The National Comprehensive Cancer Network (NCCN) has implemented categories of preference for recommendations within their clinical practice guidelines in oncology.
Categories of preference will initially be published for drugs and biologics recommended within the guidelines for multiple myeloma only. However, additional cancer types are soon to follow.
The goals of these categories are to stratify guidelines to clarify panel and institutional preference for interventions, to provide guidance to users of the guidelines on which recommendations are considered optimal, and to continue providing a range of recommendations to meet varying clinical circumstances and patient preferences.
The NCCN has stresses that all recommendations within their guidelines are still to be considered appropriate. The categories of preference are as follows:
- Preferred intervention: Interventions that are based on superior efficacy, safety, and evidence; and, when appropriate, affordability
- Other recommended intervention: Other interventions that may be somewhat less efficacious, more toxic, or based on less mature data; or significantly less affordable for similar outcomes
- Useful in certain circumstances: Other interventions that may be used for selected patient populations (defined with recommendation)
Preferred and other recommended interventions have traditionally been included in various NCCN guidelines. The latest categories of preference will serve to provide consistency in guidance across the guidelines for shared decision-making.—Zachary Bessette