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NCCN Flash Updates™: NCCN Guidelines® Updated

NCCN has published NEW NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) with NCCN Evidence Blocks™ for the following disease type:

  • Non-Small Cell Lung Cancer, V4.2016


NCCN has published updates to the NCCN Guidelines® for Prostate Cancer Early Detection. These NCCN Guidelines are currently available as Version 1.2016.

  • Baseline evaluation (PROSD-2)
    • Included a bullet for “Family history of BRCA 1/2 mutations.”
    • Added a new footnote to Race: “African-American men have a higher incidence of prostate cancer, increased prostate cancer mortality, and earlier age of diagnosis compared to Caucasian-American men. However, the effects of earlier or more intensive screening on cancer outcomes and on screening-related harms in African-American men remain unclear. Therefore, although these men may require a higher level of vigilance and different considerations when analyzing the results of screening tests, the panel cannot provide separate screening recommendations for these men until more data become available.”
    • For men age > 75 y, PSA <3 ng/mL, DRE normal (if done), and no other indications for biopsy, changed repeat testing at 1-2 y intervals to “Repeat testing in select patients at 1-4 year intervals.”


  • Indications for biopsy (PROSD-3)
    • Added a new footnote: “MRI is not recommended routinely prior to initial prostate biopsy, but emerging data suggest that, in men undergoing initial biopsy, targeting using MRI/ultrasound fusion may increase the detection of clinically significant, higher-risk (Gleason grade ≥ 4+3=7) disease while lowering the detection of lower-risk (Gleason sum 6 or lower-volume Gleason grade 3+4=7) disease. Siddiqui M, Rais-Bahrami S, Turkbey B, et al. Comparison of MRI/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer. JAMA 2015;313:390-7.”


  • Management of biopsy results (PROSD-4)
    • Follow-up recommendations for focal high-grade prostatic intraepithelial neoplasia were merged with those for benign biopsy results.
    • Follow-up for benign biopsy results were modified to read: “PSA and DRE at 6-24 month interval and Consider percent free PSA, 4Kscore, PHI, PCA3, or ConfirmMDx and/or Multiparametric MRI and/or refined prostate biopsy techniques. Repeat prostate biopsy, based on risk.”
    • Modified footnote “j”, added ConfirmMDx. Tests that improve specificity in the post-biopsy state—including 4Kscore, PHI, percent free PSA, PCA3, and ConfirmMDx—should be considered in patients thought to be higher risk despite a negative prostate biopsy.
    • Added a new footnote: “Emerging evidence suggests that use of multiparametric MRI and/or use of refined prostate biopsy techniques (image guidance using MRI/ultrasound fusion, transperineal, or saturation prostate biopsies) may be of value. These techniques may help identify regions of cancer missed on prior prostate biopsies and should be considered in selected cases after at least 1 negative prostate biopsy. Multiparametric MRI followed by lesion targeting may maximize the detection of higher-risk disease and limit the detection of lower-risk disease.”


For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), and the NCCN Chemotherapy Order Templates (NCCN Templates®), please visit


To access the NCCN Biomarkers Compendium™, please visit


To view the NCCN Guidelines for Patients®, please visit


Free NCCN Guidelines apps for iPhone, iPad, and Android tablets are now available! Visit


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