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Smoking Cessation, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology

Peter G. Shields, Laura Bierut, Douglas Arenberg, David Balis, Paul M. Cinciripini, James Davis, Donna Edmondson, Joy Feliciano, Brian Hitsman, Karen S. Hudmon, Michael T. Jaklitsch, Frank T. Leone, Pamela Ling, Danielle E. McCarthy, Michael K. Ong, Elyse R. Park, Judith Prochaska, Argelia J. Sandoval, Christine E. Sheffer, Sharon Spencer, Jamie L. Studts, Tawee Tanvetyanon, Hilary A. Tindle, Elisa Tong, Matthew Triplette, James Urbanic, Gregory Videtic, David Warner, C. Will Whitlock, Beth McCullough, and Susan Darlow

Although the harmful effects of smoking after a cancer diagnosis have been clearly demonstrated, many patients continue to smoke cigarettes during treatment and beyond. The NCCN Guidelines for Smoking Cessation emphasize the importance of smoking cessation in all patients with cancer and seek to establish evidence-based recommendations tailored to the unique needs and concerns of patients with cancer. The recommendations contained herein describe interventions for cessation of all combustible tobacco products (eg, cigarettes, cigars, hookah), including smokeless tobacco products. However, recommendations are based on studies of cigarette smoking. The NCCN Smoking Cessation Panel recommends that treatment plans for all patients with cancer who smoke include the following 3 tenets that should be done concurrently: (1) evidence-based motivational strategies and behavior therapy (counseling), which can be brief; (2) evidence-based pharmacotherapy; and (3) close follow-up with retreatment as needed.

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NCCN Guidelines® Insights: Squamous Cell Skin Cancer, Version 1.2022

Featured Updates to the NCCN Guidelines

Chrysalyne D. Schmults, Rachel Blitzblau, Sumaira Z. Aasi, Murad Alam, James S. Andersen, Brian C. Baumann, Jeremy Bordeaux, Pei-Ling Chen, Robert Chin, Carlo M. Contreras, Dominick DiMaio, Jessica M. Donigan, Jeffrey M. Farma, Karthik Ghosh, Roy C. Grekin, Kelly Harms, Alan L. Ho, Ashley Holder, John Nicholas Lukens, Theresa Medina, Kishwer S. Nehal, Paul Nghiem, Soo Park, Tejesh Patel, Igor Puzanov, Jeffrey Scott, Aleksandar Sekulic, Ashok R. Shaha, Divya Srivastava, William Stebbins, Valencia Thomas, Yaohui G. Xu, Beth McCullough, Mary A. Dwyer, and Mai Q. Nguyen

The NCCN Guidelines for Squamous Cell Skin Cancer provide recommendations for diagnostic workup, clinical stage, and treatment options for patients with cutaneous squamous cell carcinoma. The NCCN panel meets annually to discuss updates to the guidelines based on comments from panel members and the Institutional Review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new surgical recommendation terminology (peripheral and deep en face margin assessment), as well as recent updates on topical prophylaxis, immunotherapy for regional and metastatic disease, and radiation therapy.

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Basal Cell Skin Cancer, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology

Chrysalyne D. Schmults, Rachel Blitzblau, Sumaira Z. Aasi, Murad Alam, Arya Amini, Kristin Bibee, Jeremy Bordeaux, Pei-Ling Chen, Carlo M. Contreras, Dominick DiMaio, Jessica M. Donigan, Jeffrey M. Farma, Karthik Ghosh, Kelly Harms, Alan L. Ho, John Nicholas Lukens, Lawrence Mark, Theresa Medina, Kishwer S. Nehal, Paul Nghiem, Kelly Olino, Soo Park, Tejesh Patel, Igor Puzanov, Jason Rich, Aleksandar Sekulic, Ashok R. Shaha, Divya Srivastava, Valencia Thomas, Courtney Tomblinson, Puja Venkat, Yaohui Gloria Xu, Siegrid Yu, Mehran Yusuf, Beth McCullough, and Sara Espinosa

Basal cell carcinoma (BCC) is the most common form of skin cancer in the United States. Due to the high frequency, BCC occurrences are not typically recorded, and annual rates of incidence can only be estimated. Current estimated rates are 2 million Americans affected annually, and this continues to rise. Exposure to radiation, from either sunlight or previous medical therapy, is a key player in BCC development. BCC is not as aggressive as other skin cancers because it is less likely to metastasize. However, surgery and radiation are prevalent treatment options, therefore disfigurement and limitation of function are significant considerations. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) outline an updated risk stratification and treatment options available for BCC.

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NCCN Guidelines® Insights: Merkel Cell Carcinoma, Version 1.2024

Featured Updates to the NCCN Guidelines

Chrysalyne D. Schmults, Rachel Blitzblau, Sumaira Z. Aasi, Murad Alam, Arya Amini, Kristin Bibee, Diana Bolotin, Jeremy Bordeaux, Pei-Ling Chen, Carlo M. Contreras, Dominick DiMaio, Jessica M. Donigan, Jeffrey M. Farma, Karthik Ghosh, Kelly Harms, Alan L. Ho, John Nicholas Lukens, Susan Manber, Lawrence Mark, Theresa Medina, Kishwer S. Nehal, Paul Nghiem, Kelly Olino, Soo Park, Tejesh Patel, Igor Puzanov, Jason Rich, Aleksandar Sekulic, Ashok R. Shaha, Divya Srivastava, Valencia Thomas, Courtney Tomblinson, Puja Venkat, Yaohui Gloria Xu, Siegrid Yu, Mehran Yusuf, Beth McCullough, and Sara Espinosa

The NCCN Guidelines for Merkel Cell Carcinoma (MCC) provide recommendations for diagnostic workup, clinical stage, and treatment options for patients. The panel meets annually to discuss updates to the guidelines based on comments from expert review from panel members, institutional review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new page for locally advanced disease in the setting of clinical node negative status, entitled “Clinical N0 Disease, Locally Advanced MCC.” This new algorithm page addresses locally advanced disease, and the panel clarifies the meaning behind the term “nonsurgical” by further defining locally advanced disease. In addition, the guideline includes the management of in-transit disease and updates to the systemic therapy options.

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Ampullary Adenocarcinoma, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology

E. Gabriela Chiorean, Marco Del Chiaro, Margaret A. Tempero, Mokenge P. Malafa, Al B. Benson III, Dana B. Cardin, Jared A. Christensen, Vincent Chung, Brian Czito, Mary Dillhoff, Timothy R. Donahue, Efrat Dotan, Christos Fountzilas, Evan S. Glazer, Jeffrey Hardacre, William G. Hawkins, Kelsey Klute, Andrew H. Ko, John W. Kunstman, Noelle LoConte, Andrew M. Lowy, Ashiq Masood, Cassadie Moravek, Eric K. Nakakura, Amol K. Narang, Lorenzo Nardo, Jorge Obando, Patricio M. Polanco, Sushanth Reddy, Marsha Reyngold, Courtney Scaife, Jeanne Shen, Mark J. Truty, Charles Vollmer Jr, Robert A. Wolff, Brian M. Wolpin, Beth McCullough RN, Senem Lubin, and Susan D. Darlow

Ampullary cancers refer to tumors originating from the ampulla of Vater (the ampulla, the intraduodenal portion of the bile duct, and the intraduodenal portion of the pancreatic duct), while periampullary cancers may arise from locations encompassing the head of the pancreas, distal bile duct, duodenum, or ampulla of Vater. Ampullary cancers are rare gastrointestinal malignancies, and prognosis varies greatly based on factors such as patient age, TNM classification, differentiation grade, and treatment modality received. Systemic therapy is used in all stages of ampullary cancer, including neoadjuvant therapy, adjuvant therapy, and first-line or subsequent-line therapy for locally advanced, metastatic, and recurrent disease. Radiation therapy may be used in localized ampullary cancer, sometimes in combination with chemotherapy, but there is no high-level evidence to support its utility. Select tumors may be treated surgically. This article describes NCCN recommendations regarding management of ampullary adenocarcinoma.

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NCCN Guidelines® Insights: Lung Cancer Screening, Version 1.2022

Featured Updates to the NCCN Guidelines

Douglas E. Wood, Ella A. Kazerooni, Denise Aberle, Abigail Berman, Lisa M. Brown, Georgie A. Eapen, David S. Ettinger, J. Scott Ferguson, Lifang Hou, Dipen Kadaria, Donald Klippenstein, Rohit Kumar, Rudy P. Lackner, Lorriana E. Leard, Inga T. Lennes, Ann N.C. Leung, Peter Mazzone, Robert E. Merritt, David E. Midthun, Mark Onaitis, Sudhakar Pipavath, Christie Pratt, Varun Puri, Dan Raz, Chakravarthy Reddy, Mary E. Reid, Kim L. Sandler, Jacob Sands, Matthew B. Schabath, Jamie L. Studts, Lynn Tanoue, Betty C. Tong, William D. Travis, Benjamin Wei, Kenneth Westover, Stephen C. Yang, Beth McCullough, and Miranda Hughes

The NCCN Guidelines for Lung Cancer Screening recommend criteria for selecting individuals for screening and provide recommendations for evaluation and follow-up of lung nodules found during initial and subsequent screening. These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines for Lung Cancer Screening.