NCCN Releases New Guidelines for Pediatric Central Nervous System Cancers

The National Comprehensive Cancer Network (NCCN) published new Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pediatric Central Nervous System (CNS) Cancers, making it the fifth current NCCN Guidelines to focus on childrens' cancers. Though rare, pediatric brain tumors are the second-most-common type of pediatric malignancy after leukemia and are the leading cause of cancer-related death in children, according to data from the American Cancer Society and the World Health Organization.

"I think about these families and everything they go through, and I know we're going to keep working every day to make things better for them," said Anita Mahajan, MD, Mayo Clinic, Vice-Chair of the NCCN Guidelines Panel for Pediatric CNS Cancers. "These NCCN Guidelines, covering high-grade gliomas, are an important start. They consolidate the complicated information that's needed across interdisciplinary teams, including pediatric oncologists/neuro-oncologists, pediatric radiation oncologists, pathologists, and pediatric neurosurgeons, so they are all ready to work together to provide the most effective diagnosis and treatment."

Dr Mahajan continued, "We're planning to expand the guidelines to include other CNS tumor types. Right now, the science is advancing as we learn more about how to differentiate and characterize these tumors. In the future, with more trial results coming in, we anticipate an increase in personalized medicine with treatments targeted to the specific patient and tumor."

The World Health Organization recently updated their classifications for central nervous system tumors, with a new structure specifically focused on pediatric CNS tumors. This fundamental paradigm shift in classification is reflected and explained in the NCCN Guidelines for Pediatric CNS Cancers.

"Treating children with cancer is very different from adults, particularly for CNS tumors. We need to be extra careful to not impact physical and cognitive development and to protect against long term side-effects," explained NCCN Guidelines for Pediatric CNS Cancers Panel Chair Amar Gajjar, MD, Chair of the Department of Pediatrics, St Jude Children's Research Hospital. "For instance, radiation is a key component when treating adults, but options to avoid or reduce radiation in young children are important, especially those under age three. These guidelines provide a snapshot of how leading experts from across the country are applying the current evidence to recommend the best approach for infants, young children, and adolescents into early adulthood. We're committed to update these guidelines at least once a year moving forward."

NCCN intends to cover at least 90% of all incident childhood cancers through the growing library of NCCN Guidelines for pediatric cancers. The adult guidelines provide comprehensive management recommendations for 97% of all incident cancer in the United States and globally, as well as screening, prevention, and supportive care, including survivorship best practices. There are also NCCN Guidelines for Specific Populations, including recommendations for how to optimally tailor care in adolescent and young adult (AYA) patients.

Previously-published NCCN Guidelines for Pediatric ALL have also been adapted into a  version for patients and caregivers, harmonized for resource-constrained settings, and translated into Chinese, French, Indonesian, Italian, Japanese, Portuguese, Russian, and Spanish.

"We want to do whatever we can to ease the burden of cancer on children and their families and make sure every child can get the best care possible," said Robert W Carlson, MD, Chief Executive Officer, NCCN. "NCCN Guidelines have a proven track record for improving cancer outcomes and are a trusted source of information for care providers all over the world. We are proud to advance care by providing everyone with access to the very latest recommendations from some of the top experts in the field."