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Guidelines Planned on Management of Immunotherapy Side Effects: ASCO and NCCN to Collaborate on Development

(February 16, 2017) Given the pace of advances in immunotherapy in recent years and physicians’ need to keep up with these developments, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network® (NCCN®) announce a joint collaboration to publish practical clinical guidance on the management of side effects caused by immunotherapy.

Through this novel collaboration, two of the leading providers of clinical practice guidelines in oncology aim to rapidly support improved quality of care for the growing number of patients receiving immunotherapy treatment for cancer.

Immunotherapy is increasingly identified as the best option for a growing number of cancers, many of which were previously intractable. The greatest success so far has been with immune checkpoint inhibitors and the U.S. Food and Drug Administration (FDA) has approved 15 indications for these agents over the last five years. Immunotherapy usage is likely to increase as we recognize encouraging results with several other specific classes of agents.

As with all therapies, there are both common and rare toxicities that clinicians need to consider when using immunotherapies. Clinicians may need guidance to recognize and optimally manage the novel and sometimes unique side effects caused by this relatively new type of treatment.    

“We have an opportunity to better serve our members and the entire oncology community by collaborating between ASCO and NCCN to rapidly produce this guideline that addresses an issue that is new for many clinicians,” said Clifford A. Hudis, MD, FASCO, FACP, ASCO Chief Executive Officer. “ASCO and NCCN share the common goal of high-quality patient care, and we look forward to working together to improve the quality of care for the millions of people affected by cancer.”

“In this age of rapid innovation in cancer care and introduction of novel immunotherapies, NCCN and ASCO recognize the crucial need to support physicians’ decision-making through publication of timely, evidence-based clinical guidelines,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “We anticipate that, through our common mission, the collaboration between NCCN and ASCO indeed will improve the lives of patients with cancer.”

The side effects of immunotherapy are generally mild and infrequent, but when they do occur, they can be serious and even life threatening if not identified and treated in a timely manner.  The commonly known immune-mediated side effects include:

  • Pneumonitis
  • Colitis
  • Hepatitis
  • Adrenal insufficiency
  • Rash
  • Hyper/hypothyroidism
  • Hypophysitis
  • Renal insufficiency

As these immune-mediated side effects are often different from the side effects associated with other traditional cancer treatments, it is important that clinicians know how to recognize and manage them. 

Working together, each organization will use its standard methodology to develop and publish clinical practice guidelines under the lead of a multidisciplinary expert panel. At time of completion, two separate guidelines will be published: ASCO systemic review-based guideline and NCCN algorithmic guidelines. These guidelines are expected later this year.

More information about NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) is available at


About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit

The NCCN Member Institutions are:

  • Abramson Cancer Center at the University of Pennsylvania
  • Fred & Pamela Buffett Cancer Center
  • Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
  • City of Hope National Medical Center
  • Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
  • Duke Cancer Institute
  • Fox Chase Cancer Center
  • Huntsman Cancer Institute at the University of Utah
  • Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University
  • Mayo Clinic Cancer Center
  • Memorial Sloan Kettering Cancer Center
  • Moffitt Cancer Center
  • The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
  • Roswell Park Comprehensive Cancer Center
  • Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
  • St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
  • Stanford Cancer Institute
  • University of Alabama at Birmingham Comprehensive Cancer Center
  • UC San Diego Moores Cancer Center
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • University of Colorado Cancer Center
  • University of Michigan Rogel Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • University of Wisconsin Carbone Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • Yale Cancer Center/Smilow Cancer Hospital