National Comprehensive Cancer Network

NCCN Guidelines^® & Clinical Resources

NCCN Guidelines^® and Derivative Information Products: User Guide

The National Comprehensive Cancer Network® (NCCN®) is an alliance of 21 of the world's leading cancer centers, working together to develop treatment guidelines for most cancers, and dedicated to research that improves the quality, effectiveness, and efficiency of cancer care. NCCN offers a number of programs to give clinicians access to tools and knowledge that can help guide decision-making in the management of cancer.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®)

Over the past 15 years, NCCN has developed an integrated suite of tools to improve the quality of cancer care.  The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) document evidence-based, consensus-driven management to ensure that all patients receive preventive, diagnostic, treatment, and supportive services that are most likely to lead to optimal outcomes.

The NCCN Guidelines^® are a comprehensive set of guidelines detailing the sequential management decisions and interventions for the malignant cancers that affect 97 percent of all patients with cancer. In addition, separate guidelines relate to major prevention and screening topics and another set of pathways focuses on the major supportive care areas.

The NCCN Guidelines are composed of recommendations based on the best evidence available at the time they are derived.  Because new data are published continuously, it is essential that the NCCN Guidelines also be continuously updated and revised to reflect new data and new clinical information. The goal of the NCCN Guidelines is to help oncologists make the major clinical decisions encountered in managing their patients by providing ready access to synthesized information. The NCCN Guidelines provide recommendations for appropriate care for most but not all patients; however, individual patient circumstances must be considered when applying these recommendations.

The NCCN Guidelines are composed of several critical components:

• a list of panel members providing institutional affiliations and specialties,
• an algorithm or decision pathway outlining the step-by-step clinical decision-making process for patient management,
• a discussion describing the data the recommendations are based upon and the important issues considered in interpreting the data and developing the algorithm,
• references providing evidence on which recommendations are based, and
• disclosure of potential conflicts of interest of panel members, staff, and NCCN itself. 

The NCCN Guidelines are developed and updated by 44 individual panels, comprising nearly 900 clinicians and oncology researchers from the 21 NCCN Member Institutions and their affiliates.  These panel members are multidisciplinary, disease-specific subspecialists who are both clinicians and researchers.  In addition, each guideline undergoes annual institutional review where it is circulated among the multidisciplinary faculty for comment at each NCCN Member Institution. 

The panel members are supported by seven doctoral level and eight masters prepared NCCN staff who perform literature searches, draft and edit discussion sections of the NCCN Guidelines, and develop the algorithms to reflect the consensus of the panel members.  The effort is also supported by dedicated administrative personnel who perform a variety of scheduling and logistical tasks associated with maintaining a large, active program.

The NCCN Drugs & Biologics Compendium (NCCN Compendium^®)

The NCCN Drugs & Biologics Compendium (NCCN Compendium™) is based directly on the recommendations contained in the NCCN Guidelines and designed to support decision-making about the appropriate use of drugs and biologics in patients with cancer.

The NCCN Compendium® is recognized by the Centers for Medicare and Medicaid Services (CMS) and UnitedHealthcare as a mandated reference for oncology coverage policy. Managed care medical directors, pharmacy benefits directors, and other health care professionals also reference the NCCN Compendium when making decisions that impact patient access to appropriate therapy. All recommendations (at all category levels) in the NCCN Compendium constitute appropriate, medically-necessary care. The NCCN Compendium lists both FDA-approved uses and appropriate uses beyond the FDA-approved label.

The NCCN Compendium recommendations are derived and translated from the NCCN Guidelines by NCCN staff and approved by NCCN Guidelines panel members.  The goal of the compendium is to provide an easy to use resource for clinicians and payors to determine appropriate use of drugs and biologics across oncology practice.

NCCN Chemotherapy Order Templates (NCCN Templates^®)

NCCN is also developing a library of NCCN Chemotherapy Order Templates (NCCN Templates®) to improve the safe and effective use of drugs and biologics in cancer care by standardizing regimens, reducing medication errors, and facilitating the anticipation and management of adverse events. The NCCN Templates® are developed for regimens recommended in the NCCN Guidelines and the NCCN Compendium. The NCCN Templates include chemotherapy, immunotherapy, supportive care agents, monitoring parameters, and safety instructions. Special instructions for self-administered chemotherapeutic agents are also provided.

The most important precept to keep in mind as the NCCN Guidelines and other information products are being used is that they are dynamic documents and are reviewed and updated continuously to ensure up-to-date recommendations to support the safe and effective management of cancer.

Transparency of the NCCN Guidelines, the NCCN Compendium, and the NCCN Templates Development