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NCCN Flash Update: NCCN Guidelines for B-cell Lymphoma

 

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and NCCN Drugs & Biologics Compendium (NCCN Compendium®) for B-Cell Lymphomas. These NCCN Guidelines® are currently available as Version 7.2017.

  • Follicular Lymphoma, histologic transformation to DLBCL
    • Minimal or no prior chemotherapy prior to histologic transformation (FOLL-6)
      • Axicabtagene ciloleucel was added as an option after ≥2 chemoimmunotherapy regimens including at least one anthracycline-based or anthracenedione-based regimen, unless contraindicated for the following indications:
        • Partial response (PR)
        • No response (NR) or progressive disease
      • After complete response (CR), PR, and NR or progressive disease, "relapsed or progressive disease" was added with a link to FOLL-7 (multiple prior therapies prior to histologic transformation)
      • Footnote u was revised by adding, "Axicabtagene ciloleucel is not an appropriate treatment option for patients with a CR." (Also for FOLL-7)
      • Footnote w was added, "See Guidance for Treatment of Patients with Chimeric Antigen Receptor (CAR) T-Cell Therapy (BCEL-D)." (Also for FOLL-7)
    • Multiple prior therapies prior to histologic transformation (FOLL-7)
      • "Axicabtagene ciloleucel, if not previously given” was added as an option after ≥2 prior chemoimmunotherapy regimens including at least one anthracycline-based or anthracenedione-based regimen
      • If progressive disease after observation or transplant, "candidate for additional therapy" was added.
      • "No response or progressive disease" with an arrow to “candidate for additional therapy” was added.
      • Footnote y was added, "Data on transplant after treatment with axicabtagene ciloleucel are not available. HDT/ASCR is not recommended after axicabtagene ciloleucel. Allogeneic HCT could be considered but remains investigational."

 

  • Diffuse Large B-Cell Lymphoma
    • Relapsed/refractory disease (BCEL-6)
      • Axicabtagene ciloleucel was added as an option for the following indications:
        • Partial response, no response, or progressive disease following second-line therapy in patients with intention to proceed to high-dose therapy with autologous stem cell rescue (HDT/ASCR).
        • Relapse 2 or greater (if not previous given).
      • Footnote bb was added, "Some NCCN Member Institutions require a complete metabolic response in order to proceed to high-dose therapy with autologous stem cell rescue."
      • Footnote ee was added, "See Guidance for Treatment of Patients with Chimeric Antigen Receptor (CAR) T-Cell Therapy (BCEL-D)."
    • Primary Mediastinal Large B-Cell Lymphoma (BCEL-B 1 of 4)
      • Axicabtagene ciloleucel was added as an option for relapsed/refractory disease.
    • Double Hit Lymphomas (BCEL-B 3 of 4)
      • Axicabtagene ciloleucel was added as an option for relapsed/refractory disease.
    • Guidance for Treatment of Patients with Chimeric Antigen Receptor (CAR) T-Cell Therapy (BCEL-D)
      • Information related to axicabtagene ciloleucel has been added for
        • Patient selection
        • Cytokine release syndrome management
        • Neurologic toxicity management
        • Prolonged cytopenias
        • Hypogammaglobulinemia

 

*For your reference, the previous update (Version 6.2017) to the NCCN Guidelines for B-Cell Lymphomas, published on November 15, 2017, is available at the following link: https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf

 

NCCN has published updates to the following NCCN Guidelines with NCCN Evidence Blocks™:

  • Kidney Cancer, Version 2.2018

 

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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