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NCCN Flash Update: NCCN Guidelines® & NCCN Compendium® Updated

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Non-Small Cell Lung Cancer. These NCCN Guidelines® are currently available as Version 8.2017.

  • Metastatic Disease (NSCL-17)
    • Testing results
      • Adenocarcinoma, Large cell, NSCLC NOS: BRAF testing added
      • Squamous cell carcinoma: Consider BRAF testing added
         
  • Metastatic Disease – New page added for BRAF V600E mutation positive (NSCL-23)
    • First-line Therapy: Dabrafenib + trametinib or First-line therapy options as per NSCL-25 and NSCL-26.
    • Subsequent Therapy: Progression on dabrafenib + trametinib, recommendation is first-line therapy options as per NSCL-25 and NSCL-26. Progression on first-line therapy options, recommendation is dabrafenib + trametinib.
    • Footnote uu added: “At this point, there are no published data on the progression-free survival (PFS) of patients treated in the first-line setting.”
    • Footnote vv added: “Single-agent vemurafenib or dabrafenib are treatment options if the combination of dabrafenib + trametinib is not tolerated.”
    • Footnote ww added: “Although it may be reasonable to treat BRAF V600E positive tumors with first-line pembrolizumab if PD-L1 ≥ 50%, there are no data of its efficacy in this subgroup of patients. The data in the second-line setting suggest that immunotherapy is less effective, irrespective of PD-L1 expression, in tumors with an actionable mutation.”
       
  • Systemic Therapy for Advanced or Metastatic Disease (NSCL-F 2 of 4)
    • First-line Systemic Therapy Options; Adenocarcinoma, Large cell, NSCLC NOS (PS 0-1)
      • The following regimen added: pembrolizumab/carboplatin/pemetrexed.
      • Footnote ¶ added: If pembrolizumab not previously given.
         
  • Emerging Targeted Agents for Patients with Genetic Alterations (NSCL-H)
    • The following row removed: Genetic alteration BRAF V600E mutation and available targeted agents vemurafenib, dabrafenib ± trametinib. This information is now included on page NSCL-23.
       
  • The Discussion section has been updated to reflect the changes in the algorithm. (MS-1)

*For your reference, the previous update (Version 7.2017) to the NCCN Guidelines for Non-Small Cell Lung Cancer, published on June 22, 2017  is available at the following link: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients®, please visit NCCN.org/patients.

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