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Solid carcinoma — Clinical Guidelines

Overview

Solid carcinoma encompasses a broad range of malignancies originating from solid tissues, impacting various organs and requiring multifaceted management strategies including genomic profiling, immunotherapy, and supportive care. 2 7 10

Diagnosis

Genomic Tumor Profiling: Essential for identifying prognostic and predictive biomarkers, aiding in personalized treatment selection 2.

Pathological Assessment: Utilization of supervised foundation models in computational pathology to enhance diagnostic accuracy and biomarker evaluation 1.

Imaging Studies: CT, MRI, PET scans for staging and monitoring disease progression 7.

Management

First-Line Treatments: Varies by cancer type but often includes chemotherapy, targeted therapies, and immunotherapy based on genomic profiles 2 10.

Supportive Care: Prophylactic measures for venous thromboembolism (VTE) using Khorana score for risk stratification 4.

End-of-Life Care: Minimizing aggressive interventions; focus on symptom management and palliative chemotherapy judiciously 6 8.

Special Populations

Solid Cancer Patients and COVID-19 Vaccination: Tailored vaccination strategies needed due to altered immune responses 3.

Children with Solid Tumors: Survival rates significantly improved through multidisciplinary approaches and advanced treatments 9.

Elderly Patients: Considerations for chemotherapy near the end of life due to potential negative impacts 8.

Key Recommendations

Harmonize Genomic Test Result Reporting: Implement standardized approaches for interpreting genomic test results to ensure equitable precision medicine 2 (Evidence: Strong).

Risk Stratification for VTE Prophylaxis: Use the Khorana score for identifying patients at high risk for cancer-associated VTE to guide prophylaxis 4 (Evidence: Moderate).

Minimize Aggressive Interventions at EOL: Focus on palliative care and symptom management rather than aggressive treatments in the last month of life 6 8 (Evidence: Moderate).

References

1 Nicke T, Schäfer JR, Höfener H, Feuerhake F, Merhof D, Kießling F et al.. Tissue concepts: Supervised foundation models in computational pathology. Computers in biology and medicine 2025. link 2 van de Haar J, Roepman P, Andre F, Balmaña J, Castro E, Chakravarty D et al.. ESMO Recommendations on clinical reporting of genomic test results for solid cancers. Annals of oncology : official journal of the European Society for Medical Oncology 2024. link 3 Hua T, Fan R, Fan Y, Chen F. Immune response of COVID-19 vaccines in solid cancer patients: A meta-analysis. Human vaccines & immunotherapeutics 2024. link 4 Yeung J, Tjokrowidjaja A, Lewis C, Lynch J. Survey of medical oncologists and trainee practice on venous thromboembolism prophylaxis and treatment in solid cancers. Internal medicine journal 2023. link 5 Shafiq M, Malhotra R, Teo I, Ozdemir S, Kanesvaran R, Malhotra C. Trajectories of physical symptom burden and psychological distress during the last year of life in patients with a solid metastatic cancer. Psycho-oncology 2022. link 6 Malhotra C, Bundoc F, Chaudhry I, Teo I, Ozdemir S, Finkelstein E. A prospective cohort study assessing aggressive interventions at the end-of-life among patients with solid metastatic cancer. BMC palliative care 2022. link 7 Tagliabue E. Special Issue: Micro- and Macro-Environmental Factors in Solid Cancers. Cells 2021. link 8 Sheng J, Zhang YX, He XB, Fang WF, Yang YP, Lin GN et al.. Chemotherapy Near the End of Life for Chinese Patients with Solid Malignancies. The oncologist 2017. link 9 Rechnitzer C. Increased survival of children with solid tumours: how did we get there and how to keep the success going?. Cancer imaging : the official publication of the International Cancer Imaging Society 2011. link 10 Tomlinson IP, Ilyas M. Molecular pathology of solid tumours: some practical suggestions for translating research into clinical practice. Molecular pathology : MP 2001. link 11 Connors TA. Has chemotherapy anywhere to go?. Cancer surveys 1989. link

Solid carcinoma