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NCCN Posts Comparative Effectiveness White Paper for Public Comment


The National Comprehensive Cancer Network (NCCN) has posted a draft white paper for public comment that details a draft paradigm for near-term comparative effectiveness clinical evaluations based upon existing data. The document introduces the NCCN Comparative Therapeutic Index™ (CTI), a consensus-based process that compares the risk-versus-benefit of different treatment options recommended in the NCCN Clinical Practice Guidelines in Oncology™. The paper will be posted for public comment through November 23, 2009.


November 9, 2009

FORT WASHINGTON, PA — Drawing on the expertise from the world’s thought leaders in oncology, the National Comprehensive Cancer Network (NCCN) Oncology Comparative Effectiveness Work Group has developed a systematic process for applying existing data in comparative effectiveness clinical evaluations in the field of oncology that will benefit both physicians and patients. These recommendations are detailed in a draft white paper currently posted on NCCN.org that will be available for public comment through November 23, 2009.

The NCCN Clinical Practice Guidelines in Oncology™ are widely recognized and used as the standard of care in oncology in both the academic and community settings and significantly influence appropriate practice patterns, prescribing behavior, and coverage policy. With ready access to oncology experts in all relevant specialties, NCCN convened the NCCN Oncology Comparative Effectiveness Work Group comprised of expert members representing patients, clinicians, managed care, pharma/biotech, and health policy with the intent of driving the national policy process on comparative effectiveness and improving patient care.

The NCCN Work Group drafted a white paper, entitled The `NCCN Comparative Therapeutic Index™` as a Paradigm for Near Term Comparative Effectiveness Analyses of Existing Data in Oncology”, which introduces the NCCN Comparative Therapeutic Index™ (CTI). The NCCN CTI is a clinical evaluative method that communicates the ratio of the effectiveness of a proposed treatment versus its potential toxicity. Resource utilization issues are also addressed in the document.

The NCCN CTI model is based upon the evaluation of available scientific data integrated with the expert judgment of leading oncologists. The implementation of the NCCN CTI is proposed to be a gradual, progressive approach with an eventual goal of system-wide adoption into all of the NCCN Guidelines. Given the NCCN Guidelines’ stature and credibility in the cancer community, the NCCN Work Group believes they serve as an ideal channel to disseminate comparative effectiveness results for adoption into practice.

The NCCN Work Group will consider the public’s feedback and develop a second iteration of the white paper that will be presented at the NCCN Oncology Summit on December 7, 2009.

NCCN seeks to continue its leadership role in developing and communicating scientific, evaluative information to inform and improve decision-making to assure that patients have available the safest and most effective options for their cancer care.

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