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National Comprehensive Cancer Network

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NCCN Guidelines and Compendium Updated

NCCN Flash Update distributed November 21, 2012

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®) for Bladder Cancer. These NCCN Guidelines® are currently available as Version 1.2013.

  • For the primary treatment for cT2 disease, the radical cystectomy treatment option was modified by adding: "Radical cystectomy and strongly consider neoadjuvant cisplatin-based combination chemotherapy (category 1)."
  • The Principles of Chemotherapy Management was extensively reorganized and revised including:
    • Separating recommendations for first-line perioperative chemo therapy (neoadjuvant or adjuvant) and first-line chemotherapy for metastatic disease.
    • Perioperative chemotherapy (neoadjuvant or adjuvant), the following combination regimen was added: CMV (cisplatin, methotrexate, and vinblastine) as a category 2A recommendation.
    • Perioperative chemotherapy (neoadjuvant or adjuvant), the following statement was added: "DDMVAC (dose-dense) is preferred over standard MVAC-based on category 1 evidence showing DDMVAC to be better tolerated and more effective than conventional MVAC in advanced disease. Based on these data, the traditional dose and schedule for MVAC is no longer recommended.”
    • First-line chemotherapy for metastatic disease, alternative regimens option were added: "Carboplatin- or taxane-based regimens, or single-agent chemotherapy (category 2B).”
    • Second-line chemotherapy for metastatic disease, the following statement was added: "Depending on first-line treatment received, single-agent taxane or gemcitabine is preferred for palliation in this setting.”
  • 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 Drugs and Biologics Compendium (NCCN Compendium®), please visit NCCN.org.

To view the NCCN Guidelines for Patients®, please visit NCCN.com.

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

Now Available! The Virtual Library of NCCN Guidelines are now formatted for iPad. Visit NCCN.org/mobile/tablet.asp.