Oncology Gold Standard™ consensus statement on counseling patients for molecular testing and personalized cancer care

Parikh, Purvish M.; Hingmire, Sachin; Bhavesh, P.; Govind, Kanakasetty Babu; Mehta, Prashant G.; Verma, Amit Kumar; Bondarde, Shailesh Arjun; Singh, Randeep; Ghadyalpatil, N.; Rangrajan, B.; Bhattacharya, GS; Malhotra, Hemant; Doval, Dinesh Chandra; Ranade, Anantbhushan; Shah, PM

doi:10.18203/issn.2456-3994.intjmolimmunooncol20172642

Cited by 5 publications

(12 citation statements)

References 27 publications

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“…Outcome optimization depends on choosing the right approach, depending on the severity of anemia, its underlying cause, and various patient factors such as age, number/ severity of comorbidities, and finally the goal of treatment. 14,21,22 The controversy regarding use of ESAs for CAA is still ongoing. 27,28 In the early 2000s, the opinion was that ESAs have an increasing role in CAA.…”

Section: Discussionmentioning

confidence: 99%

Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries

Parikh,

Aggarwal,

Biswas

et al. 2023

South Asian J Cancer

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Cancer-associated anemia (CAA) remains a major unmet need that compromises overall survival (OS) and quality of life (QoL). Currently, available guidelines do not take into consideration the unique challenges in low- and middle-income countries (LMIC). Our CAA patients have to battle preexisting impaired nutritional status, depleted body iron stores, financial limitations, and difficulty in having easily accessible affordable healthcare. Hence, we fulfilled the need of guidelines for LMIC. A group of subject experts were put together, given background literature, met in a face-to-face discussion, voted using Delphi process, and finally agreed on the contents of this guideline document. As many as 50% of cancer patients will have significant anemia (hemoglobin < 10 g/dL) at initial diagnosis. It is most commonly seen with gastrointestinal malignancies, head and neck cancers, and acute leukemias. The hemoglobin falls further after initiation of cancer directed therapy, due to chemotherapy itself or heightened nutritional deficiency. Its evaluation should include tests for complete blood count, red blood cell morphology, reticulocyte count, Coombs test, and levels of vitamin B12 and folic acid. Iron status should be monitored using test to measure serum iron, total iron binding capacity, transferring saturation, and serum ferritin levels. A minimum of 50% of cancer patients with anemia require iron supplements. The preferred mode of therapy is with intravenous (IV) iron using ferric carboxymaltose (FCM). Most patients respond satisfactorily to single dose of 1000 mg. It is also safe and does not require use of a test dose. Significant anemia is found in at least half of all cancer patients in India, South Asian Association for Regional Cooperation region, and other LMIC countries. Its awareness among healthcare professionals will prevent it from remaining undiagnosed (in up to 70% of all cancer patients) and adversely affecting OS and QoL. The benefits of treating them with IV iron therapy are quick replenishment of iron stores, hemoglobin returning to normal, better QoL, and avoiding risk of infections/reactions with blood transfusions. Many publications have proven the value of single-dose FCM in such clinical situations. CAA has been proven to be an independent prognostic factor that adversely affects both QoL and OS in cancer patients. Use of FCM as single IV dose of 1000 mg is safe and effective in the majority of patients with CAA.

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Section: Discussionmentioning

confidence: 99%

Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries

Parikh,

Aggarwal,

Biswas

et al. 2023

South Asian J Cancer

Self Cite

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“…The discussion developed from the published evidence as well as pragmatic analysis of practical experience in real-life management of patients by these national and international experts. 12 The experts were also provided results of an online poll of oncologists (from various specialties: medical oncologists, surgical oncologists, radiation oncologists, molecular oncologists, and policy makers) who had previously shown academic interest in the management of breast cancer. 13 The domain experts then arrived at this consensus statement for the benefit of community oncologists so that they would have easy access to a ready-to-use practical recommendation.…”

Section: Methodsmentioning

confidence: 99%

“…Domain expert members were encouraged to share their experiences and give their opinion, which was taken into consideration while drafting and finalizing this consensus statement. 10 12 13 …”

Section: Methodsmentioning

confidence: 99%

Practical Consensus Recommendations for Optimizing Risk versus Benefit of Chemotherapy in Patients with HR Positive Her2 Negative Early Breast Cancer in India

Parikh¹,

Bhattacharyya

Biswas

et al. 2021

South Asian J Cancer

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Breast cancer is a public health challenge globally as well as in India. Improving outcome and cure requires appropriate biomarker testing to assign risk and plan treatment. Because it is documented that significant ethnic and geographical variations in biological and genetic features exist worldwide, such biomarkers need to be validated and approved by authorities in the region where these are intended to be used. The use of western guidelines, appropriate for the Caucasian population, can lead to inappropriate overtreatment or undertreatment in Asia and India. A virtual meeting of domain experts discussed the published literature, real-world practical experience, and results of opinion poll involving 185 oncologists treating breast cancer across 58 cities of India. They arrived at a practical consensus recommendation statement to guide community oncologists in the management of hormone positive (HR-positive) Her2-negative early breast cancer (EBC). India has a majority (about 50%) of breast cancer patients who are diagnosed in the premenopausal stage (less than 50 years of age). The only currently available predictive test for HR-positive Her2-negative EBC that has been validated in Indian patients is CanAssist Breast. If this test gives a score indicative of low risk (< 15.5), adjuvant chemotherapy will not increase the chance of metastasis-free survival and should not be given. This is applicable even during the ongoing COVID-19 pandemic.

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“…While the discussions took into consideration the scenario as exists in developing countries like India (as a representative country with limited resources), the final manuscript was to be applicable globally – a process that we have shown to be effective earlier. [ 2 3 4 ]…”

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confidence: 99%

Editorial

Parikh

Aggarwal

Hingmire

2018

South Asian J Cancer

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Oncology Gold Standard™ consensus statement on counseling patients for molecular testing and personalized cancer care

Cited by 5 publications

References 27 publications

Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries

Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries

Practical Consensus Recommendations for Optimizing Risk versus Benefit of Chemotherapy in Patients with HR Positive Her2 Negative Early Breast Cancer in India

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