Updates to the NCCN Guidelines

The NCCN Guidelines for Cervical Cancer provide interdisciplinary recommendations for treating cervical cancer. These NCCN Guidelines Insights summarize the NCCN Cervical Cancer Panel’s discussion and major guideline updates from 2014 and 2015. The recommended systemic therapy options for recurrent and metastatic cervical cancer were amended upon panel review of new survival data and the FDA’s approval of bevacizumab for treating late-stage cervical cancer. This article outlines relevant data and provides insight into panel decisions regarding various combination regimens. Additionally, a new section was added to provide additional guidance on key principles of evaluation and surgical staging in cervical cancer. This article highlights 2 areas of active investigation and debate from this new section: sentinel lymph node mapping and fertility-sparing treatment approaches. (J Natl Compr Canc Netw 2015;13:395–404) Cervical Cancer, Version 2.2015 396 NCCN Guidelines Insights C E © JNCCN—Journal of the National Comprehensive Cancer Network | Volume 13 Number 4 | April 2015 Disclosure of Relevant Financial Relationships Editor: Kerrin M. Green, MA, Assistant Managing Editor, JNCCN—Journal of the National Comprehensive Cancer Network, has disclosed that she has no relevant financial relationships. CE Authors: Deborah J. Moonan, RN, BSN, Director, Continuing Education, NCCN, has disclosed that she has no relevant financial relationships. Ann Gianola, MA, Manager, Continuing Education Accreditation & Program Operations, NCCN, has disclosed that she has no relevant financial relationships. Kristina M. Gregory, RN, MSN, OCN, Vice President, Clinical Information Operations, NCCN, has disclosed that she has no relevant financial relationships. Rashmi Kumar, PhD, Senior Manager, Clinical Content, NCCN, has disclosed that she has no relevant financial relationships. Individuals Who Provided Content Development and/or Authorship Assistance: Benjamin Greer, MD, Panel Co-Chair, has disclosed that he has no relevant financial relationships. Wui-Jin Koh, MD, Panel Co-Chair, has disclosed that he has no relevant financial relationships. Nicole R. McMillian, MS, Guidelines Coordinator, NCCN, has disclosed that she has no relevant financial relationships. Jillian L. Scavone, PhD, Oncology Scientist/Medical Writer, NCCN, has disclosed that she has no relevant financial relationships. Supported by an educational grant from Eisai; a contribution from Exelixis Inc.; educational grants from Bristol-Myers Squibb, Genentech BioOncology, Merck, Novartis Oncology, Novocure; and by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc. NCCN: Continuing Education Accreditation Statement This activity is designated to meet the educational needs of physicians, nurses, and pharmacists involved in the management of patients with cancer. There is no fee for this article. The National Comprehensive Cancer Network (NCCN) is accredited by the ACCME to provide continuing medical education for physicians. NCCN designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NCCN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center`s Commission on Accreditation. NCCN designates this educational activity for a maximum of 1.0 contact hour. Accreditation as a provider refers to recognition of educational activities only; accredited status does not imply endorsement by NCCN or ANCC of any commercial products discussed/displayed in conjunction with the educational activity. Kristina M. Gregory, RN, MSN, OCN, is our nurse planner for this educational activity. National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. NCCN designates this continuing education activity for 1.0 contact hour(s) (0.1 CEUs) of continuing education credit in states that recognize ACPE accredited providers. This is a knowledge-based activity. UAN: 0836-0000-15-004-H01-P All clinicians completing this activity will be issued a certificate of participation. To participate in this journal CE activity: 1) review the learning objectives and author disclosures; 2) study the education content; 3) take the posttest with a 66% minimum passing score and complete the evaluation at http://education.nccn.org/node/64364; and 4) view/print certificate. Release date: April 17, 2015; Expiration date: April 17, 2016 Learning Objectives: Upon completion of this activity, participants will be able to: • Integrate into professional practice the updates to the NCCN Guidelines for Cervical Cancer • Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Cervical Cancer