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National Comprehensive Cancer Network

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NCCN Flash Updates: NCCN Guidelines®, NCCN Compendium®, and the NCCN Imaging AUC™ for Anal Carcinoma

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), NCCN Drugs & Biologics Compendium (NCCN Compendium®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™) for Anal Carcinoma. These NCCN Guidelines® are currently available as Version 1.2020.

  • Anal Canal Cancer (ANAL-1)
    • “Consider fertility risk discussion/counseling in appropriate patients” was added to Workup. Also for ANAL-2.
    • Modified docetaxel/cisplatin/fluorouracil (category 2B) was added as a treatment option for metastatic disease. Also for ANAL-2, ANAL-3, and ANAL-4.
  • Follow-up and Surveillance (ANAL-3)
    • Surveillance for complete remission, 4th bullet was updated: Chest/abdominal/pelvic CT with contrast or chest CT without contrast and abdominal/pelvic CT or MRI with contrast annually for 3 y.
    • “± RT” was removed from treatment of metastatic disease. Also for ANAL-4.
    • Surveillance: “with contrast” was added to abdominal/pelvic MRI. Also for ANAL-4.
    • Footnote k is new: “Palliative RT may be considered in symptomatic patients. Records of previous RT should be carefully reviewed and considered prior to potential re-irradiation of previously irradiated fields. See Principles of Radiation Therapy (ANAL-C).” Also for ANAL-4.
  • Principles of Systemic Therapy (ANAL-B)
    • A second dosing option was added for carboplatin + paclitaxel with appropriate reference:
      Carboplatin AUC 5 IV day 1
      Paclitaxel 80 mg/m2 IV day 1, 8, 15
      Repeat every 28 days
    • Dosing for Modified DCF was added with appropriate reference.
      Docetaxel 40 mg/m2 IV day 1
      Cisplatin 40 mg/m2 IV day 1
      Fluorouracil 1200 mg/m2/day x 2 days
      (total 2400 mg/m2 over 46–48 hours)
      Repeat every 2 weeks
    • References have been updated.
  • Principles of Radiation Therapy (ANAL-C)
    • Table 1 and Table 2 are new.


For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (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/patientguidelines.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.

About NCCN Flash Updates™

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