NCCN CNS tumor guidelines update for 2023

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of 33 National Cancer Institute designated Comprehensive Cancer Centers dedicated to patient care, research, and education. The NCCN is best known for the establishment of tumor-specific clinical practice guidelines. These are based on the evaluation of evidence and formulation of recommendations by a panel of experts for each type of cancer. The impact has been far-reaching: in 2022, the CNS Guidelines were downloaded 177 296 times, including 25 944 from sites outside the United States. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers1 are formed by the efforts of a committee of 34 members compromised of 12 neurologists, 7 radiation oncologists, 5 neurosurgeons, 7 medical oncologists, 1 neuropathologist, and 1 patient advocate. Each year, the Guidelines are reviewed and updated by the committee members. During the review period, member institutions, industry representatives, and individuals outside the NCCN can submit comments, which are then collated and discussed at the annual committee meeting held at the NCCN Headquarters in Plymouth Meeting, PA. The data supporting these comments are analyzed by the committee to decide whether to add to or revise the guideline algorithms using the NCCN Categories of Evidence (1, 2A, 2B, 3) as shown in Table 1. The committee votes on assigning category recommendations based on the quality of the data (randomized controlled trials [RCTs], non-RCTS, meta-analyses, systematic review of the literature, or clinical experience), the amount of evidence (extensive, less extensive, little, or anecdotal clinical experience), and reproducibility of the evidence (highly consistent, single trial, or variable).