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NCCN Updates Guidelines for Central Nervous System (CNS) Cancers


NCCN recently updated the NCCN Guidelines for Central Nervous System (CNS) Cancers. Important new updates include the recommendation to use bevacizumab as a single agent for recurrent glioblastoma multiforme in CNS cancers, the integration of a patient’s Karnofsky Performance Status (KPS) score into treatment decisions, and an adjusted age range for adjuvant therapy options in patients with low grade gliomas.


May 18, 2009

FORT WASHINGTON, PA — The National Comprehensive Cancer Network (NCCN) announces new updates to the NCCN Clinical Practice Guidelines in Oncology™ for Central Nervous System (CNS) Cancers. These changes reflect leading developments in the treatment of patients with central nervous system cancers and represent the standard of clinical policy in oncology in both community and academic settings.

Primary and metastatic brain tumors are heterogeneous with diverse outcomes and management strategies. Because of this variability, the NCCN Guidelines note that prognostic features and treatment options for brain tumors must be carefully reviewed for each patient.

For patients with glioblastoma multiforme, the most common and most aggressive type of primary brain tumor, the updated NCCN Guidelines now recommend bevacizumab (Avastin®, Genentech/Roche) as a single agent without irinotecan (Camptosar®, Pfizer) for recurrence/salvage therapy. Previously, bevacizumab was only an option when used in combination with irinotecan.

Another noteworthy change in the updated NCCN Guidelines for patients with glioblastoma multiforme is the integration of a patient’s Karnofsky Performance Status (KPS) score into the recommendation for adjuvant therapy. A KPS score is a standard way of measuring the ability of patients to perform ordinary tasks; the higher the score, the better the patient is able to carry out daily activities.

The new NCCN Guidelines adjusted the age range for patients with specific low grade gliomas who may consider fractionated external beam radiation therapy or chemotherapy as additional options to observation following maximal safe resection to 40 years and over. Previously, patients 45 and older were considered candidates for these adjuvant treatment options. For those under the age of 40, the NCCN Guidelines continue to recommend that patients remain under observation without any adjuvant therapy.

NCCN Clinical Practice Guidelines in Oncology™ are developed and updated through an evidence-based process with explicit review of the scientific evidence integrated with expert judgment by multidisciplinary panels of physicians from NCCN Member Institutions. The most recent version of this and all the NCCN Guidelines are available free of charge at NCCN.org.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 25 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit NCCN.org.

The NCCN Member Institutions are:

  • Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center
  • City of Hope Comprehensive Cancer Center
  • Dana-Farber/Brigham and Women's Cancer Center
    Massachusetts General Hospital Cancer Center
  • Duke Cancer Institute
  • Fox Chase Cancer Center
  • Huntsman Cancer Institute at the University of Utah
  • Fred Hutchinson Cancer Research Center / Seattle Cancer Care Alliance
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University
  • Mayo Clinic Cancer Center
  • Memorial Sloan-Kettering Cancer Center
  • Moffitt Cancer Center
  • The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
  • Roswell Park Cancer Institute
  • Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
  • St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
  • Stanford Cancer Institute
  • University of Alabama at Birmingham Comprehensive Cancer Center
  • UC San Diego Moores Cancer Center
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • University of Colorado Cancer Center
  • University of Michigan Comprehensive Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • Yale Cancer Center/Smilow Cancer Hospital