National Comprehensive Cancer Network

About NCCN

Updated NCCN Framework™ for Breast and Non-Small Cell Lung Cancers

By Jorge Bacigalupo, Global Business Development Specialist, NCCN

The National Comprehensive Cancer Network® (NCCN®) has finalized and published the NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework™) for Breast and Non-Small Cell Lung Cancers.

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 based on available resources—Basic, Core, 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.

Why resource stratification?

  • 57% of cancer and 65% of cancer deaths happen in low- to mid-level resource regions of the world
  • To extend the use of NCCN Guidelines in regions with limited resources
  • To provide treatment recommendations applicable to different levels of health-care resources preserving the context of the full NCCN Guidelines
  • To provide a framework for adding health-care resources to efficiently improve patient outcomes

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

The NCCN Framework™ resources are defined as:

  • Basic Resources: Essential services needed to provide basic minimal standard of care.
  • Core Resources (formerly limited): Resources provided in the Basic Resources Framework plus additional services that provide major improvements in disease outcomes (e.g. survival) and that are not cost prohibitive.
  • Enhanced Resources: Resources provided in the Core Resources Framework and additional services that provide lesser improvements in disease outcomes and/or services that provide major improvements in disease outcomes but are cost prohibitive in lower resource settings.
  • NCCN Guidelines: The NCCN Guidelines are evidence-based, consensus-driven recommendations made by the NCCN Guidelines panels. They include services from the Enhanced Resources

Framework and additional services that provide minor improvements in disease outcomes, interventions that are cost prohibitive in lower resource settings, and/or services that do not provide improvement in disease outcomes but are desirable services.

NCCN believes that the best available resources should be provided. If Basic Resources for cancer treatment are unavailable, palliative and best supportive care should be provided.

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

To learn more about NCCN’s global initiatives, including how to distribute and/or support translation of the NCCN Framework, please contact Jorge Bacigalupo, Global Business Development Specialist, NCCN: bacigalupo@nccn.org.