[Multibilly]

New NCCN guideline updates for multiple myeloma

by Multibilly on Sat Oct 19, 2019 8:57 am

New updates to the NCCN guidelines have just been published for the diagnosis and treatment of myeloma.

Kumar, SK, et al, "NCCN Guidelines Insights: Multiple Myeloma, Version 1.2020.," JNCCN–Journal of the National Comprehensive Cancer Network, October 2019 (link to full text of article)

The NCCN guidelines are important because many insurance companies use these guide­lines to determine if they will cover a treatment or not. While the U.S. Food and Drug Administraton may approve a drug for treatment in the USA outside of clinical trials, it's still not a given that insurance will cover that drug. But if the drug or treatment regimen appears in the NCCN guidelines, then there is a much better chance that insurance will cover it.

Note that the guidelines now recommend low-dose CT or PET/CT scans instead of skeletal surveys for initial imaging workups, unless those imaging modalities are not available to the patient.

[Ron Harvot]

Re: New NCCN guideline updates for multiple myeloma

by Ron Harvot on Wed Oct 23, 2019 1:24 pm

Thanks Multibilly!

[Mark Pouley]

Re: New NCCN guideline updates for multiple myeloma

by Mark Pouley on Tue Oct 29, 2019 2:36 pm

I was first aware of the NCCN Guidelines this year when I was dealing with getting insurance approval of the Kyprolis-based maintenance therapy recommended by my doctors, but not included in the NCCN Guidelines. I can't say I "understand" everything I read in the new guidelines, but they appear "broader" in that they include more treatment options. Are they more open to the idea that there are many good treatments that can vary based on the patient? Maybe it's wishful thinking.

[Multibilly]

Re: New NCCN guideline updates for multiple myeloma

by Multibilly on Wed Oct 30, 2019 8:35 am

Hi Mark,

My understanding is that the NCCN guidelines are developed with inputs from expert panels and reviews of clinical trial outcomes. If you look at who is on the NCCN myeloma panels, you will see many of the same myeloma specialists that conduct these trials and who publish regularly in the field of myeloma research.

Many of the specialists I recognize on this list are certainly on board with the concept that myeloma is a highly heterogeneous disease that evolves differently in each patient and therefore requires different treatments from individual to individual over time.