NCCN Updates Breast Cancer Guidelines.Significant New Treatments Added JENKINTOWN, Pa. -- The National Comprehensive Cancer Network (NCCN) is proud to announce several new updates to the NCCN Clinical Practice Guidelines clinical practice guidelines Clinical policies, practice guidelines, practice parameters, practice policies Medtalk Systematically developed statements to assist practitioner and Pt decisions about appropriate health care for specific clinical circumstances. See Psychology. in Oncology(TM) for Breast Cancer. These changes highlight leading developments in the treatment of breast cancer and represent the recognized standard for clinical policy in oncology in both the community and the academic practice settings. Based on results from the NSABP NSABP National Surgical Adjuvant Breast Project Oncology A series of ongoing multicenter clinical trials evaluating the effects of various therapies, including RT, surgery and chemotherapy–eg, tamoxifen and 5-FU, in treating advanced breast or colorectal CAs Study of Tamoxifen and Raloxifene The Study of Tamoxifen and Raloxifene or STAR is a clinical trial designed determine how the drug raloxifene compares with the drug tamoxifen in reducing the incidence of breast cancer in postmenopausal women who are at increased risk of the disease. (STAR) trial, a panel of world-renowned experts added Raloxifene (Evista, Eli Lilly and Company Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company and one of the world's largest corporations. Eli Lilly's global headquarters is located in Indianapolis, Indiana, in the United States. ) as an option for reducing the risk of invasive breast cancer in postmenopausal women with lobular carcinoma in situ lobular carcinoma in situ Atypical lobular hyperplasia, LCIS Oncology A precancerous epithelial lesion of the female breast;1⁄3 of those with LCIS develop invasive CA; 8% of LCIS do not form a discrete mass. Cf Ductal carcinoma in situ. . The accuracy of HER2 assays used in clinical practice is a major concern, and results from several studies have shown that false-positive and false-negative HER2 test results are common. An NCCN Task Force reviewed this topic and issued recommendations which are summarized in a section of the guideline entitled "Principles of HER2 Testing." When breast MRI is indicated, the panel recommends that it should be performed and interpreted by an expert breast-imaging team working in concert with the multidisciplinary treatment team. Recent studies document the substantial improvement in outcome with the incorporation of trastuzumab (Herceptin, Genentech) in adjuvant treatment of HER2-postitive breast cancer. The guideline includes specific representative doses and schedules for the recommended adjuvant chemotherapy regimens. A number of chemotherapy regimens have been studied as preoperative chemotherapy. The panel believes that the regimens listed in the adjuvant setting are also appropriate to consider in the neoadjuvant setting. Aromatase inhibitors are not active in the treatment of women with functioning ovaries and should not be used in women with intact ovarian function. The assessment of ovarian function in women experiencing treatment-induced amenorrhea amenorrhea (āmĕn'ərē`a, əmĕn'–), cessation of menstruation. Primary amenorrhea is a delay in or a failure to start menstruation; secondary amenorrhea is an unexpected stop to the menstrual cycle. is difficult and requires re-evaluation over time. This has been elaborated in the "Definition of Menopause" section of the guideline. NCCN Clinical Practice Guidelines in Oncology(TM) are developed and updated through a consensus-driven process with explicit review of the scientific evidence by multidisciplinary panels of expert physicians from NCCN member institutions. The most recent version of this and all the guidelines are available for free at www.nccn.org. About the National Comprehensive Cancer Network The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 20 of the world's 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. The NCCN member institutions are: City of Hope Cancer Center, Los Angeles, CA; Dana-Farber/Partners CancerCare, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center The Fox Chase Cancer Center is a medical research facility and hospital located in the northeast section of Philadelphia, Pennsylvania, United States. The Center is an independent, non-profit institution which specializes in the treatment and prevention of cancer. , Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University, Columbus, OH; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center The Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City is a cancer treatment and research institution founded in 1884 as the New York Cancer Hospital. The main campus is located at 1275 York Avenue, between 67th and 68th Streets, with other locations in New , New York, NY; H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida • • [ , Tampa, FL; Roswell Park Cancer Institute The Roswell Park Cancer Institute is a cancer research and treatment center located in Buffalo, New York. Founded in 1898 by Dr. Roswell Park, it was the first dedicated medical facility for cancer treatment and research in the United States. , Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine Washington University School of Medicine, located in St. Louis, Missouri, is one of the most competitive and highly regarded medical schools and biomedical research institutes in the United States. , St. Louis, MO; St. Jude Children's Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham UAB began in 1936 as the Birmingham Extension Center of the University of Alabama. Because of the rapid growth of the Birmingham area, it was decided that an extension program for students who had difficulties which prevented them from studying in Tuscaloosa was needed. Comprehensive Cancer Center, Birmingham, AL; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; and The University of Texas M. D. Anderson Cancer Center, Houston, TX. For more information, visit www.nccn.org. |
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