Elements of Bayesian Statistics The main objects in a statistical model are observable data, which may include one or more outcomes, Y, possibly a vector, X, of patient covariates and treatments, and a parameter vector, θ. Parameters are unobserved conceptual…
Introduction The use of hematopoietic stem cells (HSCs) following conditioning chemotherapy in transplantation serves an important role to restore normal hematopoiesis and immune function. In allogeneic hematopoietic cell transplantation, the transplanted immune system has the additional therapeutic benefit of surveillance…
Introduction The human leukocyte antigen (HLA) system is the major histocompatibility complex (MHC) gene in humans. The HLA gene complex comprises about 3.6 Mb deoxyribonucleic acid (DNA) located on the short arm of chromosome 6 (6p21.3). It received its name…
Hematopoietic transplantation, commonly termed hematopoietic cell transplantation (HCT), involves engraftment of donor hematopoietic stem cells with subsequent regeneration of the blood and immune system. Transplants can be from another individual ( allogeneic ), a genetically identical twin ( syngeneic ),…
CLINICAL PEARLS In practice, small cell lung cancer (SCLC) is classified using the Veterans’ Administration Lung Study Group system as either limited-stage, if all disease can be encompassed within one tolerable radiotherapy port, or extensive-stage. Genomically, SCLC is characterized by…
CLINICAL PEARLS In patients with no contraindications, immunotherapy monotherapy or its use as part of combination therapy is the mainstay of treatment in non−small cell lung cancer (NSCLC). Testing for PD-L1 expression is essential to help guide treatment decisions. Unlike…
CLINICAL PEARLS Molecular profiling of tissue is now recommended during the initial workup of advanced non–small cell lung cancer. Patients may be eligible for targeted therapies to driver mutations other than EGFR and anaplastic lymphoma kinase as early as first…
CLINICAL PEARLS Testing for ALK rearrangement can be performed by using immunohistochemistry, fluorescence in-situ hybridization, and next-generation sequencing. All patients with stage 4 non–small cell lung cancer with adenocarcinoma histology should be tested for an ALK rearrangement. Next-generation ALK tyrosine…
CLINICAL PEARLS All patients with advanced, nonsquamous, non−small cell lung cancer (NSCLC) should undergo epidermal growth factor receptor (EGFR) mutation testing as a part of a broader molecular panel (e.g., targeted next-generation sequencing panel). EGFR tyrosine kinase inhibitors (TKIs) are…
CLINICAL PEARLS For immunotherapy-naïve patients, second-line anti-PD-1/PD-L1 inhibitors are preferred over cytotoxic chemotherapy due to improved efficacy and tolerability. For patients with disease progression on first-line immunotherapy monotherapy, second-line cytotoxic chemotherapy with platinum doublet is appropriate. For patients with progression…