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NCCN Guidelines® Insights: Breast Cancer, Version 4.2021

Featured Updates to the NCCN Guidelines

William J. Gradishar, Meena S. Moran, Jame Abraham, Rebecca Aft, Doreen Agnese, Kimberly H. Allison, Sarah L. Blair, Harold J. Burstein, Chau Dang, Anthony D. Elias, Sharon H. Giordano, Matthew P. Goetz, Lori J. Goldstein, Sara A. Hurvitz, Steven J. Isakoff, Rachel C. Jankowitz, Sara H. Javid, Jairam Krishnamurthy, Marilyn Leitch, Janice Lyons, Jennifer Matro, Ingrid A. Mayer, Joanne Mortimer, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Erica M. Stringer-Reasor, Melinda L. Telli, John H. Ward, Kari B. Wisinski, Jessica S. Young, Jennifer L. Burns, and Rashmi Kumar

Systemic Therapy In patients with early-stage breast cancer, systemic adjuvant therapy is administered to reduce risk of breast cancer recurrence. The decision is often based on individual risk of relapse and predicted sensitivity to treatment (eg

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Omalkhair Abulkhair, Nagi Saghir, Lobna Sedky, Ahmed Saadedin, Heba Elzahwary, Neelam Siddiqui, Mervat Al Saleh, Fady Geara, Nuha Birido, Nadia Al-Eissa, Sana Al Sukhun, Huda Abdulkareem, Menar Mohamed Ayoub, Fawaz Deirawan, Salah Fayaz, Alaa Kandil, Sami Khatib, Mufid El-Mistiri, Dorria Salem, El Siah Hassan Sayd, Mohammed Jaloudi, Mohammad Jahanzeb, and William I. Gradishar

studies, adjuvant therapy includes chemotherapy, targeted therapy with trastuzumab, and hormonal therapy. 13 – 15 In countries with limited resources, anthracyclines and taxanes are the most commonly used drugs, either in combination or sequentially

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Pamela J. DiPiro

to satisfy insistent patients. At all stages of cancer care, including at presentation, during neoadjuvant or adjuvant therapy, and in the treatment of advanced disease, evidence-based guidelines are needed to help direct physicians and their patients

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Lindsay J. Collin, Ming Yan, Renjian Jiang, Keerthi Gogineni, Preeti Subhedar, Kevin C. Ward, Jeffrey M. Switchenko, Joseph Lipscomb, Jasmine Miller-Kleinhenz, Mylin A. Torres, Jolinta Lin, and Lauren E. McCullough

to racial disparities in breast cancer mortality. Early investigations (circa 1990–2005) have reported that minority women are less likely to receive appropriate adjuvant therapy, although findings appear to be mixed and few studies report survival

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Cancer Center, “A Randomized Phase II Study Comparing Concise versus Prolonged Afatinib as Adjuvant Therapy for Stage I–III NSCLC with EGFR Mutation” The awardees responded to a request for proposals issued by the NCCN ORP to the 21 NCCN Member

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.” Approximately half of patients with metastatic melanoma harbor an activating mutation of BRAF, a signaling kinase. These patients tend to show dramatic responses to vemurafenib. Other updates include expanded recommendations on adjuvant therapy and radiation

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imaging specialists, and pulmonologists. “Radiation is recommended as an adjuvant therapy to improve local control after surgery, and it is also an effective palliative treatment for relief of chest pain that is often associated with mesothelioma,” said

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Ariel Polish and Mary F. Mulcahy

neoadjuvant or adjuvant therapy. One retrospective study focused on 49 patients with adenocarcinoma (90%) or squamous (10%) cancer of the esophagus who were staged as T2,N0,M0 and received neoadjuvant chemoradiation. 14 The study found that the 5-year rates

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Sharon H. Giordano, Anthony D. Elias, and William J. Gradishar

for advanced hormone-sensitive breast cancer at the NCCN 23rd Annual Conference. New Adjuvant Therapy Options for Patients With HER2-Positive Cancer Two new adjuvant treatment options for patients with HER2-positive disease are in the 2018 NCCN

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Crystal S. Denlinger and Andrea M. Barsevick

Edited by Kerrin G. Robinson

Fleming T Macdonald J . Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma . N Engl J Med 1990 ; 322 : 352 – 358 . 7 de Gramont A Boni C Navarro M . Oxaliplatin/5FU/LV in adjuvant colon cancer: updated efficacy