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Jai Pausch Addresses Caregiver Concerns in New Column on NCCN Patient Web site

Jai Pausch, widow and caregiver of the late Randy Pausch, acclaimed Carnegie Mellon University professor and author of the internationally best-selling book The Last Lecture, is sharing her experience and wisdom as a cancer caregiver through a new column on, the patient Web site of NCCN.

The column, entitled “Ask Jai”, allows caregivers and family members of patients with cancer to submit questions for consideration. Ms. Pausch will select one question each month and publish her response on The inaugural column is scheduled to appear later this month.

Since her husband passed away from pancreatic cancer in 2008, Ms. Pausch has been an active, articulate spokesperson for assuring that patients with cancer and their families have the resources they need throughout the course of the disease. Ms. Pausch's special interest is in making sure that the individuals who take care of people with cancer, the caregivers, are not forgotten. In addition, she has written a new foreword to the third edition of The Last Lecture, which will be published shortly.

“Cancer devastates the entire family,” said Ms. Pausch, who is also a member of the NCCN Foundation Board of Directors. “It is so painful, and in the end the caregivers are as much survivors as the patients themselves. I am pleased to participate in this opportunity on that allows me to connect with other caregivers and provide insight from my experience that may help individuals feel less isolated.” is the patient Web site of NCCN and features the NCCN Guidelines for Patients as well as enhanced content for patients and caregivers.

To submit a question to the “Ask Jai” column, e-mail questions to to view a video of Ms. Pausch speaking about her new column.

NCCN REMS Resource Webpage Updated

To help oncology clinicians stay current with drugs requiring a Risk Evaluation and Mitigation Strategy (REMS), NCCN maintains a REMS Resource Page on its Web site to serve as a clinician reference tool. The REMS Resource Page lists agents used in oncology care that have an FDA-approved REMS, including those used for active treatment and supportive care indications. The listings are comprised of the drug names (brand and generic), manufacturer, disease indications (according to the NCCN Clinical Practice Guidelines in Oncology [NCCN Guidelines] and NCCN Drugs & Biologics Compendium [NCCN Compendium]), and required REMS components. Currently, there are 23 drug listings on the page, 11 of which require elements to assure safe use.

The NCCN REMS Resource Page was recently updated to include some drugs newly added to the FDA's list of approved REMS. The table below reflects a sample of drugs recently added that may be used for a supportive care indication (e.g., pain, cancer-related fatigue) in a patient with cancer. All the drugs listed require the provision of a medication guide detailing the risks associated with these drugs whenever these agents are dispensed. Additionally, prescribing and dispensing the newly FDA-approved fentanyl sublingual tablets is contingent upon enrollment in the Abstral REMS program.


NCCN Flash Update: NCCN Guidelines and NCCN Compendium Updated

NCCN has published updates to the NCCN Guidelines and NCCN Compendium for Kidney Cancer. These NCCN Guidelines are currently available as Version 1.2011.

Significant updates include:

  • For subsequent therapy of kidney cancer with predominant clear cell histology, the category for bevacizumab was changed from a category 2B to category 2A following cytokine therapy and category 2B following tyrosine kinase inhibitor.

  • For systemic therapy of kidney cancer with non-clear cell histology, erlotinib was added with a category 3 designation. In addition, chemotherapy for sarcomatoid only (category 3) was revised to include combination therapy with gemcitabine + doxorubicin, and single-agent capecitabine, floxuridine, fluorouracil, and doxorubicin were removed.

NCCN has published updates to the NCCN Guidelines for Ovarian Cancer. These NCCN Guidelines are currently available as Version 2.2011.

Based on recent clinical trial data, the panel revised the discussion regarding bevacizumab by adding information about the ICON7 trial and the following statement: “Until there are more mature results from GOG 0218 and ICON7, the NCCN Guidelines Panel for Ovarian Cancer does not recommend the routine addition of bevacizumab to upfront therapy with carboplatin/paclitaxel or as maintenance therapy at this time. The NCCN panel encourages participation in ongoing clinical trials that are further investigating the role of antiangiogenesis agents in the treatment of ovarian cancer, both in the upfront and recurrence settings.”

NCCN has published updates to the NCCN Guidelines for Colon and Rectal Cancers. These NCCN Guidelines are both currently available as Version 2.2011 (Colon) and Version 3.2011 (Rectal).

Based upon recent presentations, the previous footnote related to BRAF mutations was removed and the following footnotes were added to the metastatic section of the NCCN Guidelines for Colon and Rectal Cancers:

  • Footnote in the first-line setting: Patients with a V600E BRAF mutation appear to have a poorer prognosis. Retrospective subset analyses suggest potential benefit from anti-EGFR monoclonal antibodies in the first-line setting with active chemotherapy regardless of V600E mutation status.

  • Footnote after progression on first-line therapy: Patients with a V600E BRAF mutation appear to have a poorer prognosis. Limited available data suggest lack of antitumor activity from anti-EGFR monoclonal antibodies in the presence of a V600E mutation when used after patient has progressed on first-line therapy.

Corresponding information related to BRAF mutations was updated in the Principles of Pathologic Review section.

For the complete updated version of these and all NCCN Guidelines, visit

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