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

{"title":"Real-World Impact of UGT1A1 Genotype-Guided Irinotecan Dosing on Severe Toxicity and Hospitalization: A Multicenter Study.","authors":"Niels Heersche, Sofía L J Peeters, Doortje Böhm, Stefan Böhringer, Roselien Guiljam, Emma C Hulshof, Femke M de Man, Mirjam de With, Marije Joosse, Gysella Oomens, Qiong-Yi Wu, Sander Bins, Irene E G van Hellemond, Brigitte C M Haberkorn, Arjan J Verschoor, Miriam L Wumkes, Anna M Thijs, Ron H N van Schaik, Hans Gelderblom, Henk-Jan Guchelaar, Ron H J Mathijssen, Maarten J Deenen","doi":"10.6004/jnccn.2026.7011","DOIUrl":"10.6004/jnccn.2026.7011","url":null,"abstract":"<p><strong>Background: </strong>Risk of irinotecan-related severe toxicity is significantly higher in patients carrying 2 dysfunctional UGT1A1 gene variants, characterized as poor metabolizers (PMs), following standard irinotecan dosing. Since 2020, we implemented UGT1A1 genotype-guided dosing of irinotecan in routine clinical practice to reduce toxicity in PMs. This study evaluates its impact on severe toxicity in a real-world cohort.</p><p><strong>Patients and methods: </strong>Our study cohort included adult patients who received UGT1A1 genotype-guided irinotecan dosing at 6 Dutch hospitals between December 2020 and April 2024. Patients were included in the primary analysis if irinotecan was dosed according to UGT1A1 genotype (ie, 100% ±10% dose intensity for intermediate and normal metabolizers [IM/NMs] and 70% ±10% for PMs) in at least cycle 1. Toxicities, hospitalizations, and treatment alterations were collected for cycles 1-3 and graded according to CTCAE version 5.0. Endpoints were compared between PMs with a 70% starting dose and fully dosed IM/NMs.</p><p><strong>Results: </strong>A total of 501 patients were included in the primary analysis; 54 of whom were PMs (10.8%). Baseline characteristics were evenly distributed between groups. The incidences of overall severe toxicity (29.6% vs 34.0%; P=.52), febrile neutropenia (3.7% vs 5.8%; P=.76), severe neutropenia (17.0% vs 17.8%; P=.88), severe diarrhea (13.0% vs 15.0%; P=.69), and toxicity-related hospitalization (14.8% vs 21.7%; P=.24) were comparable between dose-reduced PMs and fully dosed IM/NMs. In a secondary analysis, 9 UGT1A1 PMs who received an unintended full irinotecan dose experienced more severe toxicity than PMs with a 70% starting dose (overall severe toxicity: 77.8% vs 29.6%; P=.009).</p><p><strong>Conclusions: </strong>UGT1A1 genotype-guided dosing of irinotecan improves patient safety and treatment tolerability of irinotecan. A 70% starting dose of irinotecan for UGT1A1 PMs is necessary to normalize the risk of severe toxicity to that of IM/NMs.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230538","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":"Feasibility and Efficacy of Reiki Versus Massage for Cancer-Related Fatigue in Patients With Breast and Prostate Cancer Receiving Hormone Therapy.","authors":"Jeremy McGuire, Joseph Roscoe, Jennifer Reschke, Po-Ju Lin, Karen Mustian, Lindsey Mattick, Katherine Rieth, Nikesha Gilmore, Kevin Spath, Umang Gada, Luke Peppone","doi":"10.6004/jnccn.2026.7010","DOIUrl":"10.6004/jnccn.2026.7010","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue (CRF) is a common, distressing symptom in patients undergoing hormone therapy for breast and prostate cancer. Although exercise is recommended, it is not suitable for all patients. Passive therapies such as massage and Reiki may offer accessible alternatives. This study evaluated the feasibility and preliminary efficacy of Reiki and massage therapy in reducing CRF, with Reiki also assessed for potential dose-response effects.</p><p><strong>Patients and methods: </strong>Adults (age ≥21 years) with breast cancer receiving aromatase inhibitors or with prostate cancer receiving androgen deprivation therapy (ADT) for at least 8 weeks, who reported moderate CRF (score ≥4/10), were enrolled if they had completed other cancer treatments at least 2 months prior. Exclusion criteria included planned nonhormonal cancer treatments, use of erythropoietin or darbepoetin, recent professional massage or energy therapy, or contraindications to massage. CRF was assessed using the Brief Fatigue Inventory (BFI). ANCOVA, adjusted for baseline values, was used to evaluate between-group differences in BFI total score at week 6. Cohen d was used to estimate within-group effect sizes. Feasibility was assessed based on recruitment, retention, and adherence.</p><p><strong>Results: </strong>A total of 87 participants (breast cancer, n=57; prostate cancer, n=30) were randomized to 2 sessions of massage therapy, 2 sessions of Reiki, or 4 sessions of Reiki. All interventions significantly reduced CRF from baseline (P<.001). Reiki produced greater within-group effect sizes (Cohen d=0.81-1.49 for 2 sessions; 0.99-1.49 for 4 sessions) than massage (d=0.50-0.60). The 4-session Reiki group had the largest reductions in total CRF (d=1.16), worst CRF (d=1.49), and CRF interference (d=0.99). Feasibility was high, with 51% recruitment, 94% retention, and 85% adherence.</p><p><strong>Conclusions: </strong>Reiki and massage are safe, feasible, and promising interventions for managing CRF in patients receiving hormone therapy. Reiki showed the largest improvements, supporting its clinical relevance. Larger trials are needed to confirm these findings and inform CRF management guidelines.</p><p><strong>Clinicaltrials: </strong>gov Identifier: NCT02758756.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Management of BRAF V600E-Mutated Metastatic Colorectal Cancer With Liver Dysfunction Using Encorafenib-Based Therapy.","authors":"Celine Hoyek, Angelo Pirozzi, Kelley Rone, Christina Wu, Jeremy Jones, Tanios Bekaii-Saab","doi":"10.6004/jnccn.2026.7003","DOIUrl":"10.6004/jnccn.2026.7003","url":null,"abstract":"<p><p>The recent approval of encorafenib, cetuximab, and FOLFOX based on the phase III BREAKWATER trial has introduced a new standard of care for the first-line treatment of BRAF V600E-mutated metastatic colorectal cancer (mCRC). However, its safety and efficacy in patients with significant liver dysfunction remains unclear and, as such, patients are often excluded from pivotal clinical trials. This report presents a case of BRAF V600E-mutated mCRC presenting with extensive hepatic involvement and liver dysfunction. Despite the absence of guidelines, the patient was initiated on full-dose encorafenib, cetuximab, and FOLFOX. He experienced a rapid clinical and biochemical response, with near-normalization of liver enzymes after cycle 1, and complete functional recovery by cycle 3. Treatment was well tolerated, with no significant adverse events throughout 9 cycles. He subsequently transitioned to maintenance 5-FU, cetuximab, and encorafenib. Posttreatment blood-based next-generation sequencing revealed no residual actionable mutations. The patient then successfully underwent complete surgical resection of his primary tumor and metastatic disease with negative margins. This case highlights the importance of considering encorafenib-based therapy in select patients with BRAF V600E-mutated mCRC in the setting of compromised liver function.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166730","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":"Pathogenic Germline Variants in a Racially Diverse Real-World Cohort of Patients With Prostate Cancer.","authors":"Taylor B Crawford, Maliha Tayeb, Emanuel Barrett, Tara Al-Saleem, Pranavi Kondam, Ryan Hausler, Heather Symecko, Caitlin Orr, Catherine Spielman Wolfe, Derek Mann, Kelsey Spielman, Gloria Wong, Naomi B Haas, Vivek Narayan, Kyle Robinson, Samuel Takvorian, Yu-Ning Wong, Alexandra O Sokolova, Robert B Montgomery, Carolyn Menendez, Michael J Kelley, Lisa B Aiello, Isla P Garraway, Susan M Domchek, Kara N Maxwell","doi":"10.6004/jnccn.2026.7006","DOIUrl":"10.6004/jnccn.2026.7006","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic germline variant (PGV) rates in cancer risk genes and their association with clinicopathologic features inform genetic testing practices for patients with prostate cancer (PCa). In this study, we determined the rate of PGVs in PCa risk genes in a real-world, diverse cohort of patients with PCa and identified clinical predictors of carrier status.</p><p><strong>Patients and methods: </strong>Genetic testing results for 12 PCa risk genes, along with clinical, pathologic, and family history variables, were abstracted from 1,032 patients with PCa who met NCCN genetic testing criteria in oncology clinics, and 3,602 patients with PCa who underwent testing through the VA National Precision Oncology Program. Individual gene PGV rates in patients with PCa were compared with those in individuals assigned male at birth who were cancer-free. Statistical analyses were performed using unpaired t tests and Fisher exact tests.</p><p><strong>Results: </strong>Among 4,634 patients with PCa, 5.4% had PGVs, with BRCA2 (1.7%), ATM (1.3%), and CHEK2 being the most common. The total PGV rate was significantly higher in 2,825 self-identified White and 1,527 self-identified Black patients (6.3% vs 3.7%; Padjusted=.0024), although rates of BRCA2 and BRCA1 PGVs were similar (1.9% vs 1.3%; Padjusted=.0885 and 0.6% vs 0.5%; Padjusted=.8005, respectively). PGV rates did not differ significantly between 311 self-identified Hispanic and 4,188 self-identified non-Hispanic patients (3.9% vs 5.5%; Padjusted=1.000). In self-identified White and Black patients, PGV rates in BRCA2 and Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2) were significantly higher compared with a cancer-free cohort of individuals assigned male at birth. In a multivariable logistic regression, age at initial PCa diagnosis and self-identified race were significantly associated with the presence of any PGV. In this racially diverse, real-world cohort of individuals with advanced PCa meeting NCCN testing criteria, the overall PGV rate was approximately 5%. Outside of ATM and CHEK2, PGV rates were similar across self-identified race, self-identified ethnicity, and clinical stage.</p><p><strong>Conclusions: </strong>These data support NCCN Guideline-recommended universal genetic testing for patients with aggressive PCa.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153123","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":"Pathways to Advance Targeted and Helpful Serious Illness Conversations (PATH-SIC): A Randomized Clinical Trial.","authors":"Christopher R Manz, Cody E Cotner, Angela C Tramontano, Saima Awan, Nathaniel Gwynne, Emma Voligny, Jocelyn Siegel, Alex Post, Brian Finn, Matthew Rice, Jessie Brain, Charlotta Lindvall, David M Jackman, Joseph O Jacobson, James A Tulsky, Alexi A Wright","doi":"10.6004/jnccn.2025.7479","DOIUrl":"10.6004/jnccn.2025.7479","url":null,"abstract":"<p><strong>Background: </strong>Serious illness conversations (SICs) aim to elicit patient preferences and are associated with improved quality of life and reduced care utilization, but they occur infrequently. Sustainable interventions that encourage SICs are needed.</p><p><strong>Patients and methods: </strong>This pragmatic 4-arm randomized controlled trial enrolled adult patients at 5 disease-based oncology clinics at 2 sites of an academic cancer center between December 4, 2022, and July 31, 2024. All patients had pathways data indicating they were starting a treatment associated with a poor prognosis without documentation of an SIC in the Advance Care Planning module of the electronic health record (ACP-SICs) in the prior 6 months. Patients were randomized to 1 of 4 groups: (1) a nudge consisting of a mailed letter and questionnaire encouraging SICs; (2) a clinician nudge comprising an email reminder sent the day prior to the clinic visit to prompt an SIC; (3) both nudges; or (4) no nudges. The primary outcome was the proportion of patients with ACP-SICs within 60 days of randomization comparing the control (no-nudge) and combined-nudge arms; a prespecified alternate primary outcome included SICs identified in the free text of clinician notes using natural language processing (ACP + NLP-SIC).</p><p><strong>Results: </strong>A total of 1,051 patients (median age, 65 years; 60% female; 79% White) were randomized to the control (n=261), clinician-nudge (n=240), patient-nudge (n=273), and combined-nudge arms (n=277). The ACP-SIC rates were 10.7%, 16.7%, 10.6%, and 17.3% for the control, clinician-nudge, patient-nudge, and combined-nudge arms, respectively, and the ACP + NLP-SIC rates were 22.6%, 28.8%, 22.3%, and 32.5%, respectively. Patients in the combined-nudge group had significantly higher ACP-SIC and ACP + NLP-SIC rates than the control group (P=.045 and P=.01, respectively), whereas the clinician-nudge and patient-nudge groups did not.</p><p><strong>Conclusions: </strong>Combined clinician- and patient-directed nudges resulted in higher SIC rates in 60 days, driven largely by the clinician nudge. NLP increased detection of SICs, demonstrating the importance of evaluating SICs in free-text notes.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":"237-243"},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261115","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":"Open Mind.","authors":"Daniel M Geynisman","doi":"10.6004/jnccn.2026.0029","DOIUrl":"https://doi.org/10.6004/jnccn.2026.0029","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":"213"},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261112","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":"Buprenorphine for Cancer Pain: Evidence, Guidelines, and Clinical Rationale for Early Use.","authors":"Marcin Chwistek, Leigh Kinczewski, Sorin Buga, Julia L Agne, Natalie Moryl, Enas Kandil, Mona Gupta, Magdalena Anitescu, Saba Javed, Michael Noonan, Dylan Sherry","doi":"10.6004/jnccn.2025.7132","DOIUrl":"https://doi.org/10.6004/jnccn.2025.7132","url":null,"abstract":"<p><p>As cancer survivorship increases, long-term opioid therapy (LTOT) has become more common in oncology, raising concerns about opioid-related harms. Buprenorphine offers unique pharmacologic advantages that position it as a safer alternative to full agonist opioids (FAOs), yet it remains underutilized in the management of cancer pain (CP). This article reviews the clinical rationale, supporting evidence, and practical considerations for using buprenorphine in managing CP throughout the cancer care continuum, with guidance from the NCCN Adult Cancer Pain Guideline Panel. This review synthesizes findings from pharmacologic research, clinical trials, guideline updates, and expert consensus. It examines the pharmacodynamics, dosing strategies, and safety of buprenorphine in vulnerable populations, as well as its potential to mitigate opioid-related complications. This review also discusses implementation barriers, including prescriber hesitancy, formulary restrictions, and stigma. Buprenorphine provides analgesia comparable to FAOs while reducing the risks of respiratory depression, opioid-induced hyperalgesia, hormonal disruption, and neurocognitive impairment. Buprenorphine may help reduce the neuroadaptive changes associated with LTOT, thereby preserving analgesic efficacy and improving long-term functional outcomes. Multiple formulations and flexible dosing options support personalized care, although regulatory restrictions and clinician unfamiliarity remain significant barriers. Buprenorphine is a viable yet underutilized option for managing CP, particularly when LTOT is anticipated. Broader clinical integration will require more precise guideline recommendations, clinician education, and policy reform. A paradigm shift toward early and proactive buprenorphine use could significantly improve safety, function, and quality of life in oncology patients.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":""},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261066","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: Acute Myeloid Leukemia, Version 3.2026.","authors":"Daniel A Pollyea, Jessica K Altman, Rita Assi, Kimo Bachiashvili, Vijaya Raj Bhatt, Amir T Fathi, Kateryna Fedorov, James M Foran, Ivana Gojo, Aaron Goldberg, Aric C Hall, Brian A Jonas, Matthew R Levine, James Mangan, Gabriel Mannis, Guido Marcucci, Alice Mims, Kelsey Moriarty, Moaath Mustafa Ali, Jadee Neff, Reza Nejati, Rebecca Olin, Anand Patel, Mary-Elizabeth Percival, Alexander Perl, Kristen Pettit, Dinesh Rao, Farhad Ravandi, Zaker Schwabkey, Rory Shallis, Maximilian Stahl, Richard M Stone, Swapna Thota, Geoffrey L Uy, Alison Walker, Eunice Wang, Ajibola Awotiwon, Sydney L Roth, Katie Stehman","doi":"10.6004/jnccn.2026.0028","DOIUrl":"10.6004/jnccn.2026.0028","url":null,"abstract":"<p><p>Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by the clonal expansion of myeloid blasts in the peripheral blood, bone marrow, and/or other tissues. It is the most common form of acute leukemia among adults and accounts for the largest number of annual deaths from leukemias in the United States.1 The NCCN Guidelines Panel for AML convenes annually to update recommendations for the diagnosis and treatment of AML in adults. These recommendations are based on a review of recently published clinical trials that have led to significant improvements in treatment or have yielded new information regarding biologic factors that may have prognostic importance. These NCCN Guidelines Insights summarize the panel's most recent recommendations regarding the monitoring and management of measurable (minimal) residual disease.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":"222-229"},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261069","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":"The Evolving Clinical Utility of Gene Expression Profiling in Cutaneous Melanoma.","authors":"Ahmad Rajeh, Maija Kiuru, Kelly Nelson, David Chen","doi":"10.6004/jnccn.2026.7041","DOIUrl":"https://doi.org/10.6004/jnccn.2026.7041","url":null,"abstract":"<p><p>Cutaneous melanoma risk assessment relies on clinicopathologic staging, which incompletely captures individual risk of nodal involvement, recurrence, and melanoma-specific mortality. Gene expression profiling (GEP) assays have been proposed to refine prognostication by measuring multigene transcriptional signatures from primary tumors. Here, we review the development, validation evidence, and limitations of the 2 most studied GEP tests for primary melanoma, and we evaluate their potential clinical utility amid rapidly evolving treatment paradigms. We highlight key knowledge gaps that should be addressed before advocating for broader GEP assay implementation.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":"278-282"},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261193","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":"Melanoma: Cutaneous, Version 2.2026, NCCN Clinical Practice Guidelines In Oncology.","authors":"Susan M Swetter, Douglas Johnson, Mark R Albertini, Christopher A Barker, Sarah Bateni, Joel Baumgartner, Shailender Bhatia, Christopher Bichakjian, Genevieve Boland, Sunandana Chandra, David Chen, Bartosz Chmielowski, Jacob Choi, Dominick DiMaio, Roxana Dronca, Martin D Fleming, Anjela Galan, Samantha Guild, Siwen Hu-Lieskovan, Giorgos Karakousis, Kari Kendra, Maija Kiuru, Julie R Lange, Ryan Lanning, Theodore Logan, Miguel Materin, Kelly Nelson, Daniel Olson, Anthony J Olszanski, Patrick A Ott, Igor Puzanov, Luke Rothermel, April K Salama, Adrienne Shannon, Rohit Sharma, Arun Singh, Andrew Stacey, Katy Tsai, Evan Wuthrick, Yan Xing, Nicole McMillian, Sara Espinosa","doi":"10.6004/jnccn.2026.0027","DOIUrl":"10.6004/jnccn.2026.0027","url":null,"abstract":"<p><p>The NCCN Guidelines for Melanoma: Cutaneous provide strategies for the diagnosis, treatment, and follow-up of patients with cutaneous melanoma, which is among the most common cancers in the United States. The outcome of cutaneous melanoma is significantly influenced by stage at initial presentation. Generally, localized disease and smaller primary tumors have been associated with more favorable prognosis. Thus, the select content featured in this issue focuses on risk factors associated with cutaneous melanoma development and which should be considered during an initial assessment. These include (1) phenotypic predispositions, (2) personal medical history or comorbidities, (3) genetic predispositions, and (4) environmental factors.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":"24 6","pages":"272-277"},"PeriodicalIF":16.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261061","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}