Andre Deeke Sasse

Editorial Commentary Insights from PSMAfore: impact on health-related quality of life Caroline Torricelli, Natália Tobar, André Sasse, Elba Etchebehere

Purpose: Renal cell carcinoma is an aggressive disease with a high mortality rate. Management has drastically changed with the new era of immunotherapy, and novel strategies are being developed; however, identifying systemic treatments is still challenging. This paper presents an update of the expert panel consensus from the Latin American Cooperative Oncology Group and the Latin American Renal Cancer Group on advanced renal cell carcinoma management in Brazil. Methods: A panel of 34 oncologists and experts in renal cell carcinoma discussed and voted on the best options for managing advanced disease in Brazil, including systemic treatment of early and metastatic renal cell carcinoma as well as nonclear cell tumours. The results were compared with the literature and graded according to the level of evidence. Results: Adjuvant treatments benefit patients with a high risk of recurrence after surgery, and the agents used are pembrolizumab and sunitinib, with a preference for pembrolizumab. Neoadjuvant treatment is exceptional, even in initially unresectable cases. First-line treatment is mainly based on tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs); the choice of treatment is based on the International Metastatic Database Consortium (IMCD) risk score. Patients at favourable risk receive ICIs in combination with TKIs. Patients classified as intermediate or poor risk receive ICIs, without preference for ICI + ICIs or ICI + TKIs. Data on nonclear cell renal cancer treatment are limited. Active surveillance has a place in treating favourable-risk patients. Either denosumab or zoledronic acid can be used for treating metastatic bone disease. Conclusion: Immunotherapy and targeted therapy are the standards of care for advanced disease. The utilization and sequencing of these therapeutic agents hinge upon individual risk scores and responses to previous treatments. This consensus reflects a commitment to informed decision-making, drawn from professional expertise and evidence in the medical literature.

Introduction: Hepatocellular carcinoma (HCC) has a high incidence and mortality worldwide. Until 2007, there were no drugs that could increase the overall survival in advanced HCC patients. Sorafenib remains the standard-of-care in first-line setting since then. The survival benefit of sorafenib is accompanied by its high cost. All over the world, there has been an increasing discussion on treatment costs and the sustainability of health care systems. In Brazil, the government health expenditures for the public health system have not been sufficient to ensure adequate service for the population and sorafenib is not available in this setting. Therefore, this study aimed to assess the cost-effectiveness of sorafenib for advanced HCC in the public health system in Brazil.

Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers.

The Cochrane Skin Group made the decision to allow another team to incorporate the subject of this review into the protocol that they were writing in order to update another review that has been out of date for some years. We feel it makes clinical sense to combine these two reviews. This review is being withdrawn as it has been updated by incorporation into another broader Cochrane review 'Systemic treatments for metastatic cutaneous melanoma'. The citation for the new review is as follows: Pasquali S, Hadjinicolaou AV, Chiarion Sileni V, Rossi CR, Mocellin S. Systemic treatments for metastatic cutaneous melanoma. Cochrane Database of Systematic Reviews 2018, Issue 2. Art. No.: CD011123. DOI: 10.1002/14651858.CD011123.pub2.