National Comprehensive Cancer Network

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NCCN Guidelines and Compendium Updated

NCCN Flash Update distributed November 29, 2012

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Chronic Myelogenous Leukemia (CML). These NCCN Guidelines® are currently available as Version 3.2013.

  • Bosutinib was added as a treatment option in the following circumstances:
    • Chronic phase CML
      • For patients with inadequate initial response to prior tyrosine kinase inhibitor (TKI) therapy
        • BCR-ABL transcript levels > 10% by QPCR using the International Scale (IS) or < partial cytogenetic response (PCyR) on bone marrow cytogenetics at 3 months
        • Less than complete cytogenetic response (CCyR) at 12 and 18 months
      • Continuation of therapy for patients (who have been switched to bosutinib as early as 3 months for inadequate initial response to prior TKI therapy) in CCyR 12 months and 18 months or PCyR at 12 months
      • Loss of response (increase in BCR-ABL transcript levels or cytogenetic relapse) at 6, 12 and 18 months
    • Disease progression to accelerated or blast phase CML on prior TKI therapy
    • Follow-up therapy for relapse following allogeneic HSCT
  • Omacetaxine was added as a treatment option for patients with chronic phase CML, accelerated phase CML and post-transplant relapse with resistance and/or intolerance to two or more TKIs.
  • Treatment options based on mutational status was updated with bosutinib and omacetaxine.
  • Toxicity management pages were added for bosutinib and omacetaxine.
  • The Discussion Section has been updated to reflect the changes in the algorithm.


For the complete updated versions of the NCCN Guidelines® and the NCCN Compendium®, please visit

To view the NCCN Guidelines for Patients®, please visit

To access free NCCN Guidelines mobile apps for iPhone and Android, visit

Now Available! The Virtual Library of NCCN Guidelines are now formatted for iPad and Android. Visit