Citations

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC) provide recommendations for the treatment of patients with NSCLC, including diagnosis, primary disease management, surveillance, and subsequent treatment. The panel has updated the list of recommended targeted therapies based on recent FDA approvals and clinical data. This selection from the NCCN Guidelines for NSCLC focuses on treatment recommendations for advanced or metastatic NSCLC with actionable biomarkers.

These NCCN Guidelines for Distress Management discuss the identification and treatment of psychosocial problems in patients with cancer. They are intended to assist oncology teams to identify patients who require referral to psychosocial resources and to give oncology teams guidance on interventions for patients with significant distress. These guidelines also provide guidance for social workers, certified chaplains, and mental health professionals by describing treatments and interventions for various psychosocial problems as they relate to patients with cancer. These NCCN Guidelines Insights summarize the panel’s most recent recommendations regarding standards of care for distress management in patients with cancer and implementation of these standards, including application of evidence-based care delivery models, such as the collaborative care model.

Abstract Glioma stem cells (GSCs) are considered a major driver of glioblastoma (GBM) progression and are highly resistant to standard cytotoxic treatments. BMP4 has been shown to promote GSC differentiation, enhance radiosensitivity, slow tumor growth, and extend survival in animal models. Despite this promise, BMP4 has yet to achieve clinical impact, owing largely to heterogeneous and nonlinear responses across preclinical experimental systems. To elucidate how BMP4 could function as an effective targeted differentiation therapy in GBM, we develop a mathematical model that describes the growth of a GBM tumor via a hierarchy of GSCs, progenitor and terminally differentiated cells. We parameterize our model using new radiotherapy and proliferation assay data (with and without BMP4 exposure) from twelve patient-derived GSC lines. This integration of model and data allows us, for the first time, to quantitatively capture patient-specific heterogeneity in BMP4 sensitivity. We perform global sensitivity analysis on the model, identifying proliferation rate and GSC self-renewal sensitivity as key determinants of BMP4 efficacy. These parameters act as model-derived biomarkers that distinguish BMP4-responsive tumors from non-responsive ones. In an in silico analysis across a broad cohort of virtual patients, we find that continuous BMP4 delivery from surgical resection through radiotherapy consistently outperforms a single-dose strategy. Virtual clinical trials further show that, without stratification using these model-derived biomarkers, BMP4 yields little observable therapeutic benefit. In contrast, selecting patients with more proliferative, BMP4-responsive GSCs markedly increases the likelihood of observing a significant treatment effect. Citation Format: Nicholas Harbour, Lee Curtin, Loizos Michaelides, Matthew E. Hubbard, Pamela Jackson, Vinitha Rani, Rajappa Kenchappa, Virginea Farias, Anna Carrano, Markus Owen, Alfredo Quinones-Hinojosa, Kristin Swanson. Virtual clinical trials of BMP4 differentiation therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 6831.

Bruton tyrosine kinase inhibitors (BTKis) and BCL2 inhibitor (BCL2i)–containing regimens significantly improve survival outcomes in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Results from randomized clinical trials have demonstrated that time-limited treatment with BCL2i-containing regimens resulted in higher rates of undetectable measurable residual disease (uMRD) than BTKi monotherapy or chemoimmunotherapy (CIT). Pirtobrutinib (a noncovalent BTKi) and lisocabtagene maraleucel (CD19-directed CAR T-cell therapy) are newer options for relapsed or refractory disease after prior therapy with BTKi and BCL2i-contining regimens. Histologic transformation of CLL/SLL to diffuse large B-cell lymphoma (Richter transformation) is associated with a poor prognosis. Molecular analysis to determine whether there is clonal relationship between CLL/SLL and transformed diffuse large B-cell lymphoma is useful to select an appropriate treatment option. These NCCN Guideline Insights highlight significant updates to the NCCN Guidelines for the treatment of CLL/SLL and Richter transformation.

Background: NCCN publishes evidence-based guidelines across the cancer care continuum that are commonly used as the standard for clinical management and policy in cancer care. Our study aimed to assess the content of survivorship recommendations within disease-based NCCN Guidelines. Methods: In January 2024, we downloaded 64 disease-based guidelines from the NCCN website; 10 were excluded. The remaining 54 guidelines were reviewed for survivorship-focused content. Content of the guidelines was systematically categorized across domains of the Quality of Cancer Survivorship Care Framework, and the level of detail was rated as not addressed, briefly addressed, mostly addressed, or fully addressed. Guidelines were re-reviewed for updates in April 2025. Results: Of 54 guidelines reviewed in 2025, 16 (30%) included a dedicated survivorship section with focused content, although sections, titles, and formats varied. Other guidelines included survivorship recommendations in algorithms and/or discussion sections. A total of 18 guidelines (33%) had neither a dedicated section nor reference to the NCCN Survivorship Guidelines. Guidelines with a dedicated section, as well as those referencing the NCCN Survivorship Guidelines (65%), generally provided more detailed survivorship content. Across all guidelines, the surveillance for recurrences/new cancers domain was most commonly included (96%) and typically the most detailed. Information on physical (81%) and psychosocial (72%) effects and health promotion (65%) was often included, but the level of detail varied. Chronic disease management (31%) was seldomly included. Information on care coordination/communication and patient education was present in 50% of the guidelines. Compared with the guidelines reviewed in 2024, the 2025 updates had limited expansion of survivorship content. Conclusions: Cancer survivorship content is inconsistently presented across disease-specific NCCN Guidelines. As these guidelines evolve, there is an opportunity to tailor, expand, and standardize the recommendations, making them easier to find by clearly labeling and integrating them within each guideline to improve accessibility and better support clinicians in delivering patient-centered care.

Abstract Purpose To develop and implement an in‑house treatment‑management platform to improve communication, data accessibility, and task tracking across a radiation oncology department. Methods We developed Capsule, a custom software platform that centralizes patient data from the ARIA oncology information system (Varian Medical Systems, Palo Alto, United States), and integrates it with data from Outlook (Microsoft, Redmond, United States), spreadsheets, and manual inputs. Built using C#, SQL, and the .NET framework, it features a graphical interface in XAML with twelve modular tools to support workflows across a large multi‐modality department. A formal validation, feedback, and maintenance cycle was established. Its impact on workflow efficiency was evaluated using average CarePath task duration before and after implementation, supplemented by user interviews and surveys. Results The Department Schedule, Treatment Planning and On‐Treatment Whiteboard, Spreadsheet, and various workload tracking modules emerged as the most frequently used among dosimetrists surveyed.The Whiteboard module consolidates planning metadata for streamlined workflows. Workload and scheduling modules help distribute tasks fairly. The Department Schedule module centralizes daily role and contact information. The Spreadsheet module allows dosimetrists to identify a reference for unique plans and provides secure access to large exportable tabulated patient data and clinical trends. Other modules support proton down‐time replanning and special procedure physics assignment. One year after Capsule's implementation, most tasks in the external beam radiation therapy workflow experienced a reduction in average duration. Discussion Capsule streamlines workflows by integrating multiple tools into a single platform, supporting urgent scenarios, and improving task hand‐off. Its modular design allows customization to local workflows, but implementation must be guided by institutional oversight and formal quality management to ensure data security and compliance. Conclusion Capsule can provide a solution for improved workflow efficiency, communication, and interdisciplinary coordination. By democratizing access to routine and retrospective data, it supports treatment planning, scheduling, and quality improvement. Ongoing updates are essential as clinical practices evolve.