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NCCN Flash Updates: NCCN Guidelines^® and NCCN Compendium^® Updated for Testicular Cancer

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), the NCCN Drugs and Biologics Compendium (NCCN Compendium^®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™) for Testicular Cancer. These NCCN Guidelines^® are currently available as Version 1.2021.

• Workup, Primary Treatment, and Pathologic Diagnosis (TEST-1)
  • Footnote e was added stating, “May consider testis-sparing surgery (ie, partial orchiectomy) in select patients. See Principles of Surgery (TEST-H).
• Stage IIA, IIB, IIC, III (TEST-4)
  • Footnote o was added stating, “For select cases of clinical stage IIA disease with borderline retroperitoneal lymph nodes, waiting 4–6 weeks and repeating imaging (chest/abdomen/pelvic CT with contrast) to confirm staging before initiating treatment can be considered. (Also for TEST-8 and TEST-10)
• Postchemotherapy Management (TEST-5)
  • A category of “Indeterminate” was added following “Results of PET/CT scan 6-8 weeks or more past chemotherapy” with a recommendation to “Repeat PET/CT scan in 6-8 weeks”
  • Footnote cc was added stating, “If still indeterminate, recommend following with CT scan or biopsy.”
  • Footnote dd was revised to state, “If PET/CT is borderline, consider surveillance and repeat PET/Ct or CT. See Principles of Imaging (TEST-I).
• Postchemotherapy Management (TEST-9)
  • “Preferred” was added to “Surveillance of negative markers, no mass, or residual mass <1 cm on CT scan
  • New pathway was added after “Nerve-sparing bilateral RPLND and Surveillance”
  • Footnote uu was added to this page and revised on TEST-11 and TEST-12 stating, “Patients who are at higher risk for bleomycin-related complications.”
• Postsurgical Management (TEST-10)
  • Added Stage IA and IB to this page
• Postchemotherapy Management of Partial Response to Primary Treatment (TEST-12)
  • Footnote ww was added stating, “If there is a teratoma with somatic-type malignancy, consider histology-directed therapy and referral to an academic center with a high volume germ cell tumor unit. (Also for TEST-14)
• Followup for Nonseminoma (TEST-B 1 of 3)
  • Footnote a was added stating, “Risk factors for recurrence include lymphovascular invasion or invasion of spermatic cord or scrotum. Some centers consider predominance of embryonal carcinoma as an additional risk factor for relapse.
• Third-Line Chemotherapy Regimens for Metastatic Germ Cell Tumors (TEST-G)
  • Under Useful in Certain Circumstances, “Pembrolizumab” was revised to “Pembrolizumab (for MSI-H/dMMR or TMB-H tumors)
• Principles of Surgery for Germ Cell Tumors (TEST-H 1 of 2 and TEST-H 2 of 2)
  • Significant changes were made to the Principles of Surgery for Germ Cell Tumors pages

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients^®, please visit NCCN.org/patientguidelines.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.

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