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Inhibition of the anaplastic lymphoma kinase (alk) oncogenic driver in advanced non-small-cell lung carcinoma (nsclc) improves survival. In 2015, Canadian thoracic oncology specialists published a consensus guideline about the identification and treatment of ALK-positive patients, recommending use of the alk inhibitor crizotinib in the first line. New scientific literature warrants a consensus update. Clinical trials of alk inhibitor were reviewed to assess benefits, risks, and implications relative to current Canadian guidance in patients with ALK-positive nsclc. Randomized phase iii trials have demonstrated clinical benefit for single-agent alectinib and ceritinib used in treatment-na&iuml, ve patients and as second-line therapy after crizotinib. Phase ii trials have demonstrated activity for single-agent brigatinib and lorlatinib in further lines of therapy. Improved responses in brain metastases were observed for all second- and next/third-generation alk tyrosine kinase inhibitors in patients progressing on crizotinib. Canadian recommendations are therefore revised as follows: Multiple lines of alk inhibition are now recommended for patients with advanced nsclc with an ALK rearrangement.

Simple Summary Despite the strong association of the aggressive intraductal carcinoma of the prostate (IDC-P) with an increased risk of biochemical recurrence (BCR), around 40% of men remain BCR-free five years post-surgery. In this retrospective study, we aimed to evaluate the prognostic value of several morphological criteria of IDC-P using BCR as the endpoint. In multivariate analysis (validation cohort, n = 69), the presence of cells with irregular nuclear contours (CINC) or blood vessels was independently associated with an increased risk of BCR (hazard ratio [HR] 2.32, 95% confidence interval [CI] 1.09–4.96, p = 0.029). Furthermore, when combining the criteria, the presence of any CINC, blood vessels, high mitotic score, or comedonecrosis showed a stronger association with BCR (HR 2.74, 95% CI 1.21–6.19, p = 0.015). Provided that our findings are validated in larger cohorts, evaluation of morphologic features of IDC-P could serve as a risk stratification tool for patients with IDC-P. Abstract Intraductal carcinoma of the prostate (IDC-P) is an aggressive subtype of prostate cancer strongly associated with an increased risk of biochemical recurrence (BCR). However, approximately 40% of men with IDC-P remain BCR-free five years after radical prostatectomy. In this retrospective multicenter study, we aimed to identify histologic criteria associated with BCR for IDC-P lesions. A total of 108 first-line radical prostatectomy specimens were reviewed. In our test cohort (n = 39), presence of larger duct size (>573 µm in diameter), cells with irregular nuclear contours (CINC) (≥5 CINC in two distinct high-power fields), high mitotic score (>1.81 mitoses/mm2), blood vessels, and comedonecrosis were associated with early BCR (