities on the path to clinical utility. Clin Cancer Res 2015;21:4786–800.
Journal of Biological Sciences: Molecular Biology. http://www.protocol-online.org/prot/Molecular_Biology/index.html
Molecular biology techniques. https://en.wikipedia.org/wiki/Category:Molecular_biology_techniques
Sander JS, Joung JK. CRISPR-Cas systems for editing, regulating and targeting genomes. Nat Biotechnol 2014;32:347–55.
Science Education. Science Education Database. http://www.jove.com/science-education-database/2/basic-methods-in-cellular-and-molecular-biology
Biological sample collection
Hansson MG. Ethics and biobanks. Br J Cancer 2009;100:8–12.
Hewitt RE. Biobanking: the foundation of personalized medicine. Curr Opin Oncol 2011;23:112–19.
Shevde LA, Riker AI. Current concepts in biobanking: development and implementation of a tissue repository. Front Biosci (Schol Ed) 2009;1:188–93.
Zika E, Schulte In den Bäumen T, Kaye J, et al. Sample, data use and protection in biobanking in Europe: legal issues. Pharmacogenomics 2008;9:773–81.
Biomarkers
Altman DG, McShane LM, Sauerbrei W, et al. Reporting Recommendations for Tumor Marker Prognostic Studies (REMARK): explanation and elaboration. PLoS Med 2012;9:e1001216.
Buyse M, Sargent DJ, Grothey A, et al. Biomarkers and surrogate end points—the challenge of statistical validation. Nature Rev Clin Oncol 2010;7:309–17.
Pesch B, Brüning T, Johnen G, et al. Biomarker research with prospective study designs for the early detection of cancer. Biochim Biophys Acta 2014;1844:874–83.
Subramanian J, Simon R. What should physicians look for in evaluating prognostic gene-expression signatures? Nature Rev Clin Oncol 2010;7:327–34.
Data analysis and public databases
Transitioning results of translational research to clinical practice
Andre F, Mardis E, Salm M, et al. Prioritizing targets for precision cancer medicine. Ann Oncol 2014;25:2295–303.
Le Tourneau C, Lee JJ, Siu LL. Dose escalation methods in phase I cancer clinical trials. J Natl Cancer Inst 2009;101:708–20.
Sleijfer S, Bogaerts J, Siu LL. Designing transformative clinical trials in the cancer genome era. J Clin Oncol 2013;31:1834–41.
4.2.5 Principles of personalised cancer medicine
Luigi De Petris
Jonas Bergh
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Biankin AV, Piantadosi S, Hollingsworth SJ. Patient-centric trials for therapeutic development in precision oncology. Nature 2015;526:361–70.
Jonsson B, Bergh J. Hurdles in anticancer drug development from a regulatory perspective. Nat Rev Clin Oncol 2012;9:236–43.
McDermott U. Next-generation sequencing and empowering personalised cancer medicine. Drug Discov Today 2015;20: 1470–5.
Tobin NP, Foukakis T, De Petris L, et al. The importance of molecular markers for diagnosis and selection of targeted treatments in patients with cancer. J Intern Med 2015;278:545–70.
4.2.6 Staging procedures (clinical staging)
Yuichiro Ohe
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
Sobin LH, Gospodarowicz MK, Wittekind C, eds. UICC TNM classification of malignant tumours. 7th edn. Chichester: Wiley, 2009.
4.2.7 Imaging
Marius Mayerhoefer
Christian Herold
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Berrington de González A, Mahesh M, Kim KP, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med 2009;169:2071–7.
Cheson BD. Staging and response assessment in lymphomas: the new Lugano classification. Chin Clin Oncol 2015;4:5.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228–47.
Kanal E, Froelich J, Barkovich AJ, et al. American College of Radiology Subcommittee on MR Safety. Standardized MR terminology and reporting of implants and devices as recommended by the American College of Radiology Subcommittee on MR Safety. Radiology 2015;274:866–70.
Mercado CL. BI-RADS update. Radiol Clin North Am 2014;52:481–7.
Thomsen HS, Morcos SK, Almén T, et al. ESUR Contrast Medium Safety Committee. Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 2013;23:307–18.
Tirkes T, Hollar MA, Tann M, et al. Response criteria in oncologic imaging: review of traditional and new criteria. Radiographics 2013;33:1323–41.
Weinreb JC, Barentsz JO, Choyke PL, et al. PI-RADS prostate imaging—reporting and data system: 2015, version 2. Eur Urol 2015. pii:S0302-2838(15)00848-9.
4.2.8 Molecular imaging
Elisabeth G E de Vries
Andor W J M Glaudemans
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Boellaard R, Delgado-Bolton R, Oyen WJ, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015;42:328–54.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228–47.
Koopmans KP, Neels ON, Kema IP, et al. Molecular imaging in neuroendocrine tumors: molecular uptake mechanisms and clinical results. Crit Rev Oncol Hematol 2009;71:199–213.
Meignan M, Gallamini A, Haioun C, et al. Report on 2th International Workshop on interim positron emission tomogrpahy in lymphoma held in Menton, France, 8–9 April 2010. Leuk Lymphoma 2010;51:2171–80.
Meignan M, Barrington S, Itti E, et al. Report on the 4th International Workshop on Positron Emission Tomography in Lymphoma held in Menton, France, 3–5 October 2012. Leuk Lymphoma 2014;55:31–7.
Van Kruchten M, de Vries EG, Brown M, et al. PET imaging of oestrogen receptors in patients with breast cancer. Lancet Oncol 2013;14:465–75.
4.2.9 RECIST
Saskia Litière
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
Eisenhauer EA, Therasse P, Bogaerts J, New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228–47.
4.3 Therapy
Pia Österlund
Gunta Purkalne
on behalf of the ESMO/ASCO GC Working Group
Medical oncology includes a wide variety of treatment modalities. The key to cure or efficient palliation is often a combination of treatment modalities, and thus basic knowledge of chemotherapy, hormonal therapy, immunotherapy, targeted drugs and other systemic treatments is essential, but not enough. Surgery, radiotherapy and radioisotopes are additional substantial parts of the medical oncologist's toolbox to be considered. Knowledge of the opportunities and limitations of the different treatment modalities is of utmost importance in multidisciplinary team work. Supportive/palliative care modalities, such as nutritional therapy, physiotherapy, psychosocial support etc, facilitate the use of these therapeutic options, and basic knowledge of these measures is mandatory.
4.3.1 Surgical oncology
Piotr Rutkowski
Chandrajit Raut
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
European Society of Surgical Oncology Core Curriculum, 2010. http://www.essoweb.org/eursso/education/core-curriculum.html
Michelassi F. 2010 SSO presidential address: subspecialty certificate in advanced surgical oncology. Ann Surg Oncol 2010;17:3094–103.
4.3.2 Radiation oncology
Marcel Verheij
Stephen M Hahn
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ASTRO Guidelines. https://www.astro.org/clinical-practice/guidelines/index.aspx
Gunderson LL, Tepper JE. Clinical radiation oncology. 4th edn. New York: Elsevier, 2016.
Joiner M, Van der Kogel A. Basic clinical radiobiology. 5th edn. New York: CRC Press, 2014.
4.3.3 Anticancer agents
Edward Chu
Cristiana Sessa
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Chabner BA. Chemotherapy of neoplastic diseases. In: Brunton LL, Chabner BA, Knollman BC, eds. Goodman and Gilman's the pharmacological basis of therapeutics. 12th edn. New York: McGraw Medical, 2015.
Chu E, Sartorelli AC. Cancer chemotherapy. In: Katzung BG, Trevor AJ, eds. Basic and clinical pharmacology. 13th edn. New York: McGraw Medical, 2015.
Chu E, DeVita VT. Physicians’ cancer chemotherapy drug manual 2016. 16th edn. Jones and Bartlett Learning, 2016.
Perry MC. Perry's the chemotherapy source book. 5th edn. Philadelphia: Lippincott Williams & Wilkins, 2012.
Sessa C, Gianni L, Garassino M, et al. ESMO handbook of clinical pharmacology of anticancer agents. Viganello-Lugano: ESMO Press, 2012.
Tortora G, Sessa C, Scarpa A, Banerjee S. ESMO handbook of translational research. Viganello-Lugano: ESMO Press, 2014.
4.3.4 Biological therapy
Roisin Connolly
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Avendaño C, Menéndez JC. Biological therapy of cancer. In: Medicinal chemistry of anticancer Drugs. 2nd edn. New York: Elsevier, 2015.
Awada G, Kourie HR, Awada AH. Novel mechanisms and approaches in the medical therapy of solid cancers. Discov Med 2015;20:33–41.
Dietel M, Jöhrens K, Laffert MV, et al. A 2015 update on predictive molecular pathology and its role in targeted cancer therapy: a review focussing on clinical relevance. Cancer Gene Ther 2015;22:417–30.
Huang M, Shen A, Ding J, et al. Molecularly targeted cancer therapy: some lessons from the past decade. Trends Pharmacol Sci 2014;35:41–50.
Liu S, Kurzrock R. Toxicity of targeted therapy: implications for response and impact of genetic polymorphisms. Cancer Treat Rev 2014;40:883–91.
Tobin NP, Foukakis T, De Petris L, et al. The importance of molecular markers for diagnosis and selection of targeted treatments in patients with cancer. J Intern Med 2015. doi: 10.1111/joim.12429.
Widakowich C, de Castro G Jr, de Azambuja E, et al. Review: side effects of approved molecular targeted therapies in solid cancers. Oncologist 2007;12:1443–55.
4.3.5 Immunotherapy
Jeffrey S Weber
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Chen DS, Mellman I. Oncology meets immunology: the cancer-immunity cycle. Immunity 2013;39:1–10.
Ribas A. Adaptive immune resistance: how cancer protects from immune attack. Cancer Discov 2015;5:915–19.
Topalian SL, Drake CG, Pardoll DM. Immune checkpoint blockade: a common denominator approach to cancer therapy. Cancer Cell 2015;27:450–61.
4.3.6 Complications/Toxicities of treatment
Ben Markman
Josep Tabernero
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
American Society of Clinical Oncology (ASCO). Clinical practice guidelines: supportive care and treatment-related issues. http://jco.ascopubs.org/site/misc/specialarticles.xhtml
Bragalone DL. Drug information handbook for oncology. 13th edn. Hudson, OH: Lexi-Comp, 2015.
Dy GK, Adjei AA. Understanding, recognising, and managing toxicities of targeted anticancer therapies. CA Cancer J Clin 2013;63:249–79.
European Society of Medical Oncology (ESMO). Clinical practice guidelines: supportive care. http://www.esmo.org/Guidelines/Supportive-Care
Gangadhar TC, Vonderheide RH. Mitigating the toxic effects of anticancer immunotherapy. Nat Rev Clin Oncol 2014;11:91–9.
Naidoo J, Page DB, Li BT, et al. Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies. Ann Oncol 2015;26:2375–91.
National Comprehensive Cancer Network (NCCN). Guidelines for supportive care. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp
4.4 Supportive and palliative care
4.4.1 Supportive measures
Timothy Moynihan
Jørn Herrstedt
Objectives |
|
Awareness |
|
Knowledge | Haematological disease-related complications and toxicity |
Infections and neutropenia
| |
Anaemia and thrombocytopenia
| |
Thrombosis/Thromboembolism
| |
Lymphoedema
| |
Cardiovascular disease-related complications and toxicity | |
Cardiac toxicity
| |
Pericardial effusion (see Respiratory disease-related complications and toxicity) | |
Superior/inferior vena cava syndrome
| |
Respiratory disease-related complications and toxicity | |
Pulmonary toxicity
| |
Malignant effusions
| |
Gastrointestinal disease-related complications and toxicity | |
Nausea and vomiting
| |
Oral
| |
Liver
| |
Constipation
| |
Diarrhoea
| |
Ascites (see Respiratory disease-related complications and toxicity) | |
Fistula
| |
Nutritional support
| |
Urological disease-related complications and toxicity
| |
Gynaecological disease-related complications and toxicity
| |
Neurological disease-related complications and toxicity | |
Central nervous system symptoms
| |
Peripheral neuropathy
| |
Eye symptoms and toxicity
| |
Reproductive disease-related complications and toxicity | |
Hormonal effects
| |
Fertility preservation
| |
Sexuality
| |
Skin disease-related complications and toxicity | |
| |
Extravasation
| |
Alopecia
| |
Endocrine and metabolic disease-related complications and toxicity
| |
Bone disease-related complications and toxicity
| |
Supportive care in the special subpopulation of geriatric patients
| |
Oncological emergencies
| |
Paraneoplastic syndromes
| |
Education (see section 8. Patient education) | |
Fatigue (see chapter 4.4.2 Palliative care) | |
Psychosocial aspects (see section 5. Psychosocial aspects of cancer) | |
Pain (see chapter 4.4.2 Palliative care) | |
Skills |
|
References
ESMO clinical practice guidelines: supportive care. http://www.esmo.org/Guidelines/Supportive-Care
Lewis MA, Hendrickson AW, Moynihan TJ. Oncologic emergencies: pathophysiology, presentation, diagnosis, and treatment. CA Cancer J Clin 2011;61:287–314.
Olver I, ed. The MASCC textbook of cancer supportive care and survivorship. New York: Springer, 2011.
4.4.2 Palliative care
Timothy Moynihan
Florian Strasser
Jamie Von Roenn
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bruera E, Higginson I, von Gunten CF, et al. eds. Textbook of palliative medicine and supportive care. 2nd edn. New York: CRC Press, 2015.
Cherny N, Fallon M, Kaasa S, eds. Oxford textbook of palliative medicine. 5th edn. Oxford: Oxford University Press, 2015.
EPEC-O Self-Study. http://www.cancer.gov/resources-for/hp/education/epeco
Distelhorst SR, Cleary JF, Ganz PA, et al. Breast Health Global Initiative Global Summit on Supportive Care and Quality of Life Consensus Panel Members. Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014. Lancet Oncol 2015;16:e137–47.
Kloke M, Cherny N, ESMO Guidelines Committee. Treatment of dyspnoea in advanced cancer patients: ESMO clinical practice guidelines. Ann Oncol 2015;26(Suppl 5):v169–73.
NCCN Guidelines for Palliative Care. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive
Schrijvers D, Cherny NI, ESMO Guidelines Working Group. ESMO clinical practice guidelines on palliative care: advanced care planning. Ann Oncol 2014;25(Suppl 3):iii138–42.
Walsh TD. Palliative medicine: expert consult: online and print. 1st edn. Philadelphia: Saunders, 2011.
4.4.3 End-of-life care
Timothy Moynihan
Florian Strasser
Jamie Von Roenn
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bruera E, Higginson I, von Gunten CF, et al. eds. Textbook of palliative medicine and supportive care. 2nd edn. New York: CRC Press, 2015.
Cherny N, Fallon M, Kaasa S, eds. Oxford textbook of palliative medicine. 5th edn. Oxford: Oxford University Press, 2015.
EPEC-O Self-Study. http://www.cancer.gov/resources-for/hp/education/epeco
Kloke M, Cherny N, ESMO Guidelines Committee. Treatment of dyspnoea in advanced cancer patients: ESMO clinical practice guidelines. Ann Oncol 2015;26(Suppl 5):v169–73.
NCCN Guidelines for Palliative Care. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive
Schrijvers D, Cherny NI, ESMO Guidelines Working Group. ESMO clinical practice guidelines on palliative care: advanced care planning. Ann Oncol 2014;25(Suppl 3):iii138–42.
Walsh TD. Palliative medicine: expert consult: online and print. 1st edn. Philadelphia: Saunders, 2011.
4.5 Management and treatment of specific cancers
Rossana Berardi
Having understood the general principles of treatment, the trainee should be instructed in the care of specific cancer types and the unique considerations for each malignant disease.
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Ajzen I. Action control: From cognitions to behaviors. In: Kuhl J, Beckman J, eds. From intentions to action: a theory of planned behavior. New York: Springer, 1985:11–39.
Cave J, Woolf K, Dacre J, et al. Medical student teaching in the UK: how well are newly qualified doctors prepared for their role caring for patients with cancer in hospital? Br J Cancer 2007;97:472–78.
Cheung WY, Fishman PN, Verma S. Oncology education in Canadian undergraduate and postgraduate training programs. J Cancer Educ 2009;24:284–90.
Del Giudice ME, Grunfeld E, Harvey BJ, et al. Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol 2009;27:3338–45.
Egnew TR, Wilson J. Role modeling the doctor–patient relationship in the clinical curriculum. Fam Med 2011;43:99–105.
Francis JJ, O’Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci 2012;7:35.
Geller AC, Prout MN, Miller DR, et al. Evaluation of a cancer prevention and detection curriculum for medical students. Prev Med 2002;35:78–86.
Jochemsen-van der Leeuw HGAR, van Dijk N, de Jong W, et al. Educating the clinical trainer: professional gain for the trainee? A controlled intervention study in general practice. Perspect Med Educ 2014;3:455–73.
Michie S, Johnston M, Francis J, et al. From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol 2008;57:660–80.
Robèrt KH, Einhorn J, Kornhuber B, et al. European undergraduate education in oncology: a report of the EORTC Education Branch. Acta Oncol 1988;27:423–5.
World Health Organization. WHO patient safety: curriculum guide for medical schools. UK: World Health Organization, 2009.
4.5.1 Head and neck cancers
Lisa Licitra
Everett Vokes
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ESMO clinical practice guidelines: head and neck cancers. http://www.esmo.org/Guidelines/Head-and-Neck-Cancers
DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. 10th edn. Alphen aan den Rijn, the Netherlands: Wolters Kluwer, 2014.
NCCN Clinical Practice Guidelines in Oncology. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp
4.5.2 Thoracic malignancies
4.5.2.a Small-cell lung cancer
Saad Khan
Enriqueta Felip
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ESMO clinical practice guidelines: lung and chest tumours. http://www.esmo.org/Guidelines/Lung-and-Chest-Tumours
NCCN. http://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf
4.5.2.b Non-small-cell lung cancer
Saad Khan
Enriqueta Felip
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ESMO clinical practice guidelines: lung and chest tumours. http://www.esmo.org/Guidelines/Lung-and-Chest-Tumours
NCCN. http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf
4.5.2.c Mesothelioma
Saad Khan
Enriqueta Felip
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ESMO clinical practice guidelines: lung and chest tumours. http://www.esmo.org/Guidelines/Lung-and-Chest-Tumours
NCCN. http://www.nccn.org/professionals/physician_gls/pdf/mpm.pdf
4.5.2.d Thymoma and thymic cancer
Nicolas Girard
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
Girard N, Ruffini E, Marx A, et al. ESMO Guidelines Committee. Thymic epithelial tumours: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;26(Suppl 5):v40–55.
4.5.3 Gastrointestinal cancers
4.5.3.a Oesophageal cancer
Axel Grothey
Claus-Henning Köhne
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.3.b Gastric cancer
Axel Grothey
Claus-Henning Köhne
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.3.c Colon and rectal cancer
Claus-Henning Köhne
Axel Grothey
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.3.d Anal cancer
Axel Grothey
Claus-Henning Köhne
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.3.e Hepatobiliary cancers
Axel Grothey
Claus-Henning Köhne
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.3.f Pancreatic adenocarcinoma
Axel Grothey
Claus-Henning Köhne
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: gastrointestinal cancers. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers
4.5.4 Genitourinary cancers
4.5.4.a Renal cell cancer
Cora N Sternberg
Maria De Santis
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Choueiri TK, Escudier B, Powles T, et al. METEOR Investigators. Cabozantinib versus everolimus in advanced renal-cell carcinoma. N Engl J Med 2015;373:1814–23.
ESMO clinical practice guidelines: genitourinary cancers. http://www.esmo.org/Guidelines/Genitourinary-Cancers
Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 2007;356:115–24.
Motzer RJ, Hutson TE, Cella D, et al. Pazopanib versus sunitinib in metastatic renal cell carcinoma. N Engl J Med 2013;369:722–31.
Motzer RJ, Escudier B, McDermott DF, et al. CheckMate 025 Investigators. Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med 2015;373:1803–13.
Patard JJ, Pignot G, Escudier B, et al. ICUD-EAU International Consultation on Kidney Cancer 2010: treatment of metastatic disease. Eur Urol 2011;60:684–90.
Sternberg CN, Davis ID, Mardiak J, et al. Pazopanib in locally advanced and/or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol 2010;28:1061–8.
4.5.4.b Urothelial cancer
Maria De Santis
Cora N Sternberg
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol 2005;48:202–5.
Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Adjuvant chemotherapy for invasive bladder cancer (individual patient data), 2006. Cochrane Database Syst Rev 2006;(2):CD006018.
Bajorin DF, Dodd PM, Mazumdar M, et al. Long-term survival in metastatic transitional-cell carcinoma and prognostic factors predicting outcome of therapy. J Clin Oncol 1999;17:3173–81.
Bellmunt J, Theodore C, Demkov T, et al. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract. J Clin Oncol 2009;27:4454–61.
Bellmunt J, von der Maase H, Mead GM, et al. Randomized phase III study comparing paclitaxel/cisplatin/gemcitabine and gemcitabine/cisplatin in patients with locally advanced or metastatic urothelial cancer without prior systemic therapy: EORTC Intergroup Study 30987. J Clin Oncol 2012;30:1107–13.
Bellmunt J, Fougeray R, Rosenberg JE, et al. Long-term survival results of a randomized phase III trial of vinflunine plus best supportive care versus best supportive care alone in advanced urothelial carcinoma patients after failure of platinum-based chemotherapy. Ann Oncol 2013;24:1466–72.
Calabro F, Lorusso V, Rosati G, et al. Gemcitabine and paclitaxel every 2 weeks in patients with previously untreated urothelial carcinoma. Cancer 2009;115:2652–9.
Cancer Genome Atlas Research Network. Comprehensive molecular characterization of urothelial bladder carcinoma. Nature 2014;507:315–22.
De Santis M, Bellmunt J, Mead G, et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer “unfit” for cisplatin based chemotherapy: phase II–results of EORTC study 30986. J Clin Oncol 2009;27:5634–9.
De Santis M, Bellmunt J, Mead G, et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J Clin Oncol 2012;30:191–9.
Galsky MD, Hahn NM, Rosenberg T, et al. A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol 2011;12:211–14.
Galsky MD, Hahn NM, Rosenberg T, et al. Treatment of patients with metastatic urothelial cancer “unfit” for cisplatin-based chemotherapy. J Clin Oncol 2011;29:2432–8.
Galsky MD, Chen GJ, Oh WK, et al. Comparative effectiveness of cisplatin-based and carboplatin-based chemotherapy for treatment of advanced urothelial carcinoma. Ann Oncol 2012;23:406–10.
Griffiths G, Hall R, Sylvester R, et al. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol 2011;29:2171–7.
Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859–66.
Hussain SA, Stocken DD, Riley P, et al. A phase I/II study of gemcitabine and fractionated cisplatin in an outpatient setting using a 21-day schedule in patients with advanced and metastatic bladder cancer. Br J Cancer 2004;91:844–9.
Morales-Barrera R, Bellmunt J, Suarez C, et al. Cisplatin and gemcitabine administered every two weeks in patients with locally advanced or metastatic urothelial carcinoma and impaired renal function. Eur J Cancer 2012;48:1816–21.
Powles T, Eder JP, Fine GD, et al. MPDL3280A (anti-PD-L1) treatment leads to clinical activity in metastatic bladder cancer. Nature 2014;515:558–62.
Sternberg CN, de Mulder PH, Schornagel JH, et al. Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European Organization for Research and Treatment of Cancer Protocol no. 30924. J Clin Oncol 2001;19:2638–46.
Sternberg CN, Skoneczna I, Kerst JM, et al. for the European Organisation for Research and Treatment of Cancer Genito-Urinary Cancers Group; Groupe d'Etude des Tumeurs Urogénitales; National Cancer Research Institute Bladder Cancer Study Group; National Cancer Institute of Canada Clinical Trials Group; German Association of Urologic Oncology (AUO). Immediate versus deferred chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (EORTC 30994): an intergroup, open-label, randomised phase 3 trial. Lancet Oncol 2015;16:76–86.
von der Maase H, Hansen SW, Roberts JT, et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 2000;18:3068–77.
von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Cin Oncol 2005;23:4602–8.
4.5.4.c Penile cancer
Cora N Sternberg
Maria De Santis
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bermejo C, Busby JE, Spiess PE, et al. Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 2007;177:1335–8.
Crook J, Jezioranski J, Cygler JE. Penile brachytherapy: technical aspects and post implant issues. Brachytherapy 2010;9:151–8.
Crook JM, Haie-Meder C, Demanes DJ, et al. American Brachytherapy Society-Groupe Europeén de Curiethérapie-European Society of Therapeutic Radiation Oncology (ABS-GEC-ESTRO) consensus statement for penile brachytherapy. Brachytherapy 2013;12:191–8.
de Crevoisier R, Slimane K, Sanfilippo N, et al. Long-term results of brachytherapy for carcinoma of the penis confined to the glans (N- or NX). Int J Radiat Oncol Biol Phys 2009;74:1150–6.
Di Lorenzo G, Federico P, Buonerba C, et al. Paclitaxel in pretreated metastatic penile cancer; final results of a phase 2 study. Eur Urol 2011;60:1280–4.
Di Lorenzo G, Buonerba C, Federico P, et al. Cisplatin and 5-fluorouracil in inoperable, stage IV squamous cell carcinoma of the penis. BJU Int 2012;110:E661–6.
Graafland NM, Lam W, Leijte JA, et al. Prognostic factors for occult inguinal lymph node involvement in penile carcinoma and assessment of the high-risk EAU subgroup: a two-institution analysis of 342 clinically node-negative patients. Eur Urol 2010;58:742–7.
Graafland NM, MoonenLM, van Boven HH, et al. Inguinal recurrence following therapeutic lymphadenectomy for node positive penile carcinoma: outcome and implications for management. J Urol 2011;185:888–93.
Graafland NM, Teertstra HJ, Besnard AP, et al. Identification of high risk pathologicalpathologic node positive penile carcinoma: value of preoperative computerized tomography imaging. J Urol 2011;185:881–7.
Horenblas S. Lymphadenectomy in penile cancer. Urol Clin North Am 2011;38:459–69, vi–vii.
Kiltie AE, Elwell C, Close HJ, et al. Iridium-192 implantation for node-negative carcinoma of the penis: the Cookridge Hospital experience. Clin Oncol (R Coll Radiol) 2000;12:25–31.
Leijte JA, Kerst JM, Bais E, et al. Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 2007;52:488–94.
Leijte JA, Kroon BK, Valdés Olmos RA, et al. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 2007;52:170–7.
Ozsahin M, Jichlinski P, Weber DC, et al. Treatment of penile carcinoma: to cut or not to cut? Int J Radiat Oncol Biol Phys 2006;66:674–9.
Pagliaro LC, Williams DL, Daliani D, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 2010;28:3851–7.
Pettaway CA, Pagliaro L, Theodore C, et al. Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer. Urology 2010;76(Suppl 1):S58–65.
Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol 2009;55:546–51.
Rozan R, Albuisson E, Giraud B, et al. Interstitial brachytherapy for penile carcinoma: a multicentric survey (259 patients). Radiother Oncol 1995;36:83–93.
Sadeghi R, Gholami H, Zakavi SR, et al. Accuracy of sentinel lymph node biopsy for inguinal lymph node staging of penile squamous cell carcinoma: systematic review and meta-analysis of the literature. J Urol 2012;187:25–31.
Schlenker B, Tilki D, Seitz M, et al. Organ-preserving neodymium-yttrium aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up. BJU Int 2010;106:786–90.
Sobin L, Gospodarowics M, Wittekind C. TNM classi fication of malignant tumors. UICC International Union against cancer. 7th edn. West Sussex, UK: Willy Blackwell, 2009:239–42.
4.5.4.d Prostate cancer
Cora N Sternberg
Maria De Santis
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Beer TM, Armstrong AJ, Rathkopf DE, et al. PREVAIL Investigators. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med 2014;371:424–33.
de Bono JS, Logothetis CJ, Molina A, et al. COU-AA-301 Investigators. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med 2011;364:1995–2005.
Gillessen S, Omlin A, Attard G, et al. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol 2015;26:1589–604.
Mateo J, Carreira S, Sandhu S, et al. DNA-repair defects and olaparib in metastatic prostate cancer. N Engl J Med 2015;373:1697–708.
Parker C, Nilsson S, Heinrich D, et al. ALSYMPCA Investigators. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013;369:213–23.
Robinson D, Van Allen EM, Wu YM, et al. Integrative clinical genomics of advanced prostate cancer. Cell 2015;161:1215–28.
Ryan CJ, Smith MR, Fizazi K, et al. COU-AA-302 Investigators. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2015;16: 152–60.
Scher HI, Fizazi K, Saad F, et al. AFFIRM Investigators. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med 2012;367:1187–97.
Sternberg CN, Castellano D, Daugaard G, et al. Abiraterone Global EAP Investigators. Abiraterone acetate for patients with metastatic castration-resistant prostate cancer progressing after chemotherapy: final analysis of a multicentre, open-label, early-access protocol trial. Lancet Oncol 2014;15:1263–8.
Sternberg CN, Petrylak DP, Madan RA, et al. Progress in the treatment of advanced prostate cancer. Am Soc Clin Oncol Educ Book 2014:117–31.
4.5.4.e Germ cell tumours
Maria De Santis
Cora N Sternberg
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Beyer J, Albers P, Altena R, et al. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Oncol 2013;24:878–88.
Ehrlich Y, Brames MJ, Beck SD, et al. Long-term follow-up of cisplatin combination chemotherapy in patients with disseminated non seminomatous germ cell tumors: is a postchemotherapy retroperitoneal lymph node dissection needed after complete remission? J Clin Oncol 2010;28:531–6.
Feldman DR, Bosl GJ, Sheinfeld J, et al. Medical treatment of advanced testicular cancer. JAMA 2008;299:672–84.
Fizazi K, Oldenburg J, Dunant A, et al. Assessing prognosis and optimizing treatment in patients with postchemotherapy viable non seminomatous germ-cell tumors (NSGCT): results of the sCR2 international study. Ann Oncol 2008;19: 259–64.
Heidenreich A, Pfister D. Retroperitoneal lymphadenectomy and resection for testicular cancer: an update on best practice. Ther Adv Urol 2012;4:187–205.
International Germ Cell Cancer Collaborative Group. International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997;15: 594–603.
Lorch A, Bascoul-Mollevi C, Kramar A, et al. Conventional-dose versus high-dose chemotherapy as first salvage treatment in male patients with metastatic germ cell tumors: evidence from a large international database. J Clin Oncol 2011;29:2178–84.
Oldenburg J, Alfsen GC, Waehre H, et al. Late recurrences of germ cell malignancies: a population-based experience over three decades. Br J Cancer 2006;94:820–7.
Oldenburg J, Martin JM, Fossa SD. Late relapses of germ cell malignancies: incidence, management, and prognosis. J Clin Oncol 2006;24:5503–11.
Oliver RT, Mason MD, Mead GM, et al. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomized trial. Lancet 2005;366:293–300.
Tandstad T, Dahl O, Cohn-Cedermark G, et al. Risk-adapted treatment in clinical stage I non seminomatous germ cell testicular cancer: the SWENOTECA management program. J Clin Oncol 2009;27:2122–8.
Tandstad T, Smaaland R, Solberg A, et al. Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish Norwegian testicular cancer study group. J Clin Oncol 2011;29:719–25.
4.5.5 Gynaecological malignancies
4.5.5.a Ovarian cancer (including fallopian tube and primary peritoneal cancer)
Susana Banerjee
Linda R Duska
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Banerjee S, Kaye SB. New strategies in the treatment of ovarian cancer: current clinical perspectives and future potential. Clin Cancer Res 2013;19:961–8.
Ledermann JA, Raja FA, Fotopoulou C, et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(Suppl 6):vi24–32.
Morice P, Denschlag D, Rodolakis A, et al. Recommendations of the Fertility Task Force of the European Society of Gynecologic Oncology about the conservative management of ovarian malignant tumors. Int J Gynecol Cancer 2011;21:951–63.
Ray-Coquard I, Brown J, Harter P, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian sex cord stromal tumors. Int J Gynecol Cancer 2014;24(Suppl 3): S42–7.
4.5.5.b Endometrial cancer
Susana Banerjee
Linda R Duska
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Colombo N, Preti E, Landoni F, et al. Endometrial cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(Suppl 6):vi33–8.
Colombo N, Creutzberg C, Amant F, et al. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Ann Oncol 2016;27:16–41.
Meyer LA, Bohlke K, Powell MA, et al. Postoperative radiation therapy for endometrial cancer: American Society of Clinical Oncology clinical practice guideline endorsement of the American Society for Radiation Oncology evidence-based guideline. J Clin Oncol 2015;33:2908–13.
Morice P, Leary A, Creutzberg C, et al. Endometrial cancer. Lancet 2015. pii: S0140-6736(15)00130-0.
Rodolakis A, Biliatis I, Morice P, et al. European Society of Gynecological Oncology Task Force for fertility preservation: clinical recommendations for fertility-sparing management in young endometrial cancer patients. Int J Gynecol Cancer 2015;25:1258–65.
4.5.5.c Cervical cancer
Linda R Duska
Susana Banerjee
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Brotherton JM, Ogilvie GS. Current status of human papillomavirus vaccination. Curr Opin Oncol 2015;27:399–404.
Columbo N, Carinelli S, Colombo A, et al. ESMO Guidelines Working Group. Cervical cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012;23(Suppl 7):vii27–32.
Petignat P, Roy M. Diagnosis and management of cervical cancer. BMJ 2007;335:765–8.
Pfaendler KS, Tewari KS. Changing paradigms in the systemic treatment of advanced cervical cancer. Am J Obstet Gynecol 2016;214:22–30.
Sonoda Y. Fertility preservation in patients with cervical cancer. Oncology (Williston Park) 2015;29:525–6.
4.5.5.d Vulvar and vaginal cancers
Linda R Duska
Susana Banerjee
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Janco JM, Markovic SN, Weaver AL, et al. Vulvar and vaginal melanoma: case series and review of current management options including neoadjuvant chemotherapy. Gynecol Oncol 2013;129:533–7.
Lilic V, Lilic G, Filipovic S, et al. Primary carcinoma of the vagina. J BUON 2010;15:241–7.
Woelber L, Trillsch F, Kock L, et al. Management of patients with vulvar cancer: a perspective review according to tumour stage. Ther Adv Med Oncol 2013;5:183–92.
4.5.5.e Gestational trophoblastic neoplasia
Linda R Duska
Susana Banerjee
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol 2010;203:531–9.
Lurain JR. Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol 2011;204:11–18.
Seck MJ, Sebire NJ, Fisher RA, et al, on behalf of the ESMO Guidelines Working Group. Gestational trophoblastic disease: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(Suppl 6):vi39–v150.
4.5.6 Breast cancer
Fatima Cardoso
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Amant F, Deckers S, Van Calsteren K, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer 2010;46:3158–68.
Anderson BO, Cazap E, El Saghir NS, et al. Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus. Lancet Oncol 2011;12:387–98.
Cardoso F, Bedard PL, Winer EP, et al. ESO-MBC Task Force. International guidelines for management of metastatic breast cancer: combination vs sequential single-agent chemotherapy. J Natl Cancer Inst 2009;101:1174–81.
Cardoso F, Costa A, Norton L, et al. 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012;21:242–52.
Cardoso F, Costa A, Norton L, et al. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Ann Oncol 2014;25:1871–88.
Coates AS, Winer EP, Goldhirsch A, et al. Tailoring therapies—improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol 2015;26:1533–46.
Distelhorst SR, Cleary JF, Ganz PA, et al. Breast Health Global Initiative Global Summit on Supportive Care and Quality of Life Consensus Panel Members. Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014. Lancet Oncol 2015;16:e137–47.
Giordano SH, Temin S, Kirshner JJ, et al. Systemic therapy for patients with advanced human epidermal growth factor receptor 2-positive breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2014;32:2078–99.
Khatcheressian JL, Wolff AC, Smith TJ, et al. American Society of Clinical Oncology 2006 Update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 2006;24:5091–7.
Khatcheressian JL, Hurley P, Bantug E, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013;31:961–5.
Korde LA, Zujewski JA, Kamin L, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol 2010;28:2114–22.
Lin NU, Thomssen C, Cardoso F, et al. European School of Oncology-Metastatic Breast Cancer Task Force. International guidelines for management of metastatic breast cancer (MBC) from the European School of Oncology (ESO)-MBC Task Force: surveillance, staging, and evaluation of patients with early-stage and metastatic breast cancer. Breast 2013;22:203–10.
Lyman GH, Temin S, Edge SB, et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2014;32:1365–83.
Pagani O, Senkus E, Wood W, et al. ESO-MBC Task Force. International guidelines for management of metastatic breast cancer: can metastatic breast cancer be cured? J Natl Cancer Inst 2010;102:456–63.
Partridge AH, Pagani O, Abulkhair O, et al. First international consensus guidelines for breast cancer in young women (BCY1). Breast 2014;23:209–20.
Partridge AH, Rumble RB, Carey LA, et al. Chemotherapy and targeted therapy for women with human epidermal growth factor receptor 2-negative (or unknown) advanced breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2014;32:3307–29.
Ramakrishna N, Temin S, Chandarlapaty S, et al. Recommendations on disease management for patients with advanced human epidermal growth factor receptor 2-positive breast cancer and brain metastases: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2014;32:2100–8.
Senkus E, Kyriakides S, Ohno S, et al. ESMO Guidelines Committee. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;26(Suppl 5):v8–30.
Tryfonidis K, Senkus E, Cardoso MJ, et al. Management of locally advanced breast cancer-perspectives and future directions. Nat Rev Clin Oncol 2015;12:147–62.
Van Poznak C, Somerfield MR, Bast RC, et al. Use of biomarkers to guide decisions on systemic therapy for women with metastatic breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2015;33:2695–704.
Wolff AC, Hammond MEH, Hicks DG, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol 2013;31:3997–4013; Arch Pathol Lab Med 2014;138:241–56.
4.5.7 Sarcomas
4.5.7.a Bone sarcomas
Paolo Casali
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: sarcoma and GIST. http://www.esmo.org/Guidelines/Sarcoma-and-GIST
4.5.7.b Soft tissue sarcomas
Paolo Casali
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: sarcoma and GIST. http://www.esmo.org/Guidelines/Sarcoma-and-GIST
4.5.7.c Gastrointestinal stromal tumour
Paolo Casali
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
ESMO clinical practice guidelines: sarcoma and GIST. http://www.esmo.org/Guidelines/Sarcoma-and-GIST
4.5.8 Skin cancers
4.5.8.a Melanoma
Marc Ernstoff
Olivier Michielin
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Balch CM, Gershenwald JE, Soong SJ, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009;27:6199–206.
Barnhill RL, Piepkorn MW, Busam KJ. Pathology of melanocytic Nevi and melanoma. 3rd edn. Heidelberg: Springer, 2014.
Ernstoff MS. Molecular basis for treating cutaneous melanoma. In: Mendelson J, Gray JW, Howley PM, et al. eds. The molecular basis of cancer. Philadelphia: Elsevier Saunders, 2015.
Gyorki DE, Callahan M, Wolchok JD, et al. The delicate balance of melanoma immunotherapy. Clin Trans Immunol 2013;2:e5. doi:10.1038/cti.2013.5
NCCN guidelines for treatment of cancer by site (melanoma). http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#melanoma
Sondak VK, Wong SL, Gershenwald JE, et al. Evidence-based clinical practice guidelines on the use of sentinel lymph node biopsy in melanoma. Am Soc Clin Oncol Educ Book 2013. doi: 10.1200/EdBook_AM.2013.33.e320
4.5.8.b Basal cell and squamous cell cancers of the skin
Rainer Kunstfeld
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Behavioral counseling to prevent skin cancer—systematic evidence review to update the 2003 U.S. Preventive Services Task Force Recommendation. http://www.ncbi.nlm.nih.gov/books/NBK53508/
Genetics of Skin Cancer (PDQ®)—Health Professional Version. http://www.ncbi.nlm.nih.gov/books/NBK65895/
Guidelines of the British Association of Dermatologists (BAD). http://www.bad.org.uk/healthcare-professionals/clinical-standards/clinical-guidelines?sitesectionid=678&group=00016001000200020001&range=BAD%20guidelines&l=0
Guidelines of the European Dermatology Forum (EDF). http://www.euroderm.org/edf/index.php/edf-guidelines/category/5-guidelines-miscellaneous
Guidelines of the US National Comprehensive Cancer Network (NCCN). http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site
Skin Cancer Screening (PDQ®)—Health Professional Version. http://www.ncbi.nlm.nih.gov/books/NBK65861/
Skin Cancer Treatment (PDQ®)—Health Professional Version. http://www.ncbi.nlm.nih.gov/books/NBK65928/
4.5.9 Endocrine tumours
4.5.9.a Thyroid cancer
Martin Schlumberger
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26:1–133.
Wells SA Jr, Asa SL, Dralle H, et al. American Thyroid Association Guidelines Task Force on medullary thyroid carcinoma. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015;25:567–610.
4.5.9.b Neuroendocrine neoplasms
Kjell Öberg
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bosman FT, Carneiro F, Hruban RH, et al. eds. WHO classification of tumours of the digestive system. 4th edn. Lyon CEDEX 08: IARC Press, 2010.
Caplin ME, Pavel M, Cwikla JB, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med 2014;371:224–33.
Kwekkeboom DJ, de Herder WW, Krenning EP. Somatostatin receptor-targeted radionuclide therapy in patients with gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 2011;40:173–85, ix.
Oberg K, Knigge U, Kwekkeboom D, et al. Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012;23(Suppl 7):vii124–30.
Raymond E, Dahan L, Raoul JL, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med 2011;364:501–13.
Rindi G, Kloppel G, Alhman H, et al. TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2006;449:395–401.
Rindi G, Kloppel G, Couvelard A, et al. TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2007;451:757–62.
Salazar R, Wiedenmann B, Rindi G, et al. ENETS 2011 consensus guidelines for the management of patients with digestive neuroendocrine tumors: an update. Neuroendocrinology 2012;95:71–3.
Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med 2011;364:514–23.
4.5.10 Central nervous system malignancies
Jan Buckner
Roger Stupp
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Armstrong TS, Grant R, Gilbert MR, et al. Epilepsy in glioma patients: mechanisms, management, and impact of anticonvulsant therapy. Neuro Oncol 2016;18:779–89.
Brastianos PK, Batchelor TT. Primary central nervous system lymphoma: overview of current treatment strategies. Hematol Oncol Clin N Am 2012;26:897–916.
Brat DJ, Verhaak RG, Aldape KD, et al. Cancer Genome Atlas Research Network. Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med 2015;372:2481–98.
Buckner JC, Pugh SL, Shaw EG, et al. Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG. J Clin Oncol 2014;32:5s (suppl; abstr 2000).
Cairncross JG, Wang M, Jenkins RB, et al. Benefit from procarbazine, lomustine, and vincristine in oligodendroglial tumors is associated with mutation of IDH. J Clin Oncol 2014;32:783–90.
Eckel-Passow JE, Lachance DH, Molinaro AM, et al. Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med 2015;372:2499–508.
Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352:997–1003.
Killela PJ, Reitman ZJ, Jiao Y, et al. TERT promoter mutations occur frequently in gliomas and a subset of tumors derived from cells with low rates of self-renewal. Proc Natl Acad Sci USA 2013;110:6021–6.
Korfel A, Schlegel U. Diagnosis and treatment of primary CNS lymphoma. Nat Revi Neurol 2013;9:317–27.
Preusser M, de Ribaupierre S, Wöhrer A, et al. Current concepts and management of glioblastoma. Ann Neurol 2011;70:9–21.
Rossetti AO, Stupp R. Epilepsy in brain tumor patients. Curr Opin Neurol 2010;23:603–9.
Sanai N, Chang S, Berger MS. Low-grade gliomas in adults. J Neurosurg 2011;115:948–65.
Stummer W, Pichlmeier U, Meinel T, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006;7:392–401.
Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987–96.
van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol 2007;6:421–30.
van den Bent MJ, Brandes AA, Taphoorn MJ, et al. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group Study 26951. J Clin Oncol 2013;31:344–50.
Weller M, Stupp R, Reifenberger G, et al. MGMT promoter methylation in malignant gliomas: ready for personalized medicine? Nat Rev Neurol 2010;6:39–51.
Weller M, Pfister SM, Wick W, et al. Molecular neuro-oncology in clinical practice: a new horizon. Lancet Oncol 2013;14:e370–9.
Weller M, Wick W, Aldape K, et al. Glioma. Nat Rev Disease Primers 2015. Published Online First:16 July 2015. doi:10.1038/nrdp.2015.17. http://www.nature.com/articles/nrdp201517
Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med 2008;359:492–507.
Yan H, Parsons DW, Jin G, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med 2009;360:765–73.
4.5.11 Carcinoma of unknown primary site
Nicholas Pavlidis
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Economopoulou P, Mountzios G, Pavlidis N, et al. Cancer of unknown primary origin in the genomic era: elucidating the dark box of cancer. Cancer Treat Rev 2015;41:598–604.
Fizazi K, Greco FA, Pavlidis N, et al. ESMO Guidelines Committee. Cancer of unknown primary site: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;(Suppl 5):v133–8.
Kamposioras K, Pentheroudakis G, et al. Exploring the biology of cancer of unknown primary: breakthroughs and drawbacks. Eur J Clin Invest 2013;43:491–500.
Pavlidis N, Pentheroudakis G. Cancer of unknown primary site. Lancet 2012;379:1428–35.
Pavlidis N, Petrakis D, Golfinopoulos V, et al. Long-term survivors among patients with cancer of unknown primary. Crit Rev Oncol Hematol 2012;84:85–92.
Petrakis D, Pentheroudakis G, Voulgaris E, et al. Prognostication in cancer of unknown primary (CUP): development of a prognostic algorithm in 311 cases and review of the literature. Cancer Treat Rev 2013;39:701–8.
4.5.12 Haematological malignancies
4.5.12.a Leukaemias (including acute and chronic leukaemias of lymphoid and myeloid lineage)
Martin F Fey
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Coombs CC, Tallman MS, Levine RL. Molecular therapy for acute myeloid leukaemia. Nat Rev Clin Oncol 2016;13:305–18.
Cramer P, Langerbeins P, Eichhorst B, et al. Advances in first-line treatment of chronic lymphocytic leukemia: current recommendations on management and first-line treatment by the German CLL Study Group (GCLLSG). Eur J Haematol 2016;96:9–18.
DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. Section 13 “Leukemias and plasma cell tumours,” DeVita, Hellman, and Rosenberg’s cancer: principles & practice of oncology. 9th edn. Philadelphia: Lippincott Williams & Wilkins, 2011.
Dombret H, Gardin C. An update of current treatments for adult acute myeloid leukemia. Blood 2016;127:53–61.
Grimwade D, Ivey A, Huntly BJ. Molecular landscape of acute myeloid leukemia in younger adults and its clinical relevance. Blood 2016;127:29–41.
Hallek M. Chronic lymphocytic leukemia: 2015 update on diagnosis, risk stratification, and treatment. Am J Hematol 2015;90:446–60.
Jabbour E, O'Brien S, Konopleva M, et al. New insights into the pathophysiology and therapy of adult acute lymphoblastic leukemia. Cancer 2015;121:2517–228.
Larson RA. Is there a best TKI for chronic phase CML? Blood 2015;126:2370–5.
Wiestner A. The role of B-cell receptor inhibitors in the treatment of patients with chronic lymphocytic leukemia. Haematologica 2015;100:1495–507.
4.5.12.b Lymphomas
4.5.12.b.1 Hodgkin's lymphoma
Merry Jennifer Markham
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Armitage JO. Early-stage Hodgkin's lymphoma. N Engl J Med 2010;363:653–62.
Johnson P, McKenzie H. How I treat advanced classical Hodgkin lymphoma. Blood 2015;125:1717–23.
NCCN clinical practice guidelines in oncology (NCCN guidelines). Hodgkin lymphoma (Version 2.2015). http://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf
4.5.12.b.2 Non-Hodgkin's lymphoma
Merry Jennifer Markham
Bertrand Coiffier
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Campo E, Rule S. Mantle cell lymphoma: evolving management strategies. Blood 2015;125:48–55.
Casulo C, Burack WR, Friedberg JW. Transformed follicular non-Hodgkin's lymphoma. Blood 2015;125:40–47.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Non-Hodgkin's Lymphoma (Version 1.2016). http://www.nccn.org/professionals/physician_gls/pdf/nhl.pdf
Roschewski M, Staudt LM, Wilson WH. Diffuse large B-cell lymphoma-treatment approaches in the molecular era. Nat Rev Clin Oncol 2014;11:12–23.
Sehn LH, Gascoyne RD. Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity. Blood 2015;125:22–32.
Swerdlow SH, Campo E, Harris NL, et al. eds. World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press, 2008.
Wilcox RA. Cutaneous T-cell lymphoma: 2014 Update on diagnosis, risk-stratification, and management. Am J Hematol 2014;89:837–51.
4.5.12.c Plasma cell dyscrasias
Antonio Palumbo
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Brioli A, Melchor L, Walker BA, et al. Biology and treatment of myeloma. Clin Lymphoma Myeloma Leuk 2014;14(Suppl): S65–70.
Dhodapkar MV, Jacobson JL, Gertz MA, et al. Prognostic factors and response to fludarabine therapy in patients with Waldenström macroglobulinemia: results of United States intergroup trial (Southwest Oncology Group S9003). Blood 2001;98:41–8.
Dimopoulos MA, Zomas A, Viniou NA, et al. Treatment of Waldenstrom’s macroglobulinemia with thalidomide. J Clin Oncol 2001;19:3596–601.
Ludwig H, Sonneveld P, Davies F, et al. European perspective on multiple myeloma treatment strategies in 2014. Oncologist 2014;19:829–44.
Palumbo A, Anderson K. Multpple myeloma. N Engl J Med 2011;364:1046–60.
Palumbo A, Bringhen S, Mateos MV, et al. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood 2015;125:2068–74.
Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol 2015;33:2863–9.
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014;15:e538–48.
Rajkumar SV. Myeloma today: disease definitions and treatment advances. Am J Hematol 2015. doi: 10.1002/ajh.24236
Sanchorawala V, Wright DG, Seldin DC, et al. An overview of the use of high-dose melphalan with autologous stem cell transplantation for the treatment of AL amyloidosis. Bone Marrow Transplant 2001;28:637–42.
Weber D, Treon SP, Emmanouilides C, et al. Uniform response criteria in Waldenstrom’s macroglobulinemia: consensus panel recommendations from the Second International Workshop on Waldenstrom’s Macroglobulinemia. Semin Oncol 2003;30:127–31.
4.5.12.d Myeloproliferative neoplasms
Michael Pfeilstöcker
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Barbui T, Barosi G, Birgegard G, et al. European LeukemiaNet. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol 2011;29:761–70.
Vannucchi AM, Barbui T, Cervantes F, et al. Philadelphia chromosome-negative chronic myeloproliferative neoplasms: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;26(Suppl 5):v85–99.
Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 2009;114:937–51.
4.6 Rare cancers
Paolo Casali
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Casali PG, Bruzzi P, Bogaerts J, et al. Rare Cancers Europe (RCE) methodological recommendations for clinical studies in rare cancers: a European consensus position paper. Ann Oncol 2015;26:300–6.
Gatta G, van der Zwan JM, Casali PG, et al. Rare cancers are not so rare: the rare cancer burden in Europe. Eur J Cancer 2011;47:2493–511.
The Lancet Oncology Series on Rare Cancers. Published Online First: 3 February 2016. http://www.thelancet.com/series/rare-cancers
4.7 AIDS-associated malignancies
Scot C Remick
Patrick J Loehrer
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Mwamba P, Mwanda WO, Busakhala N, et al. AIDS-related non-Hodgkin's lymphoma in sub-Saharan Africa: current status and realities of therapeutic approach. Lymphoma 2012;2012. doi: 10.1155/2012/904367
Oyiro PO, Roidad N, Monga M, et al. Transmissible agents, HIV and cancer. In: Miller KD, Simon M, eds. Global perspectives on cancer: incidence, care and experience. Vol. 1 of 2 volume text. Santa Barbara, CA: ABC-CLIO, LLC Praeger, 2015:55–144.
Rogena EA, Simbiri KO, De Falco G, et al. A review of the pattern of AIDS defining, HIV associated neoplasms and premalignant lesions diagnosed from 2000–2011 at Kenyatta National Hospital, Kenya. Infect Agent Cancer 2015;10:28. doi: 10.1186/s13027-015-0021-1
Sasco AJ, Jaquet A, Boidin E, et al. The challenge of AIDS-related malignancies in sub-Saharan Africa. PLoS ONE 2010;5:e8621.
4.8 Special issues in the diagnosis and treatment of cancers in adolescents
Smita Bhatia
Giannis Mountzios
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Epelman S. The adolescent and young adult with cancer: state of the art—brain tumor. Curr Oncol Rep 2013;15:308–16.
Epelman CL. The adolescent and young adult with cancer: state of the art—psychosocial aspects. Curr Oncol Rep 2013;15:325–31.
Ferreira CG, de Melo AC, Nogueira-Rodrigues A. The adolescent and young adult with cancer: state of the art—epithelial cancer. Curr Oncol Rep 2013;15:287–95.
Gramatges MM, Rabin KR. The adolescent and young adult with cancer: state of the art—acute leukemias. Curr Oncol Rep 2013;15:317–24.
Rainusso N, Wang LL, Yustein JT. The adolescent and young adult with cancer: state of the art—bone tumors. Curr Oncol Rep 2013;15:296–307.
4.9 Special issues in the diagnosis and treatment of cancers in young adults
Smita Bhatia
Giannis Mountzios
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Epelman S. The adolescent and young adult with cancer: state of the art—brain tumor. Curr Oncol Rep 2013;15:308–16.
Epelman CL. The adolescent and young adult with cancer: state of the art—psychosocial aspects. Curr Oncol Rep 2013;15:325–31.
Ferreira CG, de Melo AC, Nogueira-Rodrigues A. The adolescent and young adult with cancer: state of the art—epithelial cancer. Curr Oncol Rep 2013;15:287–95.
Gramatges MM, Rabin KR. The adolescent and young adult with cancer: state of the art—acute leukemias. Curr Oncol Rep 2013;15:317–24.
Rainusso N, Wang LL, Yustein JT. The adolescent and young adult with cancer: state of the art—bone tumors. Curr Oncol Rep 2013;15:296–307.
4.10 Cancer and pregnancy
Fedro Alessandro Peccatori
Nicholas Pavlidis
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Amant F, Deckers S, Van Calsteren K, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer 2010;46:3158–68.
Amant F, von Minckwitz G, Han SN, et al. Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study. J Clin Oncol 2013;31:2532–9.
Amant F, Halaska MJ, Fumagalli M, et al. Gynecologic cancers in pregnancy. Int J Gynecol Cancer 2014;24:394–403.
Andersson TM-L, Johansson ALV, Fredriksson I, et al. Cancer during pregnancy and the postpartum period: A population-based study. Cancer 2015;121:2072–7.
Azim HA, Peccatori FA, Pavlidis N. Lung cancer in the pregnant woman: to treat or not to treat, that is the question. Lung Cancer 2010;67:251–6.
Cardonick EH, Usmani A, Ghaffar S. Perinatal outcomes of a pregnancy complicated by cancer, including neonatal follow-up after in utero exposure to chemotherapy. Am J Cljn Oncol 2010;33:221–8.
Cardonick EH, Gringlas MB, Hunter K, et al. Development of children born to mothers with cancer during pregnancy: comparing in utero chemotherapy-exposed children with nonexposed controls. Am J Obstet Gynecol 2015;212:658.e1–8.
Goncalves V, Sehovic I, Quinn G. Childbearing attitudes and decisions of young breast cancer survivors: a systematic review. Hum Reprod Update 2014;20:279–92.
Hahn KME, Johnson PH, Gordon N, et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 2006;107:1219–26.
Koren G, Carey N, Gagnon R, et al. Cancer chemotherapy and pregnancy. J Obstet Gynaecol Canada 2013;35:263–78.
Lambertini M, Anserini P, Levaggi A, et al. Fertility counseling of young breast cancer patients. J Thorac Dis 2013;5(Suppl 1):S68–80.
Loibl, S, Han SN, Amant F. Being pregnant and diagnosed with breast cancer. Breast Care 2012;7:204–9.
Moran BJ, Yano H, Al Zahir N, et al. Conflicting priorities in surgical intervention for cancer in pregnancy. Lancet Oncol 2007;8:536–44.
Morice P, Uzan C, Uzan S. Cancer in pregnancy: a challenging conflict of interest. Lancet 2012;379:495–6.
Pagani O, Partridge A, Korde L, et al. Pregnancy after breast cancer: If you wish, ma'am. Breast Cancer Res Treat 2011;129:309–17.
Peccatori FA, Azim HA, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(Suppl 6):vi160–70.
Peccatori FA, Corrado G, Fumagalli M. Risk factors: after gestational chemotherapy, the kids are all right. Nat Rev Clin Oncol 2015;12:254–5.
Pereg D, Koren G, Lishner M. Cancer in pregnancy: gaps, challenges and solutions. Cancer Treat Rev 2008;34:302–12.
Rizack T, Mega A, Legare R, et al. Management of hematological malignancies during pregnancy. Am J Hematol 2009;84:830–41.
Schedin P. Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer 2006;6:281–91.
Schover LR. Motivation for parenthood after cancer: a review. J Natl Cancer Inst Monogr 2005:2–5.
4.11 Geriatric oncology
Hans Wildiers
Stuart Lichtman
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist 2000;5:224–37.
Decoster L, Van Puyvelde K, Mohile S, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations. Ann Oncology 2015;26:288–300.
Hurria A, Levit LA, Dale W, et al. Improving the evidence base for treating older adults with Cancer: American Society of Clinical Oncology Statement. J Clin Oncol 2015;33:3826–33.
Lichtman S, Wildiers H, Chatelut E, et al. International Society of Geriatric Oncology Chemotherapy Taskforce. Evaluation of chemotherapy in older patients—an analysis of the medical literature; J Clin Oncol 2007;14:1832–43.
Wildiers H, Mauer M, Pallis A, et al. End points and trial design in geriatric oncology research: a joint European Organisation for Research and Treatment of Cancer–Alliance for Clinical Trials in Oncology–International Society of Geriatric Oncology position article. J Clin Oncol 2013;31:3711–18.
Wildiers H, Heeren P, Puts M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 2014;32:2595–603.
4.12 Cancer treatment in patients with comorbidities
Diana Hanna
Heinz-Josef Lenz
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Carey EC, Walter LC, Lindquist K, et al. Development and validation of a functional morbidity index to predict mortality in community-dwelling elders. J Gen Intern Med 2004;19:1027–33.
Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–83.
Edwards BK, Noone AM, Mariotto AB, et al. Annual Report to the Nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer 2014;120:1290–314.
Extermann M, Overcash J, Lyman GH, et al. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol 1998;16:1582–7.
Extermann M. Interaction between comorbidity and cancer. Cancer Control 2007;14:13–22.
Karampeazis A Extermann M. Assessment and impact of comorbidity in older adult patients with cancer. In: Hurria A, Balducci L, eds. Geriatric oncology: treatment, assessment and management. Berlin: Springer, 2009.
National Comprehensive Cancer Network. Older Adult Oncology (Version 2.2015). http://www.nccn.org/professionals/physician_gls/pdf/senior.pdf
Pal SK, Hurria A. Impact of age, sex, and comorbidity on cancer therapy and disease progression. J Clin Oncol 2010;28:4086–93.
Piccirillo JF, Tierney RM, Costas I, et al. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA 2004;291:2441–7.
Søgaard M, Thomsen RW, Bossen KS, et al. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013;5(Suppl 1):3–29.
5 PSYCHOSOCIAL ASPECTS OF CANCER
Lidia Schapira
Luzia Travado
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Adler NE, Page AEK, eds. Cancer care for the whole patient: meeting psychosocial needs. Washington DC: The National Academies Press, 2008.
Bultz BD, Travado L, Jacobsen PB, et al. 2014 President's plenary international psycho-oncology society: moving toward cancer care for the whole patient. Psychooncology 2015;24:1587–93. doi: 10.1002/pon.3844
Holland JC, Breitbart WS, Jacobsen PB, et al. eds. Psycho-oncology. 3rd edn. Oxford: Oxford University Press, 2015.
Multilingual Core Curriculum in Psycho-Oncology. http://www.ipos-society.org/multilingual-core-curriculum-in-psycho-oncology/
National Breast Cancer Centre and National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Camperdown, NSW, Australia: National Breast Cancer Centre, 2003. http://canceraustralia.gov.au/sites/default/files/publications/pca-1-clinical-practice-guidelines-for-psychosocial-care-of-adults-with-cancer_504af02682bdf.pdf
National Cancer Action Team. National Cancer Peer Review Programme: Manual for Cancer Services: Psychological Support Measures Version 1.0. National Health Service, UK, 2011. http://www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=1624
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Distress management. Version 1.2015, 2015. http://www.nccn.org/professionals/physician_gls/default.asp
Surbone A, Zwitter M, Rajer M, et al. eds. New challenges in communication with cancer patients. Berlin: Springer, 2013.
Travado L, Dalmas M. Psychosocial Oncology Care. In: Albreht T, Martin-Moreno JM, Jelenc MJ, et al. eds. European guide for quality National Cancer Control Programmes. Ljubljana, Slovenia: National Institute of Public Health, 2015:35–9. http://www.cancercontrol.eu/uploads/images/European_Guide_for_Quality_National_Cancer_Control_Programmes_web.pdf
6 COMMUNICATION
Friedrich Stiefel
Alexander Kiss
Don S Dizon
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Bourquin C, Stiefel F, Bernhard J, et al. Mandatory communication skills training for oncologists: enforcement does not substantially impact satisfaction. Support Care Cancer 2014;22:2611–14.
Bousquet G, Orri M, Winterman S, et al. Breaking bad news in oncology: a metasynthesis. J Clin Oncol 2015;33:2437–43.
Dizon DS, Politi MC, Back AL. The power of words: discussing decision making and prognosis. Am Soc Clin Oncol Educ Book 2013:442–446.
Kissane DW, Bylund CL, Banerjee SC, et al. Communication skills training for oncology professionals. J Clin Oncol 2012;30:1242–7.
Moore PM, Rivera Mercado S, Grez Artigues M, et al. Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev 2013;3:CD003751.
Salmon P, Young B. Creativity in clinical communication: from communication skills to skilled communication. Med Educ 2011;45:217–26.
Stiefel F, Barth J, Bensing J, et al. Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009. Ann Oncol 2010;21:204–7.
7 GENETIC COUNSELLING
Lidia Schapira
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
Robson ME, Bradbury AR, Arun B, et al. American Society of Clinical Oncology Policy statement update: genetic and genomic testing for cancer susceptibility. J Clin Oncol 2015;33:3660–7.
8 PATIENT EDUCATION
Lidia Schapira
Lorenz Jost
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ASCO. Resources for patients. http://www.cancer.net/
ESMO. Cancer guides for patients. http://www.esmo.org/Patients/Patient-Guides
ESMO. Guide for patients with advanced cancer: getting the most out of your oncologist. http://www.esmo.org/Patients/Getting-the-Most-out-of-Your-Oncologist
ESMO. Personalised cancer medicine explained. http://www.esmo.org/Patients/Personalised-Medicine-Explained
National Cancer Institute. Resources for patients, caregivers, and health professionals. http://www.cancer.gov/
UpToDate® Resources for patients. http://www.uptodate.com/contents/table-of-contents/patient-information/beyond-the-basics
9 SURVIVORSHIP
Elizabeth Charlotte Moser
Charles L Shapiro
Lifang Liu
In cancer, survivorship—as defined by the National Cancer Institute (NCI) of the USA—begins at the time of initial diagnosis and continues until the end of life. Family members, friends and caregivers are also affected by the survivorship experience and are included in this definition. However, not all individuals who are treated for cancer wish to be called survivors and in some countries other than USA, the term may not carry the same positive cultural associations.
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
ASCO survivorship compendium clinical resources, 2015. https://www.asco.org/practice-guidelines/cancer-care-initiatives/prevention-survivorship/survivorship/survivorship-compendium
Oncoline. Cancer rehabilitation, 2011. http://www.oncoline.nl/cancer-rehabilitation
Oncoline. Cancer survivorship care, 2011. http://www.oncoline.nl/cancer-survivorship-care
van Halteren H, ed. ESMO handbook on rehabilitation issues during cancer treatment and follow-up. Viganello–Lugano: ESMO Press, 2014. http://oncologypro.esmo.org/Publications/Handbooks/Rehabilitation-Issues-During-Cancer-Treatment-and-Follow-Up
10 BIOETHICAL, LEGAL AND ECONOMIC ISSUES
10.1 Bioethical and legal issues
Johannes G Meran
Mark Robson
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
Reference
Beauchamp TL, Childress JF. Principles of biomedical ethics, 7th edn. Oxford: Oxford University Press, 2013.
10.2 Economic issues of new cancer drugs
Lowell Schnipper
Richard Sullivan
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Ades F, Senterre C, de Azambuja E, et al. Discrepancies in cancer incidence and mortality and its relationship to health expenditure in the 27 European Union member states. Ann Oncol 2013;24:2897–902.
Chalkidou K, Marquez P, Dhillon PK, et al. Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries. Lancet Oncol 2014;15:e119–31.
Cherny NI, Sullivan R, Dafni U, et al. A standardised, generic, validated approach to stratify the magnitude of clinical benefit that can be anticipated from anti-cancer therapies: the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Ann Oncol 2015;26:1547–73.
Collingridge D, Sullivan R. Affordable cancer care: pipedream or achievable reality? Lancet Oncol 2014;15:257–8.
Davis C. Drugs, cancer and end-of-life care: a case study of pharmaceuticalization? Soc Sci Med 2015;131:207–14.
Fojo T, Lo AW. Price, value, and the cost of cancer drugs. Lancet Oncol 2016;17:3–5.
Jönsson B. Ten arguments for a societal perspective in the economic evaluation of medical innovations. Eur J Health Econ 2009;10:357–9.
Jönsson B. Technology assessment for new oncology drugs. Clin Cancer Res 2013;19:6.
Porter ME. What is value in healthcare? N Engl J Med 2010;363:2477–81.
Smith S, Brick A, O’Hara S, et al. Evidence on the cost and cost-effectiveness of palliative care: a literature review. Palliat Med 2014;28:130–50.
11 CANCER CARE DELIVERY IN LOW-RESOURCE ENVIRONMENTS
Alexandru Eniu
Objectives |
|
Awareness |
|
Knowledge |
|
Skills |
|
References
Anderson BO, Yip CH, Smith RA, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer 2008;113(8 Suppl):2221–43.
Eniu A, Carlson RW, El Saghir NS, et al. Breast Health Global Initiative Treatment Panel. Guideline implementation for breast healthcare in low- and middle-income countries: treatment resource allocation. Cancer 2008;113(8 Suppl):2269–81.
Distelhorst SR, Cleary JF, Ganz PA, et al. Breast Health Global Initiative Global Summit on Supportive Care and Quality of Life Consensus Panel Members. Optimisation of the continuum of supportive and palliative care for patients with breast cancer in low-income and middle-income countries: executive summary of the Breast Health Global Initiative, 2014. Lancet Oncol 2015;16:e137–47.
El-Saghir NS, Charara RN, Kreidieh FY, et al. Global practice and efficiency of multidisciplinary tumor boards: results of an ASCO international survey. J Global Oncol 2015;1:1–8. http://jgo.ascopubs.org/content/early/2015/09/30/JGO.2015.000158
Stewart BW, Wild CP, eds. World Cancer report 2014. The International Agency for Research on Cancer, 2014. http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=80&codcch=275
Global cancer surgery. Lancet Oncol 2015. http://www.thelancet.com/commissions/global-cancer-surgery
Responding to the cancer crisis: expanding global access to radiotherapy. Lancet Oncol 2015. http://www.thelancet.com/commissions/radiotherapy
WHO Model Lists of Essential Medicines. http://www.who.int/medicines/publications/essentialmedicines/en/
Yip CH, Cazap E, Anderson BO, et al. Breast cancer management in middle-resource countries (MRCs): consensus statement from the Breast Health Global Initiative. Breast 2011;20(Suppl 2):S12–19.
12 SKILLS
Michael Kosty
Objectives |
|
Awareness |
|
Knowledge |
Anticancer agent administration
|
Bone marrow aspiration, biopsy and interpretation
| |
Ommaya reservoir and lumbar puncture
| |
Paracentesis, thoracentesis
| |
Tumour assessment
| |
Skills |
|
References
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. Ann Oncol 2004;15:1603–12.
Hansen HH, Bajorin DF, Muss HB, et al. ESMO/ASCO Task Force on Global Curriculum in Medical Oncology. Recommendations for a Global Core Curriculum in Medical Oncology. J Clin Oncol 2004;22:4616–25.
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. https://www.esmo.org/content/download/8171/168764/file/ESMO-ASCO-Revised-Recommendations-for-a-Global-Curriculum-in-Medical-Oncology.pdf
ESMO/ASCO recommendations for a Global Curriculum in medical oncology, 2010 update. http://www.asco.org/sites/default/files/esmo-asco_revised_recommendations.pdf
ACGME Program Requirements for Graduate Medical Education in Medical Oncology (Internal Medicine), 2015. https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/147_medical_oncology_int_med_07012015.pdf
ENDORSEMENTS FROM SOCIETIES
Albania
Shoqata Mediko-Onkologjike Shqiptare
Albanian Oncology Association (AOA)
Armenia
Արյունաբանության և Ուռուցքաբանությա ն Հայկական Ասոցիացիա
Armenian Association of Hematology and Oncology (AAHO)
Austria
Österreichische Gesellschaft für Hämatologie und Medizinische Onkologie (OeGHO)
Austrian Society for Haematology and Medical Oncology
Belarus
Общественное Объединение «Белорусское Общество Онкологов» (ОО БОО)
Public Association ‘Belarusian Society Of Oncologists’ (PA ‘BSO)’
Грамадскае Аб‘яднанне «Беларускае Таварыства Анколагаў» (ГА БТА)
Belgium
Belgian Society of Medical Oncology (BSMO)
Bosnia and Herzegovina
Udruženje Onkologa BiH
Bosnian Oncology Society
Brazil
Sociedade Brasileira de Oncologia Clínica (SBOC)
Brazilian Society of Clinical Oncology
China
中国临床肿瘤学会
Chinese Society of Clinical Oncology (CSCO)
Croatia
Hrvatsko društvo za internističku onkologiju (HDIO)
Croatian Society of Medical Oncology
Cyprus
Ογκολογική Εταιρεία Κύπρου (OEK)
Cyprus Oncology Society
Czech Republic
Česká onkologická společnost (ČOS)
Czech Society for Oncology
Denmark
Dansk Selskab for Klinisk Onkologi (DSKO)
Danish Society for Clinical Oncology
Egypt
الجمعيه المصريه لامراض السرط
Egyptian Cancer Society (ECS)
Estonia
Eesti Onkoteraapia Ühing (EOÜ)
Estonian Society of Medical Oncology
Estonia
Eesti Onkoloogide Selts (EOS)
Estonian Society of Oncologist
Germany
Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)
German Society for Haematology and Medical Oncology
Greece
Εταιρεία Ογκολόγων Παθολόγων Ελλάδας (ΕΟΠΕ)
Hellenic Society of Medical Oncology (HeSMO)
Hungary
Magyar Klinikai Onkológiai Társaság (MKOT)
Hungarian Society of Clinical Oncology
Hungary
Magyar Onkológusok Társasága (MOT)
Hungarian Cancer Society
Hungary
Magyar Onkológusok Gyógyszerterápiás Tudományos Társasága (MAGYOT)
Drug Therapeutic Scientific Society of Hungarian Oncologists
Iceland
Félag íslenskra krabbameinslaekna (FÍK)
Icelandic Society of Oncology
India
Indian Society of Medical and Paediatric Oncology (ISMPO)
Ireland
Irish Society of Medical Oncology (ISMO)
Israel
ישראל, האיגוד הישראלי לאונקולוגיה קלינית ורדיותרפיה
The Israel Society of Clinical Oncology & Radiation Therapy (ISCORT)
Italy
Associazione Italiana di Oncologia Medica (AIOM)
Italian Association of Medical Oncology
Japan
Nihon Rinshoushuyou Gakkai (日本臨床腫瘍学会)
Japanese Society of Medical Oncology (JSMO)
Republic of Korea
Korean Association for Clinical Oncology (KACO)
Latvia
Latvijas onkologu ķīmijterapeitu asociācija (LOKA)
Latvian Association of Medical Oncologists
Lebanon
الجمعية اللبنانية لأطباء التورم الخبيث
Lebanese Society of Medical Oncology (LSMO)
Lithuania
Lietuvos chemoterapeutų draugija (LCD)
Lithuanian Society for Medical Oncology (LiSMO)
Luxembourg
Société Luxembourgeoise d'Oncologie (SLO)
Luxembourg Society of Oncology
Mexico
Sociedad Mexicana de Oncologia A.C. (SMeO)
Mexican Society of Clinical Oncology
Myanmar
Myanmar Oncology Society (MOS)
Philippines (the)
Philippine Society of Medical Oncology (PSMO)
Poland
Polskie Towarzystwo Onkologii Klinicznej (PTOK)
Polish Society of Clinical Oncology
Portugal
Sociedade Portuguesa de Oncologia (SPO)
Portuguese Society of Oncology
Romania
Societatea Română de Radioterapie şi Oncologie Medicală (SRROM)
Romanian Society of Radiotherapy and Medical Oncology (RSRMO)
Russian Federation
Pоссийское общество клинической онкологии
Russian Society of Clinical Oncology (RUSSCO)
Serbia
Udruženje medikalnih onkologa Srbije (UMOS)
Serbian Society for Medical Oncology
Singapore
Singapore Society of Oncology (SSO)
Slovak Republic
Slovenská onkologická spoločnosť (SOS)
Slovak Cancer Society
Spain
Sociedad Española de Oncologia Médica (SEOM)
Spanish Society of Medical Oncology
Sweden
Svensk onkologisk förening (SOF)
Swedish Society of Oncology
Switzerland
Schweizerische Gesellschaft für Medizinische Onkologie (SGMO)
Swiss Society of Medical Oncology
Thailand
มะเร็งวิทยาสมาคมแห่งประเทศไทย
The Thai Society of Clinical Oncology (TSCO)
Turkey
Türk Tıbbi Onkoloji Derneği
Turkey Society of Medical Oncology (TSMO)
Ukraine
Асоціація онкогематологів України
Association of Oncohematologists of Ukraine
Acknowledgments
Keith McGregor deserves special credit for his constant encouragement to conceive the GC 2016 in its actual version. The members of the ESMO/ASCO GC Working Group wish to thank Katharine Fumassoli, Roberta Candiani, Gracemarie Bricalli, Tanya Kenny, Nicola Latino, Marina Cogo and Vanessa Pavinato from the ESMO Head Office for their valuable contribution. The members of the ESMO/ASCO GC Working Group appreciate liaising of the ESMO National Representatives with the national societies in their countries for endorsement of the GC, as well as the personal endorsement by the ESMO National Representative from Macedonia (FYROM).
Footnotes
Contributors: More than 100 contributors to the GC contributed in different ways and at varying degrees as detailed: The 12 members of the GC Working Group, including the chair contributed to the conception of the GC (see ESMO/ASCO GC Working Group members). The 9 members of the Editorial Board were responsible for the further selection of the topics and authors of the respective contributions of the GC (see Editorial Board). The 9 members of the Review Board undertook an anonymised review of the entire GC manuscript (see Review Board). The 96 authors of the GC were responsible alone or in collaboration with other authors for the delivery of the respective contentual segments their names are allocated to (see List of Authors in alphabetical order).
Competing interests: JBe received research support to Karolinska Institutet and University Hospital from Amgen, AstraZeneca, Bayer, Merck, Roche and Sanofi-Aventis. JBu received travel accommodations from Genentech/Roche. FC received a consultant honoraria in Astellas/Medivation, AstraZeneca, Celgene, Daiitchi-Sankyo, Eisai, GE Oncology, Genentech, GlaxoSmithKline (GSK), Merck-Scharp, Merus BV, Novartis, Pfizer, Pierre-Fabre, Roche, Sanofi, Teva. HC has worked in a consulting or advisory role in Amgen received speakers’ bureau in Baxalta, Celgene and received research funding from Celgene. PC received honoraria for consultancy/advisory role and/or for lectures from Bayer, Blueprint Medicines, Eisai, Eli Lilly, Glaxo SK, Merck SD, Merck Serono, Nektar Ther., Novartis, Pfizer, PharmaMar. AC received honoraria from MerckSerono, Roche, Amgen, Bayer, Lilly and speakers’ bureau from Roche and MerckSerono. RC received research funding from Genentech/Roche, Puma Biotechnology, Novartis and travel, accommodations, expenses from Novartis. LDP received fees as consultant or for lectures (no speakers’ bureau) from F. Hoffmann-La Roche, Pfizer, Bristol Meyer Squibb, AstraZeneca, Qiagen, Boehringer Ingelheim. All fees were paid to Institution. MDS received honoraria and consultation fees from Amgen, Astellas, Bayer, Celgene, Dendreon, Eisai Inc, ESSA, Ferring, GSK, Janssen Cilag, Merck, Novartis, Pfizer, Pierre Fabre Oncologie, Roche, Sanofi Aventis, Shionogi, Synthon, Takeda, Teva/OncoGenex; received research grant from Pierre Fabre Oncologie. EGEdV received research grants to the institute from Roche/Genentech, Amgen, Novartis, Pieris, Servier, is part of data monitoring committee in Biomarin and of advisory board in Synthon. CD received (un)restricted research grants donated to the research institute from Amgen, AstraZeneca, Bayer, Celgene, Eisai, Boehringer Ingelheim, Merck, MSD, Mundipharma, Novartis, Pfizer Corporation, PharmaMar, Pierre Fabre, Roche Austria, Sanofi-aventis, Takeda; received honoraria for consulting from AstraZeneca, Eli Lilly, Merck, Novartis Pharma, Roche Austria. DSD has worked in a consulting or advisory role for UpToDate and received research funding from Aeterna Zentaris (to Institution). LRD received research funding from GlaxoSmithKline (to Institution), Millennium (to Institution), Bristol-Myers Squibb (to Institution), Aeterna Zentaris (to Institution), Millenuim (to Institution) and has other relationship with Genentech. NES received honoraria from Roche, Novartis, MSD Oncology; received research funding from GlaxoSmithKline, Roche; received travel, accommodations, expenses from Novartis, Roche, Celgene. AE conduct research sponsored by Roche, GSK, Novartis, AstraZeneca, Celltrion, Apotex Inc. ME has stock and other ownership interests with Bristol-Myers Squibb, GE Healthcare, Nestle SA, Pfizer, CVS CAREMARK; has worked in a consulting or advisory role from Merck, Bristol-Myers Squibb, ALKERMES; received research funding from Altor BioScience, Bristol-Myers Squibb, Merck, Alkermes, Polynoma; received travel, accommodations, expenses from Myriad Genetics, Bristol-Myers Squibb, Merck. EF has worked as a consultant for Boehringer Ingelheim, Eli Lilly, Pfizer, Roche, BMS, MSD, Novartis; received speaker's bureau from Eli Lilly, BMS, Novartis. MFF has owned stock from Novartis. PKG research funding from Abbvie (to Institution) and Onyx (to Institution). AG has worked in a consulting or advisory role for Genentech/Roche (to Institution), Bayer (to Institution), Sanofi (to Institution), Bristol-Myers Squibb (to Institution), Lilly (to Institution), Boston Biomedical (to Institution), Amgen (to Institution); received research funding from Genentech/Roche (to Institution), Bayer (to Institution), Pfizer (to Institution), Eisai (to Institution), Sanofi (to Institution), Lilly (to Institution), Boston Biomedical (to Institution); received travel, accommodations, expenses from Genentech/Roche, Bayer, Bristol-Myers Squibb, Boston Biomedical, Amgen. SMH has stock and other ownership interests with Liquid Biotech, USA; has patents, royalties, other intellectual property with Liquid Biotech, USA. JH received advisory board and speaker fee from Tesaro and honorarium from SOBI. DVJ has worked in a consulting or advisory role for Bayer. UK received honoraria from Amgen, BMS, GSK, Glycotope, MerckSerono, Merck/MSD, Pfizer; received research support from Pfizer, MerckSerono, Innate, Sirtec. RK conduct research supported by Roche; a member of speaker's bureau of Roche, Meda, Novartis. SK received research funding from Novartis (to Institution), Merck (to Institution), Threshold Pharmaceuticals (to Institution), Gilead Sciences (to Institution), Bayer/Onyx (to Institution); received travel, accommodation, expenses from Novartis. C-HK received honoraria from Merck/Darmstadt, Amgen. MK is on speakers’ bureau for Astellas Pharma, Genentech/Roche, Sanofi, Lilly, Bayer; received research funding from Genentech/Roche (to Institution) and Merck Serono (to Institution). H-JL has received honoraria from Merck Serono, Roche, Celgene, Bayer, Boehringer Ingelheim; has served in a consulting or advisory role for Merck Serono, Roche, Bayer; received travel, accommodations, expenses from Merck Serono, Bayer, Roche. LL has served as a consultant/advisory for EISAI, BMS, MSD, Merck-Serono, Boehringer Ingelheim, DEBIOPHARM, SOBI, Novartis, AstraZeneca, Bayer and Roche; received research funds to institute for clinical studies from EISAI, MSD, Merck-Serono, Boehringer Ingelheim, Novartis, AstraZeneca and Roche; received travel coverage for medical meetings from Merck-Serono, DEBIOPHARM, SOBI, Bayer. PJL received research funding from Novartis (to Institution), Celgene (to Institution), ImClone Systems (to Institution), Taiho Pharmaceutical (to Institution); has patents, royalties, other intellectual property US PPA/61/499,988 Gene Expression Analysis of Thymic Neoplasms Inventors Sunil Badve, Yesim Gokmen-Polar, Patrick Loehrer (to Institution). RIL has served in consulting or advisory role for Roche, Novartis, Janssen; received speakers’ bureau from Roche, Novartis, Janssen. MJM received research funding from Astex Pharmaceuticals (to Institution). TN has ownership interest with Bioclassifier LLC; has role for invention of PAM50 breast cancer assay, which has been licensed to NanoString technologies and being marketed as Prosigna; has served as a consultant for NanoString. KÖ received speaker bureau from Novartis, Ipsen. PÖ received consulting fees, honoraria, travel grants or lecturing fees from Amgen, Bayer, Baxalta, Celgene, EliLilly, Merck, Nordic Drugs, Prime Oncology, Sanofi Oncology. AP received honoraria and consultancy fee from Amgen, Novartis, Bristol-Myers Squibb, Genmab A/S, Celgene, Janssen-Cilag, Millennium Pharmaceuticals, Onyx Pharmaceuticals, Sanofi Aventis. MR received honoraria from AstraZeneca; has served in a consulting or advisory role for Bayer, Pfizer, McKesson; received research funding from AstraZeneca (to Institution), AbbVie (to Institution), Myriad Genetics (to Institution), Biomarin (to Institution); received travel, accommodations, expenses from AstraZeneca, Biomarin. LS has served in a consulting or advisory role for bioTheranostics. MS conduct research sponsored by AstraZeneca, Bayer, Eisai, Exelixis, Genzyme. H-JS is an advisor for Roche, Bayer. LS has served in leadership for Eviti; has served in a consulting or advisory role for Merck; has patents, royalties, other intellectual property; as Co-Editor-in-Chief of UpToDate, Oncology. JS is an employee of Genentech; received honoraria, speakers’ bureau, travel, accommodations, expenses from Genentech. CNS received honoraria or research grant from Novartis, GSK, Pfizer, Merck, Lilly, BMS, Astellas, Bayer, Janssen, Sanofi. FS received unrestricted industry grants for clinical research from Celgene, Fresenius, Helsinn; FS participates in Novartis-lead clinical trials and received punctual advisorship (boards, expert meetings) from Acacia, ACRAF, Amgen, Baxter, Celgene, Danone, Fresenius, GlaxoSmithKline, Grünenthal, Helsinn, ISIS Global, Millennium/Takeda, Mundipharma, Novartis, Novelpharm, Nycomed, Obexia, Otsuka, Ono, Pharm-Olam, Pfizer, Psioxus, PrIME, Santhera, Sunstone, Teva, Vifor. RS received honoraria or consulting fee (paid to institution) from Roche, Merck KGaA/EMD-Serono, MSD/Merck & Co, Pfizer, Ipsen Pharma, Novartis. JT has worked in a consultant/advisory role for Amgen, Bayer, Boehringer Ingelheim, Celgene, Chugai, Lilly, MSD, Merck Serono, Novartis, Pfizer, Roche, Sanofi, Symphogen, Taiho and Takeda. EV has stock and other ownership interests with McKesson; has worked in a consulting or advisory role for Abbvie, AstraZeneca, Boehringer Ingelheim, Celgene, Clovis Oncology, GeneCentric, Genentech, Merck, Synta, VentiRx, Eisai, Lilly, Transgene; received speakers’ bureau for Amgen; received research funding from Abbvie (to Institution), Bristol-Myers Squibb (to Institution), Gen Vec Inc, (to Institution), Sanofi (to Institution), Monsanto (to Institution), Cyclacel (to Institution); received travel, accommodations, expenses from Amgen. JSW has stock and other ownership interests with Altor BioScience, Celldex, cCam Biotherapeutics; received honoraria from Bristol-Myers Squibb, Merck, Genentech, Abbvie, AstraZeneca, Daiichi Sankyo, GlaxoSmithKline, Eisai, Altor BioScience, Lion Biotechnologies, Amgen, Roche, Ichor Medical Systems, Celldex, cCam Biotherapeutics, Pieris; has worked in a consulting or advisory role for Celldex, Ichor Medical Systems, cCam Biotherapeutics, Lion Biotechnologies, Pieris, Altor BioScience, Bristol-Myers Squibb, Merck, Genentech, Roche, Amgen, AstraZeneca, GlaxoSmithKline, Daiichi Sankyo, Abbvie, Eisai; received research funding from Bristol-Myers Squibb (to Institution), Merck (to Institution), GlaxoSmithKline (to Institution), Genentech (to Institution), Astellas Pharma (to Institution), Incyte (to Institution), Roche (to Institution), Novartis (to Institution); received travel, accommodations, expenses from Bristol-Myers Squibb, GlaxoSmithKline, Daiichi Sankyo, Pieris, cCam Biotherapeutics, Lion Biotechnologies, Roche, Celldex, Amgen, Merck, AstraZeneca, Genentech.
Provenance and peer review: Not commissioned; internally peer reviewed.