NCCN Guidelines® Updates: Melanoma: Cutaneous

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Melanoma: Cutaneous, published in this issue (page 439), include the latest updates. To assist readers interested in noting how the guidelines were updated, highlights of major changes pertaining to the portion of the guidelines published in this issue are provided below. To view the most recent version of the guidelines, visit

Updates in Version 2.2021 from Version 1.2020 include:

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  1. Reference was added for Pembrolizumab: Marabelle A, Le DT, Ascierto PA, et al. Efficacy of pembrolizumab in patients with noncolorectal high microsatellite instability/mismatch repair-deficient cancer: results from the phase 2 KEYNOTE-158 study. J Clin Oncol 2020;38:1-10.

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  1. “Good PS” was removed.
  2. Olaparib (only for germline BRCA1/2 mutations) was moved from “useful in certain circumstances” to “preferred.”
  3. The following regimens were moved from “useful in certain circumstances” to “other recommended”:
    1. Capecitabine
    2. Gemcitabine + nab-paclitaxel modified schedule (category 2B)
    3. Gemcitabine single agent (category 2B)
  4. FOLFIRI (preferred regimen) was removed and replaced with 5-FU ± irinotecan (useful in certain circumstances).
  5. FOLFOX (category 2B) was moved from “other recommended regimens” to “useful in certain circumstances.”
  6. Footnote was removed: ECOG 0-2 for combination regimens; ECOG 0-3 for single agent options.
  7. Footnotes “k” and “l” were added.

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  1. Heading was modified: Second-line Subsequent Therapy for Locally Advanced/Metastatic Disease and Therapy for Recurrent Disease.

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

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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