Citations

The NCCN Guidelines for Survivorship offer guidance for health care providers who care for survivors of adult-onset cancer. These guidelines include screening, evaluation, and treatment recommendations for common physical and psychosocial problems resulting from cancer and its treatment and provide a framework for care coordination. They also present guidance for helping cancer survivors to enhance their wellness and maintain a healthy lifestyle. This article summarizes the panel’s current recommendations and recent updates regarding anxiety, depression, distress, and trauma in cancer survivors.

Mesothelioma is a rare cancer that originates from the mesothelial surfaces of certain sites within the body. Pleural mesothelioma is the most common type and represents approximately 85% of mesotheliomas. The NCCN Guidelines for Mesothelioma: Pleural provide recommendations for evaluation and treatment in patients with pleural mesothelioma. The NCCN Guidelines will continue to be updated annually based on available clinical evidence and panel consensus.

Abstract Incretin‐based therapies, including glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) and dual incretin agonists, are increasingly used for the management of diabetes, obesity, and cardiometabolic disease. Although their systemic benefits are well established, uncertainty remains regarding their safety in patients with neuroendocrine neoplasms (NENs), a biologically heterogeneous group of tumors with diverse molecular profiles. Preclinical studies suggest that GLP‐1 receptor activation may promote tumor growth in select receptor‐expressing models, although receptor expression varies widely across NEN subtypes and is often absent in common tumors such as ileal neuroendocrine tumors. Population‐level and retrospective clinical data have not demonstrated a consistent increase in oncologic risk but are limited by methodological constraints. In this expert consensus statement, the authors synthesize current evidence and provide a practical framework for the use of incretin mimetics in patients with NENs. The authors emphasize individualized risk assessment, shared decision‐making, and multi‐disciplinary collaboration, balancing potential but unquantified oncologic risks against substantial cardiometabolic benefits. Until prospective data are available, careful patient selection, dose optimization, and close clinical and radiologic surveillance remain essential to guide safe and effective use of these agents in this population.

Background: Nasal and sinonasal findings have been reported in patients with Behçet’s syndrome, but their frequency, clinical significance, and relationship to underlying disease remain unclear. We performed a scoping review to map the published literature on epidemiology, clinical characteristics, and management. Methods: Following PRISMA-ScR guidance, we systematically searched MEDLINE, EMBASE, and Web of Science from inception through June 2026 for peer-reviewed primary studies reporting nasal or sinonasal findings in patients with Behçet’s syndrome. Two reviewers independently screened studies and extracted data. Results: Fifteen eligible studies, including seven case reports and eight observational studies, were identified. Reported frequencies of nasal or sinonasal findings varied substantially across studies. A spectrum of nasal and sinonasal symptoms was noted among the literature, including direct mucosal lesions, sinonasal symptoms and functional abnormalities such as olfactory impairment or delayed mucociliary clearance, and secondary nasal conditions occurring in patients with Behçet’s syndrome. Oral ulcers were consistently reported in the limited studies describing associated systemic features. Treatment data were sparse, and no evidence-based management approach specific to nasal disease was identified. Conclusions: The published literature suggests that a range of nasal and sinonasal findings may occur in patients with Behçet’s syndrome. However, the available evidence is sparse, heterogeneous, and insufficient to determine true prevalence, attribution, or optimal management. Future studies should distinguish direct Behçet-related nasal lesions from secondary or nonspecific findings and use standardized clinical assessment.

Abstract Objective Rituximab causes B‐cell depletion and hypogammaglobulinemia, increasing risk for infections. This study aims to determine the incidence of chronic rhinosinusitis (CRS) in patients following rituximab therapy. Study Design Retrospective cohort study using chart review of patients prescribed rituximab between January 2019 and January 2025. Setting Multisite study across Mayo Clinic Enterprise locations in Arizona, Florida, Minnesota, and Wisconsin. Methods Patients with documented rituximab use were included; those with pre‐existing CRS were excluded. Demographic and clinical data—including timing and duration of rituximab therapy, CRS diagnosis, comorbidities (asthma, allergic rhinitis, GERD), and need for sinus surgery—were collected. Descriptive statistics summarized patient characteristics. Group comparisons were performed using t ‐tests, Mann‐Whitney U , and chi‐square tests. Analyses were conducted using SPSS v28. Results Among 17,851 patients prescribed rituximab (median age 64.0 years, M:F ratio 1.1:1), 1105 (6.2%) developed CRS, with an annual incidence of 1.03% (1032 cases per 100,000 person‐years). The median duration of rituximab therapy for those diagnosed with CRS was 5.9 months (IQR, 0.5‐42.6). Most CRS cases occurred after rituximab discontinuation (62.7%, n = 693) compared to during active treatment (37.3%, n = 412). The median delay between rituximab discontinuation and CRS diagnosis was 17.0 months (IQR, 4.3‐41.7). Conclusions This study demonstrates an annual incidence of 1.03% for CRS diagnoses following rituximab. While prior studies report varying CRS incidences in the general population (0.25%‐0.73%), our findings suggest increased risk among rituximab users. Most CRS diagnoses occurred after rituximab discontinuation, emphasizing the need for a comprehensive medication history review during CRS evaluation.

Abstract Aim To confirm or refute recent pilot studies showing unexpectedly high rates of undetected heart failure (HF) in cardiology patients. Methods We assessed the prevalence, characteristics, and outcome of undetected HF in a large prospective cohort study of patients referred for non-invasive coronary artery disease (CAD) work-up with cardiac positron emission tomography computed tomography. HF presence and phenotype were centrally adjudicated by an independent cardiologist according to clinical practice guidelines requiring three mandatory criteria: symptoms, elevated natriuretic peptides, and structural/functional cardiac abnormalities. The endpoint was a composite of cardiovascular death and acute HF (AHF) hospitalization through 2-year of follow-up. Results Among 1738 eligible patients (median age 67 years, 30% women), 138 patients (7.9%) had known HF, and 534 of 1600 patients (33.4%) without known HF had adjudicated undetected HF, resulting in a ratio of undetected HF to known HF of 3.9 (95%CI, 3.2–4.7)-to-1 and a number needed to screen to detect one patient with undetected HF of 3.0 (95%CI, 2.9-3.1). In undetected HF, left ventricular ejection fraction (LVEF) was preserved in 72.3%, mildly reduced in 16%, and reduced in 11.7%. Older age, known CAD, atrial fibrillation, previous pacemaker implantation, and ECG abnormalities were associated with a higher likelihood for undetected HF. Undetected HF was associated with an increased cumulative incidence of the composite endpoint (adjusted subdistribution hazard ratio 7.37 [95%CI, 3.87-14.06], p<0.001, versus no HF). Conclusion One-out-of three patients referred for CAD work-up had undetected HF, which was associated with cardiovascular death and AHF hospitalization.

This article describes clinical, serologic, and histopathologic features of the first North American cohort of patients with positive anti-p200 serology identified at Mayo Clinic, Rochester, Minnesota, USA and Beutner Laboratories, Buffalo, New York, USA. Forty-seven patients were identified with positive p200 laminin beta 4 autoantibodies, detected with either immunoglobulin (Ig)G or IgG4 modified indirect immunofluorescence on HEK293 cells transfected with recombinant laminin beta.