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NCCN Flash Updates: NCCN Guidelines Updated for Gastric Cancer
NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™) for Gastric Cancer. These NCCN Guidelines® are currently available as Version 2.2024.
Link directly to the Updates section of the NCCN Guidelines: Gastric Cancer
GAST-10
- Treatment revised to: Systemic therapy (GAST-F 4 of 20) for a minimum of
6 months3 months - "Low PCI (≤10), stable or improved disease..." pathway; Additional Treatment; Revised: "Cytoreductive surgery with gastrectomy and IC/HIPEC/PIPAC" changed to "Gastrectomy with cytoreductive surgery, and intraperitoneal chemotherapy/hyperthermic intraperitoneal chemotherapy".
- Box describing abbreviations for intraperitoneal chemotherapy, hyperthermic intraperitoneal chemotherapy, and pressurized intraperitoneal aerosolized chemotherapy was removed.
GAST-B 5 of 6
- Next-Generation Sequencing: First bullet revised: At present, several targeted therapeutic agents (GAST-F) have been approved by the FDA for use in gastric cancer. Immunohistochemistry/in situ hybridization/targeted PCR should be considered first for the identification of biomarkers, followed by NGS testing. If limited tissue is...
GAST-C 3 of 5
- Resectable Tumors
- First arrow sub-bullet revised: The evidence for the use of IC/HIPEC
/PIPACis limited. There are no randomized trials to demonstrate efficacy, and results are limited to case reports and small series. However,this technologyIC/HIPEC may be effective in selected patients with low burden of tumor. The decision to pursue IC/HIPEC/PIPACshould be made only after multidisciplinary discussion. - New arrow sub-bullet added: PIPAC is investigational and should only be done in the context of a clinical trial.
- Third arrow sub-bullet revised: Intraperitoneal chemotherapy (IC/HIPEC
/PIPAC) may be a therapeutic alternative for carefully selected patients with peritoneal carcinoma as only disease. - First diamond sub-bullet revised: Patients who are being considered for IC/HIPEC
/PIPACshould undergo pre-treatment evaluation with a chest/abdomen/pelvis CT, diagnostic laparoscopy with washings to assess for PCI and/or cytology positive disease, and consider a PET scan to rule out distant metastatic disease. Patients with documented peritoneal metastatic disease should begin with systemic therapy given for a minimum of6 months3 months.... - First dashed sub-bullet revised: IC/HIPEC
/PIPACcan be used in conjunction with cytoreductive surgery for patients with low peritoneal cancer index (PCI ≤10) that are candidates to undergo complete cytoreduction. - Second dashed bullet revised: In patients with a higher burden of peritoneal disease (PCI >10), IC/HIPEC
/PIPACmay be considered in the setting of a clinical trial.
- First arrow sub-bullet revised: The evidence for the use of IC/HIPEC
Previous updates to the NCCN Guidelines for Gastric Cancer can be found in the UPDATES section of the current version.
NCCN has published updates to the NCCN Biomarkers Compendium®, based on updates to the following NCCN Guidelines:
- Breast Cancer, 2.2024
- Melanoma: Cutaneous, 2.2024
- Neuroblastoma, 1.2024
- Thyroid Carcinoma, 2.2024
For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.
To view the NCCN Guidelines for Patients®, please visit NCCN.org/patientguidelines.
Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.
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