New therapeutic options for gynecological cancers (in particular, targeted therapies and immunotherapies) are associated with potential cardiovascular toxicities that oncologists should be able to identify, detect and manage together with a cardiologist. The first step consists of evaluating the patient's individual cardiovascular risk, regardless of planned oncologic treatment, to determine whether this treatment can be initiated immediately or if cardiological advice is required. In a second step, the risk of cardiovascular toxicity of the selected treatment must be assessed, considering its intrinsic risk and the patient's comorbidities. Once treatment has started, appropriate monitoring should be implemented during administration, and after discontinuation. Beyond general recommendations, specific situations are detailed for initial workup and surveillance relating to most common protocols of chemotherapy, immunotherapy, targeted therapy and associations used in gynecological oncology. If cardiotoxicity occurs (hypertension, QT interval increase, left ventricular dysfunction, troponin increase, myocarditis), the oncologist must be aware of the principles of management, and distinguish between what he can manage on his own and what requires referring to specialists. Prior to rechallenge after cardiotoxicity, multidisciplinary discussion is mandatory to assess the patient's benefit/risk ratio.

Febrile neutropenia, a common complication of systemic antineoplastic therapy, varies in risk depending on malignant disease, treatment, and patient factors. The risk increases with the depth and duration of neutropenia and can be reduced with prophylactic use of G-CSF. International guidelines are conflicting in several aspects and do not reflect all patient groups. We therefore updated the 2014 Infectious Diseases Working Party (AGIHO) guideline of the German Society of Hematology and Medical Oncology (DGHO) on evidence-based recommendations for the use of G-CSF in patients with cancer.

Neutropenic fever is a common complication of haematology and oncology treatments and is associated with a significant risk of morbidity and mortality. Few studies report patients' and carers' understanding of neutropenic fever, including risk reduction, recognition and optimal management. This guideline aims to improve communication around prevention, recognition and management strategies for neutropenic fever in patients receiving cancer treatment. Medical specialists, allied health physicians, other key stakeholders, parents and carers, and patient consumers collaborated to develop guidelines for patients and carers on neutropenic fever. This addition to the 2024 Australasian Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer is the first directed at healthcare workers treating paediatric and adult patients at risk of neutropenic fever.

Patients receiving treatment that has the potential to negatively affect their gonads, including chemotherapy, surgery, and radiation therapy, should be informed of options for fertility preservation and future reproduction before initiating treatment. Reproduction in the context of fertility-affecting treatment raises a number of ethical issues related to the welfare of both patients and offspring. This document replaces the document titled, "Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion," last published in 2018.

Patients preparing to undergo therapies that pose a risk to their fertility or who are at risk of premature ovarian insufficiency should be provided prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients. This document replaces the document entitled "Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion," last published in 2019.

Current guidelines for managing infections in pediatric patients with cancer do not recommend routine antibiotic prophylaxis (AP). However, several aspects of AP, including the role of diagnosis, the impact of neutropenia duration, screening for resistant bacterial colonization, and antibiotic stewardship, remain a matter of debate.

Innovative therapeutic approaches, including poly(ADP-ribose)polymerase inhibitors (PARPi), have shown promising results in metastatic castration-resistant prostate cancer (mCRPC), particularly when combined with androgen receptor inhibitors (ARPi). Irrespective of HRR gene mutations, patients benefit from improved radiological progression-free survival and overall survival. The success of PARPi/ARPi combination therapy relies heavily on the effective management of both treatment administration and the associated side-effects. Common haematological side-effects include anaemia, leukopenia, and thrombocytopenia, whereas non-haematological reactions - particularly fatigue, diarrhea, nausea, and constipation - are also clinically relevant. In addition to basic diagnostics and preventive measures, dose adjustments or temporary discontinuation may be required depending on the severity of the side-effects. For anaemia, the most common side-effect, supportive measures such as blood transfusions may be necessary to ensure optimal patient care. This guide provides uro-oncologists with practical recommendations for daily clinical practice.

Asparaginase is an integral component of therapy for pediatric patients with acute lymphoblastic leukemia/lymphoblastic lymphoma. The success of asparaginase-containing regimens has led to trials of pediatric/pediatric-inspired regimens incorporating asparaginase for treating adolescent and young adult (AYA) and adult populations with acute lymphoblastic leukemia/lymphoblastic lymphoma. While treatment of AYA patients with these regimens is associated with improved clinical outcomes compared with adult-specific protocols, AYA patients face unique challenges with these treatments, further complicated by a rapidly evolving therapeutic landscape. In this article, we identify barriers and other feasibility issues associated with administering asparaginase-based treatment to AYA patients and provide recommendations from a consensus panel of experts to optimize AYA patient outcomes and experiences. Barriers identified include the limited access to clinical trials and specialized expertise in pediatric-inspired regimens for AYA patients compared with pediatric patients, the complex management of asparaginase toxicities, limited medical facilities and experienced staff to administer and manage pediatric-inspired regimens, and reduced AYA patient access/adherence to treatment due to lifestyle-related or psychosocial challenges. Recommendations are provided on addressing and managing these challenges to improve asparaginase-based treatment accessibility and safety in AYA patients, including specific recommendations for high-risk populations. Trial Registration: ClinicalTrials.gov: NCT04817761.

Extravasation is an uncommon but high-risk adverse event that occurs when an agent with the potential to cause tissue damage leaks out of the intended administration space into the surrounding area. This guideline presents evidence-based side effect management recommendations to support interprofessional teams in decision-making to minimize severity or progression of extravasation injury from antineoplastic treatment in individuals with cancer.

The conventional drug development pathway in oncology, spanning 10-15 years, has long been slow, costly, and complex, often marked by late-stage failures due to efficacy or safety concerns.

Immune checkpoint inhibitors (ICIs) are being increasingly used in patients with preexisting inflammatory arthritides (IAs). However, there are concerns that concomitant baseline immunosuppression at the time of ICI initiation may worsen cancer outcomes, a risk that needs to be balanced with the risk of IA flare. The objective of this study was to develop a living guideline that will offer up-to-date guidance on the management of baseline immunosuppression for preexisting IAs when initiating cancer immunotherapy with ICIs.

The harmonization workshops of the leukemia committee of the Société française des cancers de l'enfant (SFCE) aim to establish practical recommendations based on the one hand, on data from the literature and international recommendations and, on the other hand, by consensus in the absence of formally proven data. Adolescent pubescent girls and young adults undergoing intensive chemotherapy treatment may present with heavy uterine bleeding (HUB). Data collected from 25 French centers showed that there was considerable heterogeneity in the management of HUB either in prophylaxis or curative strategy. Analysis of the literature showed that, given the incidence of spontaneous amenorrhea during chemotherapy treatment, there is no indication for systematic prophylaxis of HUB in patients treated for leukemia. In case of proven HUB, non-hormonal treatment and hormonal treatment can be introduced as a matter of urgency. For secondary prophylaxis, various hormonal treatments aiming at achieving prophylactic amenorrhea may be discussed.

Adjuvant anticancer agents are often prescribed to patients with breast cancer to reduce recurrence risk and improve outcomes. Many patients take these medications during primary and staged breast reconstruction. This study presents a review of the literature on adjuvant anticancer medications and whether, based on side effects and risks, they should be held for elective, medically necessary reconstructive procedures. The authors provide expert multidisciplinary consensus recommendations for commonly prescribed agents.

An evidence-based clinical practice guideline for systemic cancer treatment in pregnant women is lacking.

How should fertility preservation in child and adolescent males receiving gonadotoxic therapies be managed?

Cardiac risk stratification is clinically useful prior to initiation of oncologic therapy in asymptomatic patients in order to guide treatment decisions and allow for initiation of cardioprotective therapy or modification of treatment regimens. Once oncology treatment is underway, patients may develop cardiac symptoms. In this setting, imaging can be used for assessment of ventricular and valvular function, myocardial characterization, pericardial effusion or constriction, as well as to evaluate for ischemia as a cause of symptoms. Results can help guide treatment choices and shared decision-making regarding modification or cessation of treatments with associated cardiotoxicity. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Childhood, adolescent, and young adult (CAYA) survivors of cancer are at risk of nephrotoxicity. Surveillance guidelines are important for timely diagnosis and treatment of these survivors, which could slow the progression to higher stages of kidney dysfunction.

Belzutifan offers a significant therapeutic advance for von Hippel-Lindau-associated and advanced renal cell carcinoma but is associated with notable toxicities, particularly anemia and hypoxia. Effective management requires vigilant monitoring, timely interventions, and dose adjustments.

Survival rates after a diagnosis of cancer are improving. Poorly managed gastrointestinal (GI) side effects can interfere with delivery of curative cancer treatment. Long-term physical side effects of cancer therapy impinge on quality of life in up to 25% of those treated for cancer, and GI side effects are the most common and troublesome.

The cancer burden in the Nordic European countries remains substantial, but new treatment approaches, such as targeted therapy, have increased the survival of cancer patients. During and following cancer treatment regimens, however, patients' quality of life may be severely affected by sequelae, including cutaneous adverse events (cAEs). Overall, practical clinical tools for the management of cAEs in cancer patients and survivors have been lacking.