NCCN reveals new value initiative for CML and Multiple Myeloma

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 26 of the world's leading cancer centers, today unveiled its new value initiative—the NCCN Evidence Blocks™, published within new versions of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Myelogenous Leukemia (CML) and Multiple Myeloma.

"In cancer care, the most important value perspective is that of the individual patient," said Robert W. Carlson, MD, chief executive officer, NCCN. "NCCN Evidence Blocks will educate providers and patients about the efficacy, safety, and affordability of systemic therapy, serving as a starting point for shared decision-making based on the individual patient's value system."

The announcement was made at the NCCN 10th Annual Congress: Hematologic Malignancies™ at the San Francisco Marriott Marquis. The NCCN Annual Congress focuses on the increasingly complex treatment of hematologic malignancies and new approaches that have been incorporated into patient management, including the use of drugs, biologics, and diagnostics.

The NCCN Evidence Blocks™ are published in a new version of the NCCN Guidelines and are intended as a visual representation of five key value measures that provide important information about specific Guidelines recommendations:
•Efficacy of regimens,
•Safety of regimens,
•Quality and quantity of evidence for regimens,
•Consistency of evidence for regimens, and
•Affordability of regimens.

In a rapidly evolving field like oncology, thousands of new publications are released each year, adding to the existing body of knowledge and resulting in improvement in outcomes. In publishing the NCCN Guidelines, panel members are able to integrate new findings with existing information to determine what the evolving standard of care should be for a given disease state. Implicit in the evaluation of each treatment is the efficacy and expected associated toxicities, as well as the quality, quantity, and consistency of the evidence supporting the recommendation.

By adding affordability to NCCN's existing criteria for evaluating treatment options, patients will be empowered to identify, alongside their physician, optimal treatment based on clinical and economic considerations that are of most value to them. The affordability measurement represents an estimate of overall total cost of a therapy, including but not limited to acquisition, administration, in-patient vs. out-patient care, supportive care, infusions, toxicity monitoring, antiemetics and growth factors, and hospitalization.

"Some patients will want an emerging therapy even with limited data; others will be most concerned about the expected side effects of the treatment indicated in the safety column. Still others may be very sensitive to cost," Dr. Carlson said. "By considering the attributes of the range of possible therapies, the health care provider and the patient can discuss the benefits and drawbacks of each option and come to a decision most acceptable to the individual."

By the end of 2015, NCCN expects to publish NCCN Evidence Blocks™ for systemic therapies (not surgery or radiation therapy) in the NCCN Guidelines for Breast, Colon, Non-Small Cell Lung, and Rectal Cancers; NCCN Evidence Blocks™ for systemic therapies are expected to be contained within the complete library of NCCN Guidelines by the end of 2016.

In addition to the usefulness of the conversation that the affordability dimension produces, the design of the resulting NCCN Evidence Blocks™, with its signature blue squares, provides oncologists a valuable reference.

"In an age of visual information, the NCCN Evidence Blocks™ are a time-saving tool for efficient scanning and interpretation of multiple therapy options in an efficient format," said Dr. Carlson.