National Comprehensive Cancer Network

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Now Available! New NCCN Framework™ for Non-Small Cell Lung (Preliminary), Gastric, Hepatobiliary, and Prostate Cancers

By Jorge Bacigalupo, Global Business Development Specialist, NCCN

The National Comprehensive Cancer Network® (NCCN®) has published the NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework™) for Gastric, Hepatobiliary and Prostate Cancers and the Preliminary NCCN Framework™ for Non-Small Cell Lung Cancer.

The NCCN Framework™ guides evidence-based adaptation to available clinical treatment resources. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) are used widely around the world, including in a number of low- and middle-income countries (LMICs) where certain diagnostic tests and/or treatment approaches may be unavailable. The goal of the NCCN Framework™ is to define appropriate treatment pathways at four resource levels—Basic, Limited, Enhanced, and NCCN Guidelines®—and deliver a tool for health care providers to identify treatment options that will provide the best possible outcomes given specific resource constraints.

The NCCN Framework™ outlines a rational approach for building cancer management systems to provide the highest achievable level of cancer care by applying available and affordable services in a logical sequence. Each level builds on the one before it, providing a framework for improving cancer care with incremental changes to the allocation of resources. Treatment recommendations applicable to each level of the NCCN Framework™ can be viewed within the context of the parent NCCN Guidelines.

The four levels of NCCN Framework™ resources are defined as:

  • Basic: Essential services needed to provide basic minimal standard of care\
  • Limited: Services from the Basic Level and additional services that provide major improvements in disease outcomes, e.g. survival, that are not cost prohibitive
  • Enhanced: Services from the Limited Level and additional services that provide lesser improvements in disease outcomes and/or services that provide major improvements in disease outcomes but are cost prohibitive at lower resource levels
  • NCCN Guidelines: The parent NCCN Guidelines are evidence-based, consensus-driven recommendations made by the NCCN Guidelines panels. They include services from the Enhanced Level and additional services that provide minor improvements in disease outcomes, interventions that are cost prohibitive at lower resource levels, and/or services that do not provide improvement in disease outcomes but are desirable services.

NCCN believes that if higher-level resources are available, providers should use the higher level. If basic level cancer treatments or higher are unavailable, palliative and best supportive care should be provided.

NCCN develops and maintains 62 NCCN Guidelines for cancer prevention, detection, treatment, and supportive care, as well as more than 70 translations of NCCN Content in 13 languages and several international adaptations that allow for consideration of biologic differences in populations, local accessibility, and regulatory status of interventions used in specific global regions.

NCCN Framework™ for Cervical, Gastric, Hepatobiliary, and Prostate Cancers and the preliminary versions of Breast and Non-Small Cell Lung Cancers are available at NCCN.org/framework.