NCCN has published updates to the NCCN Guidelines and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Central Nervous System Cancers. These NCCN Guidelines are currently available as Version 1.2016.
- FLASCO
- August 8, 2016
- News
NCCN has published updates to the NCCN Guidelines and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Central Nervous System Cancers. These NCCN Guidelines are currently available as Version 1.2016.
- Anaplastic Gliomas (GLIO-2)
- The following adjuvant treatment option has been removed for 1p19q codeleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma: PCV or temozolomide chemotherapy (category 2B).
- Glioblastoma (GLIO-3 and GLIO-4)
- For patients with good performance status, post-operative adjuvant treatment options have been separated by MGMT (O6-methylguanine-DNA methyltransferase) promotor status.
- “Standard brain RT + concurrent temozolomide and adjuvant temozolomide + alternating electric field therapy” has been added as an adjuvant treatment option for patients with good performance status and either methylated or unmethylated/indeterminate MGMT promoter status, with the following footnote: “Alternating electric field therapy is only an option for patients with supratentorial disease.”
- Standard brain RT alone has been added as an adjuvant option for patients with good performance status and unmethylated/indeterminate MGMT promoter status.
- Adult Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumor (AMED-2)
- “Craniospinal RT + chemotherapy” has been added as an adjuvant therapy option for patients with a standard risk of recurrence.
- Primary CNS Lymphoma (PCNS-2)
- For patients with primary CNS lymphoma who receive induction therapy with a high-dose methotrexate-based regimen, “high-dose cytarabine + etoposide” has been added as a consolidation therapy option.
- Meningiomas (MENI-1)
- For small, asymptomatic meningiomas, the following treatment option has been revised: “Surgery if potential neurologic consequences and if accessible, followed by RT if WHO Grade III; consider RT for resected or incompletely resected WHO Grade II and consider RT for incompletely resected WHO Grade I if residual disease is potentially symptomatic.”
- For small, symptomatic meningiomas, the following treatment option has been revised: “Surgery if accessible, followed by RT if WHO Grade III; consider RT for resected WHO Grade II.“
- Limited (1-3) Metastatic Lesions (LTD-2)
- For patients with limited metastatic lesions and newly diagnosed/stable systemic disease or reasonable systemic treatment options, the following options for resectable disease have been changed to category 2A recommendations: Surgical resection, followed by WBRT or followed by SRS; or SRS alone; or SRS + WBRT.
- Footnote “h” has been revised to: “If an active agent exists (eg, cytotoxic, targeted, or immune modulating), trial of systemic therapy with good CNS penetration may be considered in select patients (eg, patients with small asymptomatic brain metastases who have not had prior systemic therapy).”
- Principles of Brain and Spinal Cord Tumor Radiation Therapy (BRAIN-C)
- Recommended radiation protocols have been revised for high-grade gliomas (grade III/IV), craniospinal radiation of ependymomas, WHO grade I meningiomas, and metastatic spine tumors.
- A new section has been added, titled: “Principles of brain tumor pathology.” (BRAIN-F)
- Imaging recommendations have been clarified throughout to include the following: appropriate timing/frequency of imaging, the site(s) to be imaged (eg, brain, spine), recommended imaging modality (eg, MRI, CT, PET/CT), and recommended alternatives if preferred imaging modality or contrast is contraindicated. Footnotes were added/revised to include links to more specific imaging recommendations on BRAIN-A.
For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Chemotherapy Order Templates (NCCN Templates®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.
To access the NCCN Biomarkers Compendium®, please visit NCCN.org/biomarkers.
To view the NCCN Guidelines for Patients®, please visit NCCN.org/patients.
Free NCCN Guidelines apps iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.
