Background: Immune-related adverse events (irAEs) are common toxicities of immune checkpoint inhibitors (ICIs) in non–small cell lung cancer (NSCLC), but their prognostic implications in older adults remain uncertain. Patients and Methods: We conducted a retrospective cohort study using SEER–Medicare (2010–2019). We included patients aged ≥66 years with locally advanced or metastatic NSCLC who initiated ICI monotherapy or chemoimmunotherapy from 2015–2017. Follow-up began at treatment initiation and continued until death, Medicare disenrollment, or December 31, 2019. The primary exposure was a clinically meaningful irAE, defined as an irAE diagnosis with evidence of systemic immunosuppressant use and/or treatment delay, or discontinuation. In secondary analyses, we categorized patients as having no irAE, an irAE managed without hospitalization, or an irAE requiring hospitalization. The primary outcome was overall survival. We estimated adjusted survival differences and restricted mean survival time using doubly robust causal inference methods. Results: The cohort included 5,304 patients (mean age, 75 years; 52.7% female; 81.9% White). Clinically meaningful irAEs occurred in 1,807 (34.1%) patients, with a median onset of 3.8 months (IQR, 1.1–9.4). Death occurred in 65.1% of patients with irAEs and 78.7% without irAEs, corresponding to an adjusted absolute survival benefit of 6.6% (95% CI, 5.3%–8.0%) and a 6.5-month gain in restricted mean survival time (95% CI, 5.6–7.4). In secondary analyses, irAEs managed without hospitalization showed the greatest benefit (odds ratio [OR], 0.44; 95% CI, 0.35–0.54), whereas irAE hospitalization was associated with attenuated benefit (OR, 0.94; 95% CI, 0.89–0.99). Conclusions: Among older adults with advanced NSCLC receiving ICIs, clinically meaningful irAEs were associated with improved overall survival, particularly when managed without hospitalization. These findings highlight the clinical importance of early recognition of immune-related toxicities; irAE-related hospitalization may identify a higher-risk group warranting closer monitoring and supportive care.
The Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) are a group of heterogenous hematologic malignancies characterized by the proliferation of blood cells and consist of myelofibrosis, polycythemia vera, and essential thrombocythemia. The NCCN Guidelines for MPN were developed as a result of meetings convened by a multidisciplinary panel with expertise in MPN, with the aim of providing recommendations for the comprehensive care of adults with these diseases. The panel of experts convenes at least once a year to discuss requested changes to the Guidelines and to evaluate emerging data. These Guideline Insights focus on some of the recent updates for myelofibrosis. J Natl Compr Canc Netw 2026;24(7):e260034 doi:10.6004/jnccn.2026.0034
The NCCN Clinical Practice Guidelines for Breast Cancer include recommendations for clinical management of patients with carcinoma in situ, invasive breast cancer, Paget's disease, Phyllodes tumor, inflammatory breast cancer, and management of breast cancer during pregnancy. The panel convenes annually to update recommendations based on a review of recently published clinical trials. This selection from the NCCN Guidelines for Breast Cancer focuses on the recommendations for the management of recurrent or stage IV (M1) metastatic breast cancer. It summarizes the treatment strategies stratified by tumor biology, including hormone receptor status and HER2 expression, as well as clinical factors such as prior therapy and disease-free interval. Throughout all treatment lines, supportive care, quality of life preservation, toxicity minimization, and clinical trial participation are emphasized as integral components of patient care.
Mantle cell lymphoma (MCL) is a heterogenous subtype of B-cell non-Hodgkin lymphoma (NHL). The treatment landscape of newly diagnosed MCL has evolved in recent years with the incorporation of covalent BTK inhibitors, sensitive assays for the assessment of measurable residual disease (MRD), and predefined maintenance or continuous therapy. Covalent BTK inhibitor-based regimens are also appropriate options for patients with previously untreated classic MCL with TP53 mutations. Pirtobrutinib (a highly selective noncovalent BTK inhibitor) and CAR T-cell therapy (brexucabtagene autoleucel or lisocabtagene maraleucel) have emerged as effective treatment options for refractory or progressive disease after prior treatment with covalent BTK inhibitors. This selection from NCCN Guidelines for B-Cell Lymphomas focuses on the recommendations for the diagnosis and treatment of MCL.
Esophageal cancer is the seventh leading cause of cancer-related deaths worldwide. Esophageal cancers are histologically classified as squamous cell carcinoma (ESCC) or adenocarcinoma (EAC), which differ in their etiology, pathology, tumor location, therapeutics, and prognosis. In patients with locally advanced or metastatic disease, systemic therapy can provide palliation, improve survival, and/or en-hance quality of life. The implementation of biomarker testing and immunotherapy has had a significant impact on clinical practice and pa-tient care. This selection from the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers highlights current recommendations for advanced ESCC, including the evolving landscape of first-line immunotherapy.
