Discussing specific patient cases, providing the rationale for the treatment choices based on expert experience and recent data from trials, and outlining strategies to provide adequate supportive care will assist clinicians treating transplant ineligible and elderly patients with multiple myeloma in making optimal treatment decisions and improving patient outcomes.
For each of the emerging therapies described (bevacizumab, PARP inhibitors, and HIPEC), the treatment settings, patient selection criteria, and other therapies used in conjunction have varied widely across clinical trials. This has led to much discussion and likely confusion regarding the exact clinical contexts in which these new options should be considered.
Recent advances have led to rational drug development as new therapeutically actionable molecular targets have emerged. It is important for clinicians to be aware of how to incorporate these novel treatment options into clinical practice in ways that achieve meaningful patient outcomes, as well as best practices for providing supportive care and patient education.
Both acute and chronic graft-versus-host disease, while fairly common in allogeneic HSCT, can be potentially fatal. The clinical manifestations of this complication can linger for years and often times impair quality of life drastically. Hematology and oncology specialists can optimize care by early recognition and prompt initiation of systemic therapies.
Pharmacists should be aware of data on targeted therapy and immunotherapy for RCC and be able to make appropriate therapy recommendations. In addition, pharmacists play an important role in the management of toxicity of targeted therapy or immunotherapy and encouraging compliance for patients on targeted therapies for RCC.
Pediatric ALL is a potentially curable malignancy and systemic therapy is the mainstay of treatment. Understanding the diagnosis, workup, and subsequent treatment of this disease will help clinicians play an important role in providing medication-related recommendations, supportive care, and patient counseling which can improve the outcomes and the quality of patient care.
For each of the emerging therapies described (bevacizumab, PARP inhibitors, and HIPEC), the treatment settings, patient selection criteria, and other therapies used in conjunction have varied widely across clinical trials. This has led to much discussion and likely confusion regarding the exact clinical contexts in which these new options should be considered.
Although considerable progress has been made in identifying supportive care issues in HCT survivors, large, prospective trials demonstrating the effectiveness of supportive care interventions for HCT-related complications are needed to guide future development of evidence-based guidelines. Importantly, because long-term HCT recipients may no longer be followed by transplant centers, recommendations for supportive care should be geared toward community healthcare providers who may not routinely care for HCT recipients.
Clinicians need to stay current on the knowledge of benefits and risks, including the potential for lifetime radiation toxicity, of the multiple acceptable treatment strategies and apply high-level clinical evidence and expert advice to individualize the treatment and maximize outcomes.
Clinician and patient education is critical for safe administration of checkpoint immunotherapies and screening to identify patients who are not suitable candidates for checkpoint inhibitor therapy.

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