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NCCN Flash Updates: NCCN Guidelines Updated for Biliary Tract Cancers and Hepatocellular Carcinoma

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium^®) for Biliary Tract Cancers. These NCCN Guidelines^® are currently available as Version 3.2024.

Link directly to the Updates section of the NCCN Guidelines: Biliary Tract Cancers

BIL-C (3 of 5)

• Primary Treatment for Unresectable and Metastatic Disease
  • For NTRK gene fusion-positive tumors:
    • Repotrectinib was added as a category 2A recommendation. (Also for Subsequent-Line Therapy for Biliary Tract Cancers if Disease Progression)

BIL-C (4 of 5

• Reference 15 added: Solomon BJ, Drilon A, Lin JJ, et al. Repotrectinib in patients (pts) with NTRK fusion-positive (NTRK+) advanced solid tumors, including NSCLC: Update from the phase I/II TRIDENT-1 trial [abstract]. Ann Oncol 2023;34:Abstract 1372P.

Previous updates to the NCCN Guidelines for Biliary Tract Cancers can be found in the UPDATES section of the current version.

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium^®) for Hepatocellular Carcinoma. These NCCN Guidelines^® are currently available as Version 2.2024.

Link directly to the Updates section of the NCCN Guidelines: Hepatocellular Carcinoma

HCC-I (1 of 2)

• Principles of Systemic Therapy
  • First-Line Systemic Therapy
    • Other Recommended Regimens
      • Tislelizumab-jsgr was added as a category 1 recommendation.
    • Useful in Certain Circumstances
      • Repotrectinib was added as a category 2B recommendation for NTRK gene-fusion positive tumors.
• Footnote i revised: Larotrectinib and entrectinib are treatment options for patients with NTRK gene-fusion positive HCC. Repotrectinib (category 2B) is a treatment option for patients with NTRK gene-fusion positive HCC that has progressed on a prior NTRK-targeted treatment.
• Footnote j added: For patients who have not been previously treated with a checkpoint inhibitor unless following atezolizumab + bevacizumab.
• Footnote k added: There is a lack of data for subsequent use of single agent immunotherapy in patients who have previously been treated with a checkpoint inhibitor.
• Footnote l revised: For patients who have not been previously treated with a checkpoint inhibitor because there is a lack of data for subsequent use of immunotherapy in patients who have previously been treated with a checkpoint inhibitor.

HCC-I (2 of 2)

• Reference 7 added: Qin S, Kudo M, Meyer T, et al. Tislelizumab vs sorafenib as first-Line treatment for unresectable hepatocellular carcinoma: A phase 3 randomized clinical trial. JAMA Oncol 2023;9:1651-1659.
• Reference 9 added: Solomon BJ, Drilon A, Lin JJ, et al. Repotrectinib in patients with NTRK fusion-positive advanced solid tumors, including non-small cell lung cancer: Update from the phase 1/2 TRIDENT-1 trial [abstract]. Ann Oncol 2023;34:Abstract 1372P.
• Reference 16 added: Roessler D, Öcal O, Philipp AB, et al. Ipilimumab and nivolumab in advanced hepatocellular carcinoma after failure of prior immune checkpoint inhibitor-based combination therapies: A multicenter retrospective study. J Cancer Res Clin Oncol 2023;149:3065-3073.

Previous updates to the NCCN Guidelines for Hepatocellular Carcinoma can be found in the UPDATES section of the current version.

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.

About NCCN Flash Updates™

NCCN Flash Updates™ is a subscription service from NCCN that provides timely notification of updated and new information appearing in the NCCN Guidelines, the NCCN Compendium^®, and other NCCN Content.

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