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Breast cancer, version 3.2013: featured updates to the NCCN guidelines.

ABSTRACT: These NCCN Guidelines Insights highlight the important updates specific to the management of HER2-positive metastatic breast cancer in the 2013 version of the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer. These include new first-line and subsequent therapy options for patients with HER2-positive metastatic breast cancer.

SUBMITTER: Theriault RL

PROVIDER: S-EPMC3991132 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Breast cancer, version 3.2013: featured updates to the NCCN guidelines.

Theriault Richard L RL Carlson Robert W RW Allred Craig C Anderson Benjamin O BO Burstein Harold J HJ Edge Stephen B SB Farrar William B WB Forero Andres A Giordano Sharon Hermes SH Goldstein Lori J LJ Gradishar William J WJ Hayes Daniel F DF Hudis Clifford A CA Isakoff Steven J SJ Ljung Britt-Marie E BM Mankoff David A DA Marcom P Kelly PK Mayer Ingrid A IA McCormick Beryl B Pierce Lori J LJ Reed Elizabeth C EC Schwartzberg Lee S LS Smith Mary Lou ML Soliman Hatem H Somlo George G Ward John H JH Wolff Antonio C AC Zellars Richard R Shead Dorothy A DA Kumar Rashmi R

Journal of the National Comprehensive Cancer Network : JNCCN 20130701 7

These NCCN Guidelines Insights highlight the important updates specific to the management of HER2-positive metastatic breast cancer in the 2013 version of the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer. These include new first-line and subsequent therapy options for patients with HER2-positive metastatic breast cancer. ...[more]

PMID: 23847214

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Project description:BackgroundIntegration of specialist palliative care into routine oncologic care improves patients' quality of life and survival. National Comprehensive Cancer Network (NCCN) cancer treatment guidelines are instrumental in standardizing cancer care, yet it is unclear how palliative and hospice care are integrated in these guidelines. In this study, we examined the frequency of occurrence of "palliative care" and "hospice care" in NCCN guidelines and compared between solid tumor and hematologic malignancy guidelines.Materials and methodsWe reviewed all 53 updated NCCN Guidelines for Treatment of Cancer. We documented the frequency of occurrence of "palliative care" and "hospice care," the definitions for these terms if available, and the recommended timing for these services.ResultsWe identified a total of 37 solid tumor and 16 hematologic malignancy guidelines. Palliative care was mentioned in 30 (57%) guidelines (24 solid tumor, 6 hematologic). Palliative care was mentioned more frequently in solid tumor than hematologic guidelines (median, 2 vs. 0; p = .04). Among the guidelines that included palliative care in the treatment recommendation, 25 (83%) only referred to NCCN palliative care guideline. Specialist palliative care referral was specifically mentioned in 5 of 30 (17%) guidelines. Only 14 of 24 (58%) solid tumor guidelines and 2 of 6 (33%) hematologic guidelines recommended palliative care in the front line setting for advanced malignancy. Few guidelines (n = 3/53, 6%) mentioned hospice care.Conclusion"Palliative care" was absent in almost half of NCCN cancer treatment guidelines and was rarely discussed in guidelines for hematologic malignancies. Our findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.Implications for practiceIntegration of specialist palliative care into routine oncologic care is associated with improved patient outcomes. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have an important role to standardize palliative care involvement for cancer patients. It is unclear how often palliative care referral is recommended in these guidelines. In this study involving 53 NCCN Guidelines for Treatment of Cancer, the researchers found that palliative care was not mentioned in over 40% of NCCN guidelines and was rarely discussed in guidelines for hematologic malignancies. These findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.

Dataset Information

Breast cancer, version 3.2013: featured updates to the NCCN guidelines.

Publications

Breast cancer, version 3.2013: featured updates to the NCCN guidelines.

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