National Comprehensive Cancer Network

About NCCN

NCCN Guidelines for Non-Small Cell Lung Cancer Updated to Incorporate Maintenance Therapy


NCCN updates the NCCN Guidelines for Non-Small Cell Lung Cancer to include guidance on maintenance therapy, several new therapeutic recommendations for specific patients with Non-Small Cell Lung Cancer, and a revised staging system.


December 9, 2009

FORT WASHINGTON, PA — The National Comprehensive Cancer Network (NCCN) recently updated the NCCN Guidelines for Non-Small Cell Lung Cancer (NSCLC) to incorporate a new section about maintenance therapy, a number of new indications for specific therapies for advanced NSCLC, and the recently revised staging system for lung cancer. Lung cancer remains the leading cause of cancer death in the United States.

The updated NCCN Guidelines now include a description of maintenance therapy for patients with advanced or metastatic disease. Maintenance therapy refers to treatment that prevents a cancer from spreading after it has responded to initial treatments with chemotherapy (usually 4 to 6 rounds of treatment). This new section helps distinguish between recommended therapies for continuation maintenance versus switch maintenance.

Noteworthy updates to the NCCN Guidelines involving specific therapies for advanced NSCLC include:

  • The addition of erlotinib (Tarceva®, Genentech BioOncology and OSI Oncology) as a first-line treatment option for EGFR mutation positive patients with advanced or metastatic disease.
  • Bevacizumab (Avastin™, Genentech BioOncology) and cetuximab (Erbitux®, Bristol-Myers Squibb Company and ImClone Systems Incorporated) have been added as treatment options for continuation maintenance with a category 1 designation.
  • Pemetrexed (Alimta®, Eli Lilly & Company) and erlotinib have been added as treatment options for switch maintenance with a category 2B designation and docetaxel (Taxotere®, sanofi-aventis, U.S.) has been added with a category 3 designation.

The international staging system for lung cancer was recently revised and has been incorporated into the updated NCCN Guidelines. Staging provides the basis for evaluating a patient’s prognosis and is a valuable aid in the treatment selection of patients with lung cancer. The revised system more accurately reflects a patient’s prognosis and current practice. The new staging will affect one out of every six lung cancer patients and takes effect January 1, 2010.

The 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