The NCCN 22nd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care attracted more than 1,650 registrants from across the United States and the globe, including oncologists (in both community and academic settings), oncology fellows, nurses, pharmacists, and other healthcare professionals. The breadth of topics presented at the conference is a reflection of the impact NCCN and the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) have on people with cancer and their families. This special issue of JNCCN—Journal of the National Comprehensive Cancer Network presents these Highlights as a synopsis of the proceedings.
During the conference, esteemed NCCN Guidelines Panel members presented the latest best practices in the treatment of patients with cancer and NCCN Guidelines updates for various diseases, including bladder, breast, colorectal, kidney, lung, and pancreatic cancers, as well as chronic lymphocytic leukemia, gynecologic malignancies, Hodgkin lymphoma, neuroendocrine tumors, non-Hodgkin's lymphomas, soft tissue sarcoma, and the latest NCCN Guideline—myeloproliferative neoplasms.
NCCN experts also discussed frontline supportive care and screening issues. For example, Paul Cinciripini, PhD, of The University of Texas MD Anderson Cancer Center, discussed the benefits of smoking cessation for patients with cancer, as well as the latest advances and best avenues for intervention. Kenneth Offit, MD, MPH, of Memorial Sloan Kettering Cancer Center, discussed personalized medicine. Dr. Offit noted that practitioners could reduce deaths by up to 60% by paying attention to known risk genetic and lifestyle risk factors for cancer. He also presented the 2017 NCCN Guidelines for Genetic/Familial High-Risk Assessment, which have begun to incorporate data to guide screening based on age-specific risks of genes included on multigene panels.
Stephanie Andrews, MS, ANP-BC, of Moffitt Cancer Center, discussed the management of adverse events for immunotherapy and how to identify them. She noted that enthusiasm for immunotherapy agents should be tempered by a healthy respect for their power. NCCN has devised a teaching and monitoring tool for immunotherapy available at NCCN.org, and is in the process of developing clinical practice guidelines in collaboration with ASCO specifically for the management of immunotherapy-related toxicities in patients with cancer.
The 22nd Annual Conference also featured one of the NCCN's seminal roundtables, opening with a timely expert discussion of disparities in oncology care. Moderated by Clifford Goodman, PhD, from the Lewin Group, the session featured Shauntice Allen, PhD, University of Alabama at Birmingham Comprehensive Cancer Center; Moon S. Chen Jr, PhD, MPH, University of California Davis Comprehensive Cancer Center; Anne Filipic, Enroll America; Edith Mitchell, MD, Sidney Kimmel Cancer Center at Jefferson; and Phyllis Pettit Nassi, MSW, Huntsman Cancer Institute at the University of Utah.
The panelists noted that cancer is the leading cause of death among some communities, and there is an opportunity to make real gains by applying current medical knowledge to these populations. They also spoke of the need to overcome biases to deliver what the individual patient needs, and the need for experts to come out of “silos” and work together. The roundtable ended with panelists challenging attendees to share their opinions with lawmakers so that their voices can be heard.
During Friday's keynote session, which I had the pleasure to moderate, Lucy Kalanithi, MD, widow of the late Paul Kalanithi, MD, author of When Breath Becomes Air, joined Paul's oncologist, Heather Wakelee, MD, of Stanford Cancer Institute, for the first time in public. Together, they recalled the moments with Paul that most influenced their lives and the way they practice medicine.
“Paul faced his cancer in a very, very brave manner,” said Dr. Wakelee, who had worked with him at Stanford but didn't get to know him until he was her patient. “What he captures in the book is the essence of what we try to do to help our patients with cancer. Even though he was dying since the time I met him, he really lived.”
“Time stood still and sped up at the same time, especially when [Paul] was getting really sick,” Dr. Lucy Kalanithi said. “There was this sense of time standing still that came out of the [realization] that the future is not guaranteed.”