Journal of the National Comprehensive Cancer Network : JNCCN最新文献

{"title":"Comparative Cost-Effectiveness Analysis of First-Line Immunotherapy for Advanced Melanoma Based on 10-Year Clinical Outcomes.","authors":"Guiyuan Xiang, Yin Sun, Xue Yang, Yao Liu","doi":"10.6004/jnccn.2026.7031","DOIUrl":"10.6004/jnccn.2026.7031","url":null,"abstract":"<p><strong>Background: </strong>Recently, the CheckMate 067, KEYNOTE-006, and RELATIVITY-047 trials demonstrated the long-term efficacy and safety of 5 first-line therapies for advanced melanoma, including nivolumab + relatlimab, with >10 years of follow-up. However, the long-term economic outcomes are still unclear. This study aimed to assess the comparative cost-effectiveness of these strategies from a US health care perspective using more than a decade of clinical trial data.</p><p><strong>Methods: </strong>Based on the data from clinical trial reports, we simulated a cohort of 1,662 patients with advanced melanoma across 5 treatment groups in which patients received ipilimumab, nivolumab, pembrolizumab, nivolumab + ipilimumab, or nivolumab + relatlimab as first-line therapy. A flexible parametric survival model was used, combined with background mortality rates, to estimate patients' lifetime overall survival and progression-free survival. A partitioned survival model was constructed to assess the total cost, quality-adjusted life-years (QALYs), total life-years, and incremental cost-effectiveness ratios (ICERs) for the 5 treatment strategies. Sensitivity analyses, including univariate, probabilistic, scenario, and subgroup analyses, were conducted to evaluate the robustness of the model and population differences.</p><p><strong>Results: </strong>Nivolumab + ipilimumab provided the highest QALYs (7.30), followed by nivolumab + relatlimab (6.67 QALYs). Ipilimumab and nivolumab + relatlimab were associated with the lowest ($239,168) and highest ($471,610) costs, respectively. Compared with nivolumab, only nivolumab + ipilimumab resulted in ICERs below the willingness-to-pay threshold of $150,000/QALY. Drug costs and body weight were the most influential factors affecting ICERs. Nivolumab + ipilimumab demonstrated the highest probability of being the most cost-effective strategy.</p><p><strong>Conclusions: </strong>Among first-line immunotherapy strategies for advanced melanoma, nivolumab + ipilimumab and nivolumab + relatlimab provided the greatest survival benefits. After integrating treatment costs, safety, and health-related quality of life, nivolumab + ipilimumab was the most cost-effective strategy under base-case assumptions, followed by nivolumab monotherapy.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Composite MACE End Points May Limit Actionable Cardiovascular Surveillance for CDK4/6 Inhibitors in Breast Cancer.","authors":"Xingxia Yang, Xiang Lv, Yi Yang","doi":"10.6004/jnccn.2026.7066","DOIUrl":"10.6004/jnccn.2026.7066","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interview With New NCCN Chief Medical Officer Renuka Iyer, MD.","authors":"Daniel M Geynisman","doi":"10.6004/jnccn.2026.0044","DOIUrl":"https://doi.org/10.6004/jnccn.2026.0044","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply to the Letter to the Editor by Yang et al: Composite MACE End Points May Limit Actionable Cardiovascular Surveillance for CDK4/6 Inhibitors in Breast Cancer.","authors":"Chanhyun Park","doi":"10.6004/jnccn.2026.7065","DOIUrl":"10.6004/jnccn.2026.7065","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in the Management of Early-Stage Hodgkin Lymphoma: The Role of Radiation Therapy.","authors":"Yorleny Vicioso Mora, Christopher R Kelsey","doi":"10.6004/jnccn.2026.7019","DOIUrl":"https://doi.org/10.6004/jnccn.2026.7019","url":null,"abstract":"<p><p>The treatment of early-stage Hodgkin lymphoma is one of oncology's great success stories. Numerous large randomized trials have tested and refined conventional chemotherapy regimens, optimized radiation therapy (RT) approaches, explored the integration of metabolic imaging such as PET/CT, and are now evaluating novel agents. What was once a fatal disease is now cured in almost all patients. Combined-modality therapy, typically involving a short course of chemotherapy followed by low-dose, highly conformal RT, has emerged as the most effective strategy for achieving durable remissions. Nonetheless, concerns about the long-term toxicities associated with RT have prompted investigations into chemotherapy-only regimens as a potential alternative to combined-modality therapy. To date, neither interim nor postchemotherapy PET/CT imaging has been able to identify patients who can safely omit consolidation RT without compromising efficacy, although additional studies are ongoing. Meanwhile, novel agents such as nivolumab and brentuximab vedotin have significantly advanced the treatment of advanced-stage disease and are now demonstrating promising activity in early-stage Hodgkin lymphoma. In parallel with advances in systemic therapy, radiation technologies have also progressed substantially. Techniques such as proton therapy, intensity-modulated RT, and image-guided RT dramatically reduce radiation exposure to healthy tissues compared with historical approaches, thereby improving the therapeutic ratio. Despite the high cure rates achieved today, clinical trials continue to explore novel and personalized approaches to achieve long-term remission without compromising quality of life.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Clinic: Neighborhood Poverty and End-of-Life Care in Cancer.","authors":"Xin Hu, Changchuan Jiang","doi":"10.6004/jnccn.2026.7075","DOIUrl":"10.6004/jnccn.2026.7075","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NCCN Guidelines® Insights: Esophageal and Esophagogastric Junction Cancers, Version 4.2026.","authors":"Jaffer A Ajani, Thomas A D'Amico, David J Bentrem, Sakti Chakrabarti, Carlos U Corvera, Prajnan Das, Peter C Enzinger, Thomas Enzler, Hans Gerdes, Michael K Gibson, Patrick Grierson, Garima Gupta, Wayne L Hofstetter, David H Ilson, Shadia Jalal, Ning Jin, Sunnie Kim, Samuel Klempner, Moshim Kukar, Jill Lacy, Vincent Lam, Byrne Lee, Frank Licciardi, Shane Lloyd, Quan P Ly, Karen Matsukuma, Ryan P Merkow, Aaron M Miller, Mary F Mulcahy, Kyle A Perry, Jose M Pimiento, Deepti M Reddi, Scott Reznik, Robert E Roses, Alireza Sedarat, Vivian E Strong, Stacey Su, Nataliya Uboha, Christopher G Willett, Harry H Yoon, Nicole R McMillian, Nicholas Sansone, MaryElizabeth Stein","doi":"10.6004/jnccn.2026.0043","DOIUrl":"10.6004/jnccn.2026.0043","url":null,"abstract":"<p><p>Esophageal cancer is the seventh leading cause of cancer-related deaths worldwide. Esophageal cancers are histologically classified as squamous cell carcinoma (ESCC) or adenocarcinoma (EAC), which differ in their etiology, pathology, tumor location, therapeutics, and prognosis. In patients with locally advanced or metastatic disease, systemic therapy can provide palliation, improve survival, and/or enhance quality of life. The implementation of biomarker testing and immunotherapy has had a significant impact on clinical practice and patient care. This selection from the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers highlights current recommendations for advanced ESCC, including the evolving landscape of first-line immunotherapy.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Paradigms in the Management of Castleman Disease.","authors":"Yoshito Nishimura, Thomas M Habermann, Ariela Noy","doi":"10.6004/jnccn.2026.7046","DOIUrl":"10.6004/jnccn.2026.7046","url":null,"abstract":"<p><p>Castleman disease (CD) comprises a heterogeneous group of rare lymphoproliferative disorders unified by characteristic lymph node histopathology but with substantial clinical, biologic, and therapeutic diversity. Over the past decade, major advances in disease classification, pathophysiologic understanding, and targeted therapy have reshaped the management of CD, particularly idiopathic multicentric CD (iMCD). The introduction of IL-6-directed therapy has transformed the management of iMCD by shifting treatment from empirical immunosuppression or cytotoxic chemotherapy toward a biologic-based approach, achieving durable disease control in most patients. Progress has also been made over the past several years in the anatomic, etiologic, and clinical classification of CD, enabling more individualized, severity-adapted treatment approaches across the disease spectrum. Emerging paradigms in CD management include the recognition of oligocentric CD (OligoCD) as an intermediate anatomic entity with distinct therapeutic implications, as well as the validation of idiopathic plasmacytic lymphadenopathy (IPL) as a clinically distinct subtype of iMCD. These developments underscore the importance of integrating disease distribution, subtype, and severity into therapeutic decision-making. In addition, the recent paradigm of CD management emphasizes early identification of refractory disease and timely escalation beyond biologic therapy. This review provides an updated overview of CD management, drawing on recent advances to discuss practical considerations in treatment selection across disease subtypes, as well as ongoing challenges and future directions.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-Cell Lymphomas, Version 4.2026, NCCN Clinical Practice Guidelines In Oncology.","authors":"Andrew D Zelenetz, Leo I Gordon, Jeremy S Abramson, Ranjana H Advani, Alaa Altahan, Babis Andreadis, Nancy L Bartlett, L Elizabeth Budde, Paolo F Caimi, Sven DeVos, Bhagirathbhai Dholaria, Luis E Fayad, Sameh Gaballa, Thomas M Habermann, Francisco Hernandez-Ilizaliturri, Boyu Hu, Manali Kamdar, Yasmin Karimi, Christopher R Kelsey, Rebecca King, Justin Kline, Susan Krivacic, Ann S LaCasce, Daniel Landsburg, Megan Lim, Marcus Messmer, Priyanka Pophali, Rachel Rabinovitch, Praveen Ramakrishnan, Erin Reid, Peter Riedell, Kenneth B Roberts, Aditi Saha, Naoyuki G Saito, Yazeed Sawalha, Stephen D Smith, Lode J Swinnen, Joseph Tuscano, Julie M Vose, Mary Dwyer, Hema Sundar","doi":"10.6004/jnccn.2026.0042","DOIUrl":"10.6004/jnccn.2026.0042","url":null,"abstract":"<p><p>Mantle cell lymphoma (MCL) is a heterogenous subtype of B-cell non-Hodgkin lymphoma (NHL). The treatment landscape of newly diagnosed MCL has evolved in recent years with the incorporation of covalent BTK inhibitors, sensitive assays for the assessment of measurable residual disease (MRD), and predefined maintenance or continuous therapy. Covalent BTK inhibitor-based regimens are also appropriate options for patients with previously untreated classic MCL with TP53 mutations. Pirtobrutinib (a highly selective noncovalent BTK inhibitor) and CAR T-cell therapy (brexucabtagene autoleucel or lisocabtagene maraleucel) have emerged as effective treatment options for refractory or progressive disease after prior treatment with covalent BTK inhibitors. This selection from NCCN Guidelines for B-Cell Lymphomas focuses on the recommendations for the diagnosis and treatment of MCL.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 9","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering Improvements in Equitable Care Delivery: Insights From the Health Equity Report Card (HERC) Pilot in Academic Cancer Centers.","authors":"Ashley Orr, Taneal D Carter, Mallory Stubblebine, Heather McKee Hurwitz, Tiffany Go, Leticia Mercado, Darryl Outlaw, Elizabeth Bouchard, Levent Dumenci, Crystal S Denlinger, Alyssa A Schatz","doi":"10.6004/jnccn.2026.7042","DOIUrl":"10.6004/jnccn.2026.7042","url":null,"abstract":"<p><strong>Background: </strong>The Health Equity Report Card (HERC) was developed to support institutions in measuring equitable care practices and implementing improvement efforts. An objective of this study was to determine whether academic cancer centers can use their baseline HERC scores to identify institution-specific strategies to improve equitable care delivery.</p><p><strong>Methods: </strong>This quality improvement study collected quantitative and qualitative data from 5 NCCN Member Institutions about their quality improvement efforts in response to their HERC baseline scores. This project took place over 18 months, between April 2022 and October 2024.</p><p><strong>Results: </strong>The secondary objective of utilizing HERC baseline scores to identify improvement efforts was met, with 4 sites identifying and implementing improvement efforts in at least one domain. Sites reported barriers and facilitators for their improvement projects. Utilization of the HERC to develop strategies to improve equitable care delivery in response to baseline scores was feasible in academic cancer centers. Four sites used the HERC findings to support and prioritize strategies that had been previously identified and discussed but not fully implemented. Two sites identified new improvement efforts that had not been previously considered by their institution. The complexity of the health system, collaboration across departments, resource allocation, competing priorities, and leadership support were discussed as both challenges and facilitators in identifying and implementing improvement strategies.</p><p><strong>Conclusions: </strong>The HERC may offer a useful framework for prioritizing and assessing improvement efforts for academic cancer centers seeking to improve equitable care delivery.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}