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2017-01-11T15:15:21.000Z

Updated NCCN Guidelines for HL, FL and MCL

Jan 11, 2017
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The National Comprehensive Cancer Network (NCCN) has updated its guidelines for several lymphoma subtypes in light of the new 2016 WHO classifications for Mature B-Cell, T-Cell, and NK-Cell conditions, and due to the latest drug approvals and clinical data. Below are some of the key changes in the updated NCCN Guidelines for Hodgkin Lymphoma, and other B-cell Lymphomas. The current version for both of these guidelines are Version 3.2016 for Hodgkin Lymphoma and Version 1.2017 for B-cell Lymphomas. Please see the individual guidelines for full details.

Hodgkin Lymphoma:

  • Nivolumab is not indicated as a treatment option in relapsed or progressing classical HL after Autologous Hematopoietic Stem Cell Rescue (ASCR) with High Dose Therapy (HDT) and maintenance therapy with brentuximab vedotin

Follicular Lymphoma:

  • Diagnosis Cyclin D1 (IHC) has been moved to ‘Useful under certain conditions’ from ‘Essential’
  • Stage I and II have been separated into:
    • Stage I (non-bulky), contiguous stage II (non-bulky) and the initial therapy is Involved Site Radiation Therapy (ISRT)
    • Stage I (bulky), contiguous stage II (bulky) or non-contiguous stage II.
  • First-line
    • Addition of rituximab for consideration in patients with low tumor burden
    • Lenalidomide and rituximab is now a category 2B recommendation, rather than category 3
  • Second-line
    • Idelalisib added in patients refractory to both alkylator and rituximab
    • Added bendamustine + obinutuzumab to category 2A

MCL

  • Less aggressive therapy
    • Lenalidomide + rituximab treatment of MCL added to category 2A
  • Second-Line therapy
    • Venetoclax added to category 2A
    • Rituximab, bendamustine, and bortezomib added to category 2B
    • FCMR combination therapy was removed in MCL
    • FMR combination therapy was removed in MCL

  1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). B-cell Lymphomas. Version 1.2017 – Dec 2016.
  2. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Hodgkin Lymphoma. Version 3.2016 – Jun 2016.

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