Guest Editorial: Reflections of a New Chief Executive Officer

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Crystal S. Denlinger National Comprehensive Cancer Network

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When I attended my first NCCN Annual Conference and Fellows Program almost 20 years ago, I did not anticipate that I would become NCCN’s newest Chief Executive Officer as of last fall. That first conference highlighted the importance of guidelines as a framework for clinical decision-making and way to organize the ever-evolving data at the point of care. Two years later, as institutional representative to my first NCCN Guidelines Panel, I realized the true benefit of collective expertise in generating recommendations that were grounded in evidence while accounting for common variations in care. These experiences laid the foundation for my interest in clinical practice guideline development and guideline-concordant care as a mechanism for democratizing evidence and knowledge across oncology care settings to ensure everyone receives quality, effective, equitable, and accessible cancer care.

During my years as a medical oncologist at Fox Chase Cancer Center, NCCN was an integral part of my oncology career both clinically and academically. In the clinic, I used the NCCN Guidelines almost daily to support decision-making and as an educational tool in discussions with my trainees. I have served on 5 guideline panels and had the honor to chair the NCCN Survivorship Guidelines Panel for 8 years, positions that taught me much about cancer care and leadership. My NCCN Foundation Young Investigator Award provided a funding opportunity to engage in survivorship research when survivorship was a newer concept. Conversations with colleagues in Sub-Saharan Africa during guideline harmonizations emphasized that some challenges in providing good oncology care are fundamentally similar despite variations in resource accessibility. Collaborations with experts from NCCN Member Institutions across the country for NCCN’s Oncology Research Program, Continuing Education Program, Policy and Advocacy Program, Chemotherapy Order Templates, and Guidelines for Patients highlighted the vast NCCN resources available to providers, patients, payers, and policymakers for cancer-related issues. These experiences prepared me for becoming NCCN’s first Chief Scientific Officer in 2021, where I had the opportunity to support NCCN’s mission and programs as an organizational leader while working with the incredible NCCN staff who move the mission forward daily. Suffice to say, I am truly appreciative of how NCCN shaped my career, providing an outlet for professional growth and mentorship while grounding me in evidence-based decision-making for every patient I see.

I love being an oncologist. My passion for ensuring equitable access to quality and effective cancer care derived from not only my work with NCCN but also my personal experiences. I am the proud daughter of 2 cancer survivors. My mother remains disease-free 14 years after a cancer diagnosis and my father passed away 15 years ago after a 15-year journey with cancer before effective therapies existed. I recognize that my mom’s ability to forego chemotherapy was the result of years of clinical research and clinical trial enrollment of women who came before her, and that my dad’s participation in clinical research paved the way for many standard treatment options available today for his cancer type. This is the power of cancer research and why NCCN considers enrollment in a clinical trial to be one of the best ways to treat a patient—the potential benefits pay forward. As an informal family caregiver, having cared for both parents during their cancer journeys and now my mom who is living with dementia, I also know that cancer and caregiving are hard. As an oncology community and as health care providers, we need to think about how to meet the needs of all people living with a diagnosis of cancer, not just the one in whose body it resides. NCCN helps support these needs through patient and clinical information resources to address supportive care and specific populations in addition to disease-specific resources. I can attest to this, as I have used these resources first-hand in supporting family and friends through cancer over the years.

These experiences inform my roles as NCCN’s CEO and as a practicing oncologist during my half-day weekly clinic. Facing cancer with my family in early adulthood and living my entire adulthood as an informal caregiver has made me a better doctor and a steadfast steward of NCCN’s mission and activities. I know that gaps in care exist and what “good care” can look like. In the past 2 decades, significant improvements have been made in cancer care, including those cancers affecting my family directly, although we still have significant progress to make. Those advances should be available to everyone, regardless of geographic location or oncology practice setting. Clinical practice guidelines and the work that NCCN does allows this to be possible, for every oncology provider, patient, payer, and policymaker to know what appropriate care should be and how to deliver it, and for every patient to have the options and availability for care that align with their goals. Clinical practice guidelines such as NCCN’s democratize care and provide knowledge to providers, patients, payers, and policymakers that can make meaningful differences in individual lives. Knowledge is power, and NCCN’s resources provide opportunities for accessible knowledge delivery that transcend geographic location and practice setting.

JNCCN is an important component of NCCN’s dissemination efforts through publishing the NCCN Guidelines, NCCN Guidelines Insights articles that discuss the thinking behind guideline recommendations, and original research and reports that contribute to the global body of evidence defining appropriate care. Recent trends in medical information suggest readers are shifting to online and digital platforms to get information. To ensure we are meeting oncologists where they are most likely obtaining their medical information, JNCCN is striving to improve our digital content. In 2024, JNCCN will publish 2 exclusively digital issues (January and June) and 10 issues in print with expanded digital content at JNCCN.org. We endeavor to further understand the preferences of our readers and contributors to ensure that our journal meets their needs in both print and online forms. All articles published in JNCCN will continue to be fully indexed by PubMed and others, remain available at JNCCN.org with no required paid subscription, be fully citable and searchable with digital object identifiers (DOIs), and remain downloadable at JNCCN.org as PDFs in addition to plain text formats. We believe this transition to more online content aligns with readers’ and contributors’ current preferences regarding journal delivery and use.

As an oncologist, my personal mission is to cure cancer. NCCN’s mission is to improve and facilitate quality, effective, equitable, and accessible cancer care so that all patients can live better lives. NCCN’s resources further both missions through the generation and dissemination of evidence-based, consensus-driven recommendations and derivative content. JNCCN provides a platform for publication of these recommendations through NCCN Guidelines and NCCN Guidelines Insights articles and serves as a source of new evidence to move the field of oncology forward. NCCN, through our resources and work, will remain broadly impactful in oncology care in continuous pursuit of our mission.

CRYSTAL S. DENLINGER, MD

Crystal S. Denlinger, MD, is the Chief Executive Officer at NCCN. Dr. Denlinger became CEO in October 2023 after serving as NCCN’s Senior Vice President, Chief Scientific Officer.

Dr. Denlinger has a long history of global cancer care leadership with NCCN and beyond. She was named an NCCN Young Investigator Awardee in 2012 and received the NCCN Rodger Winn Award in 2018 for exemplifying leadership, drive, and commitment in service to developing the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Before being named Chief Scientific Officer in January 2021, she was Chair of the NCCN Guidelines Panel for Survivorship; served on the Bone, Esophageal/Gastric, Occult Primary Cancers, and Older Adult Oncology Panels; was a member of the JNCCN Editorial Board; served on numerous abstract and scientific review committees; and participated on the NCCN Harmonized Guidelines for Sub-Saharan Africa.

Prior to joining NCCN, Dr. Denlinger served as Chief, Gastrointestinal Medical Oncology; Deputy Director, Early Drug Development Phase 1 Program; Director Survivorship Program; and Associate Professor, Department of Hematology/Oncology at Fox Chase Cancer Center, an NCCN Member Institution. She remains a practicing gastrointestinal medical oncologist with a limited voluntary practice at Fox Chase Cancer Center.

Dr. Denlinger graduated from a combined BS/MD program at The College of New Jersey and Rutgers New Jersey Medical School, followed by an internal medicine residency with Mount Sinai Medical Center, and hematology/oncology fellowship at Fox Chase Cancer Center/Temple University Hospital.

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