Margaret Tempero, MD, has offered this month’s “Oncology Watch” to Dr. Koh to discuss the future of NCCN. She will return to this space in next month.
In September 2018, I left Seattle, where I worked for 30 years as an academic radiation oncologist, to join NCCN as its Chief Medical Officer. I previously knew well and valued some parts of NCCN; I had served on the NCCN Guidelines Panels for Pancreatic Adenocarcinoma and Cervical/Uterine Cancers, and was honored to have led the latter for more than a decade. The impact of the NCCN Guidelines library is clear—they are the most widely used arbiter of high-quality, effective, and efficient cancer care nationally. However, I have now had the opportunity to participate in many more facets of NCCN, and to share in their vision and development.
In 2018, the total number of guidelines downloaded from NCCN.org and the mobile app exceeded 10 million copies for the first time (a 26% increase from 2017). The current format of the guidelines (PDFs) is familiar, but NCCN is committed to developing a digital version that combines easy human comprehension with search/filter functions, and machine-readable outputs that can be readily configured for information technology and electronic health record vendors who wish to embed our content. This is an ambitious multiyear project that will allow NCCN to extend its impact in a digital world, simplify “real-time” updates to the algorithms, and support research into guideline concordance.
Multiple translations and adaptations of NCCN Guidelines for international use are available, and approximately one-third of downloads occur outside the United States. This attests to the global influence of NCCN. Most personally gratifying has been my recent involvement in helping develop Harmonized Guidelines in Sub-Saharan Africa and the Caribbean, where the NCCN Guidelines are modified to account for specific resource availability and regulatory issues. I see NCCN continuing to expand its international footprint and influence, such as in Asia and Latin America, and partnering with other organizations to study and report on the impact of adopting NCCN content worldwide.
As indispensable as the NCCN Guidelines are to healthcare providers, NCCN recognizes that also providing them in a patient-friendly format is critically important, so that patients can better understand their situation and fully contribute to important decisions regarding their cancer management and recovery. We will continue to expand on the development of patient versions to cover all disease entities for which we have clinical guidelines, as well as supportive care and survivorship, and work on translations that can be incorporated into our global programs.
NCCN has an active Oncology Research Program (ORP), which has traditionally focused on preclinical, phase I, and early phase II studies of agents or devices. We have updated the ORP vision to emphasize broader innovation and knowledge discovery that will improve the lives of patients. Although traditional agent-based clinical trials remain important, there is now greater emphasis on investigations that lead to new insights in care delivery processes and to identify solutions to barriers affecting optimal cancer management. For example, we recognize the importance of research on patient-reported outcomes, geographic/economic impediment to care access, financial toxicity of cancer treatment, and the role of support systems, such as patient navigators and integrative medicine. The opportunity to define quality metrics and measure their impact on specific patient outcomes, using real-world data, is exciting and increasingly realizable. The ORP will seek greater recognition and grant funding from industry and foundations to increase research opportunities for faculty at NCCN Member Institutions.
It has been an exciting first few months. But for NCCN, I fully believe that the best is yet to be.