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A study out of Sweden finds that people diagnosed with localized prostate cancer are unlikely to die from the cancer if they are treated according to NCCN Guidelines.

PLYMOUTH MEETING, Pa., July 10, 2025 /PRNewswire/ — New research in the July 2025 issue of JNCCN—Journal of the National Comprehensive Cancer Network finds that for people diagnosed with nonmetastatic low-risk prostate cancer later in life, and treated according to NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), 90% were likely to survive their cancer for their remaining life-expectancy. Of those with nonmetastatic higher-risk cancer and a longer life expectancy, that likelihood was still greater than 65%.

The researchers studied 62,839 people diagnosed with non-metastatic prostate cancer in Sweden between the years 2000-2020. All were placed within a defined risk category, had a life expectancy of more than three years, and were treated according to evidence-based, expert consensus-driven recommendations from the NCCN Guidelines^® for Prostate Cancer. Those with low- and intermediate-risk cancer were six times more likely to die of other causes than prostate cancer. Those with high-risk cancer were still twice as likely to die of other causes.

“Our data support adherence to guideline recommendations for treatment of prostate cancer,” said lead researcher Pietro Scilipoti, MD, of Uppsala University in Sweden and IRCCS San Raffaele Hospital in Italy. “If guideline-recommended treatment is used, most people with prostate cancer will live for many years after diagnosis. That includes active surveillance as an excellent treatment strategy for appropriately selected people.”

The Gleason score/Grade Group, clinical TNM stage, treatment data, and other information for the study came from the National Prostate Cancer Register (NPCR) of Sweden. Life expectancy at the time of diagnosis was calculated based on age and comorbidity. Date and cause of death were taken from the Cause of Death Register.

“This study offers a big sigh of relief for many men facing a prostate cancer diagnosis,” commented Ahmad Shabsigh, MD, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Member of the NCCN Guidelines Panel for Prostate Cancer, who was not involved with this research. “It reveals that with NCCN Guidelines-recommended treatment, you’re significantly more likely to die from something else—up to six times more likely, in fact—even if your cancer is high-risk. This holds true even when looking at data from a different healthcare system, like Sweden’s. What’s truly striking is that for patients with low-risk prostate cancer, many of whom were on active surveillance, the 30-year mortality risk from the cancer itself was only about 11%. It really underscores the power of evidence-based treatment plans and the importance of focusing on a person’s overall health, not just their cancer.”

To read the entire study, “Long-Term Outcomes After Guideline-Recommended Treatment of Men With Prostate Cancer,” visit JNCCN.org.

The NCCN Guidelines for Prostate Cancer are now available in an interactive digital delivery format with advanced search capabilities. Learn more about the new NCCN Guidelines Navigator™ at NCCN.org/navigator.

For people facing prostate cancer and their loved ones, NCCN offers two NCCN Guidelines for Patients^® focused on this disease type, separated into Early and Advanced Stage. An independent study found them to be among the most trustworthy online resources for patients and caregivers, worldwide. They are available for free at NCCN.org/patientguidelines thanks to funding from the NCCN Foundation^®.

About JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside/BroadcastMed. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. Follow JNCCN at x.com/JNCCN.

About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network^® (NCCN^®) is marking 30 years as a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to defining and advancing quality, effective, equitable, and accessible cancer care and prevention so all people can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) provide transparent, evidence-based, expert consensus-driven recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients^® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation^®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit NCCN.org for more information.

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A new allergy medication is prompting clinicians to adjust their approach to oral food challenges — medically supervised tests in which clinicians give increasing doses of an allergen like peanut or milk to see how a patient reacts.

The FDA in 2024 approved omalizumab (Xolair) to help reduce allergic reactions in adults and children aged 1 year or older with immunoglobulin E-mediated food allergy. Patients receiving the injections are supposed to avoid foods to which they are allergic. In the event of an accidental exposure, the medication can afford protection against a serious reaction.

The approval opened a new frontier in allergy therapy but also raised questions without clear answers, like: How can patients be sure the medication is working? And how will they know if they “outgrow” an allergy, as some people do? 

After the approval, clinicians wrote to the American Academy of Allergy, Asthma & Immunology seeking advice.

Earlier this year, a committee for the academy published a report with “consensus-based guidance” on using omalizumab for food allergy and acknowledged that clinical guidance will likely evolve as groups monitor and report real-world outcomes.

In the meantime, the committee suggested that various approaches to treatment, including the use of oral food challenges to assess treatment response, could be used.

“Clinicians should consider assessing treatment success against individualized goals that the patient and prescribing clinician have set for therapy,” they wrote.

Any food challenges “to assess treatment response should be offered no earlier than 16-20 weeks after initiating omalizumab therapy,” the duration of treatment in a randomized trial that supported the drug’s approval for food allergy, they wrote. “In nonresponding patients, the clinician should strongly consider discontinuation of omalizumab given lack of benefit.”

Although its use for food allergy is relatively new, omalizumab is not a new medication. The drug first was approved for asthma in 2003. The drug also is approved to treat chronic spontaneous urticaria and chronic rhinosinusitis with nasal polyps.

‘Bite Safe’ Testing?

Scott Sicherer, MD, director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York City, fielded the inquiry when a clinician wrote to the American Academy of Allergy, Asthma, & Immunology’s “Ask the Expert” column last year wondering: “With recent approval of Xolair for management of food allergies, how do we approach food challenges?” 

In some cases, additional food challenges make sense before starting omalizumab to confirm or rule out possible allergies, so patients are not avoiding certain foods unnecessarily while on therapy, responded Sicherer, who coauthored a 2024 paper in The New England Journal of Medicine about omalizumab for the treatment of multiple food allergies.

After starting therapy, a scaled back food challenge to determine whether treatment has rendered an allergen “bite safe” might be reasonable, added Sicherer, meaning a patient could accidentally have a bite of the food in question without a severe reaction.

“Given that the commitment to treatment includes time and expense and there are no good biomarkers yet, and a small percentage of people do not respond, I think many patients would like an [oral food challenge] to some agreed upon amount of the food, perhaps something they would view as ‘bite safe,’” Sicherer wrote in his response. “If the treatment is not protecting them to small amounts, why continue?”

The exact parameters of such a test could depend on the patient’s goals, Sicherer told Medscape Medical News.

Some patients might simply look for reassurance that they could eat half a peanut without a problem.

If that is the case, “maybe that is what we would aim for,” Sicherer said. “It’s not like there is a rule written down about this.”

Introducing Egg

Sicherer’s reply also discussed ways to handle a scenario where a patient on omalizumab had egg, cashew, and peanut allergies — with the egg allergy expected to resolve.

One approach could involve discontinuing omalizumab for at least 4-5 months before performing an oral food challenge with egg, he wrote.

Alternatively, clinicians might conduct a food challenge with egg while the patient remains on omalizumab.

If they tolerate the full amount of egg on therapy, they could be encouraged to eat that food regularly, Sicherer said.

Then if the patient eventually stops omalizumab and has symptoms after eating egg, then perhaps the allergy never resolved, he added.

Shared Decisions

Understanding a family’s goals and preferences is crucial, said Jennifer Dantzer, MD, assistant professor of pediatrics in the Division of Allergy, Immunology, and Rheumatology at Johns Hopkins University School of Medicine in Baltimore.

Decisions about food challenges for patients on omalizumab is “something that we are talking through with every family,” said Dantzer, who has studied the medication and coauthored the article in The New England Journal of Medicine with Sicherer.

The definition of treatment success can vary. In some cases, a child might be able to consume a full serving of an allergen. Or a patient might react to a relatively small amount but have a reaction that is far less severe than before.

Either instance could be deemed a success. Results from food challenges can provide reassurance that certain activities like dining out are now lower risk, Dantzer said.

For now, clinicians have no firm guidelines about when to reassess therapy or consider adjusting the dose. “I think the allergy community would like there to be a bit more guidance,” Dantzer said. “Hopefully with time that will become available.”

Sicherer’s institution received funding for participating in a trial of omalizumab for food allergy. Dantzer’s research on patient-centered outcomes is supported by grants from the National Institutes of Health and Food Allergy Research & Education.

Video content above is prompted by the following:

All-oral combination regimens represent a transformative advancement in chronic lymphocytic leukemia (CLL) treatment, offering patients fixed-duration therapy options without requiring intravenous infusions. These combinations, particularly BTK inhibitors paired with venetoclax, are revolutionizing the treatment landscape by providing convenient, effective therapy that significantly improves patient quality of life. The elimination of intravenous requirements reduces clinic visit frequency and allows greater treatment flexibility, making therapy more accessible and manageable for patients with CLL.

The most significant advancement with oral combination therapies is their efficacy in high-risk CLL populations, particularly patients with TP53 mutations or 17p deletions. While the CAPTIVATE study showed limitations for ibrutinib-venetoclax combinations in high-risk patients, newer trials like AMPLIFY with acalabrutinib-venetoclax and SEQUOIA with zanubrutinib-venetoclax demonstrate improved outcomes in these challenging cases. These regimens appear to address the critical unmet need for effective treatments in high-risk CLL, offering hope for previously difficult-to-treat patient populations.

Selecting from available oral combination regimens requires consideration of patient-specific factors, including genetic risk profiles, comorbidities, and individual tolerance concerns. For patients with TP53/17p abnormalities, zanubrutinib-venetoclax may be preferred based on SEQUOIA data, while other factors like hypertension management might influence Bruton tyrosine kinase inhibitor selection. The availability of multiple effective oral combinations allows for truly personalized CLL treatment approaches, matching regimen characteristics to individual patient needs and disease characteristics for optimal outcomes.