NCCN Guidelines® Updates: AIDS-Related Kaposi Sarcoma

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NCCN Guidelines® Updates: AIDS-Related Kaposi Sarcoma

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for AIDS-Related Kaposi Sarcoma published in this issue (page 171) include the latest updates. To assist readers interested in noting how the guidelines were updated, highlights of major changes pertaining to the version published in this issue are printed below. To view the most recent version of the guidelines, visit NCCN.org.

Updates in Version 2.2019 from Version 1.2018 include:

KS-1

  • Workup, Essential: 1st bullet, 2nd sub-bullet was revised, “including complete skin, and oral, and lymph node exams and documentation of edema.”

KS-2

  • After limited cutaneous, the qualifier was revised, “Symptomatic and/or Cosmetically unacceptable.”

  • Footnote “l” was added.

KS-3

  • Eligible for clinical trial or systemic therapy: After first-line therapy, “Refractory disease” was revised as, “Stable or progressive disease.”

  • Not eligible for clinical trial or systemic therapy:

    • ➤ After first-line therapy, the algorithm was revised by removing the options for “Response” and “Refractory disease” and the algorithm was re-directed to “Reassess for eligibility for clinical trial or systemic therapy.”

    • ➤ After “Reassess for eligibility for clinical trial or systemic therapy,” the options for “Not eligible for clinical trial or systemic therapy” was changed from “ART ± Palliative RT or Surgical excision” to “Best supportive care.”

  • Footnote was removed: “Patients with relapsed/refractory disease who received RT in first-line therapy should receive systemic therapy if possible.”

KS-4

  • Surveillance: 1st bullet, 1st sub-bullet was revised from: “Every 3 months for year 1, then every 4–6 months for year 2, then every 6–12 months thereafter,” to: “Follow-up periodically based on the level of HIV, immune reconstitution, and response to therapy.”

KS-B

  • Goals of therapy: 2nd bullet was revised, “Patients with symptomatic or cosmetically unacceptable disease should use the most minimally invasive and the least toxic therapy to control disease.”

KS-C

  • Intralesional chemotherapy: Vinblastine, 3rd sub-bullet was added.

  • Content related to radiotherapy was moved to the new “Principles of Radiation Therapy” page (KS-E).

KS-E

  • General principles: 3rd sub-bullet was added.

The goal of the NCCN Guidelines® Updates is to provide readers with important changes that the NCCN Guidelines Panel has incorporated into the algorithm since it was last published. For a more complete detailing of the updated guideline’s modifications, access the NCCN Guidelines in this issue or, for the complete and most up-to-date version, at NCCN.org.

Note: The addition of new language is indicated in italics. Wording that was removed from the previous update is indicated in strikeout.

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