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NCCN Presents Updates to NCCN Guidelines for Thyroid Carcinoma

NCCN presented new updates to the NCCN Clinical Practice Guidelines in Oncology(TM) for Thyroid Carcinoma at the NCCN 14th Annual Conference on March 14. Notable updates include a new page on Thyroid Stimulating Hormone (TSH) Suppression, the expanded recommendation of small molecule kinase inhibitors, and revised procedures for evaluating thyroid nodules. Steven I. Sherman, MD, of The University of Texas M.D. Anderson Cancer Center and chair of the NCCN Guidelines Panel for Thyroid Carcinoma, presented the new NCCN Guidelines.

HOLLYWOOD, Fla., March 16 /PRNewswire-USNewswire/ -- The incidence of thyroid carcinoma is increasing faster than any other solid tumor according to Steven I. Sherman, MD, of The University of Texas M.D. Anderson Cancer Center during a recent presentation at the National Comprehensive Cancer Network's 14th Annual Conference discussing updates to the NCCN Clinical Practice Guidelines in Oncology(TM) for Thyroid Carcinoma.

"The increasing incidence of thyroid carcinoma is a worldwide phenomenon," stated Dr. Sherman as he outlined major updates to the NCCN Guidelines.

A notable addition to the NCCN Guidelines is a recommendation to consider commercially available, small molecule kinase inhibitors such as sorafenib (Nexavar(R), Bayer) or sunitinib (Sutent(R), Pfizer, Inc.) in the treatment of metastatic papillary carcinoma, follicular carcinoma, Hurthle cell carcinoma, or medullary carcinoma.

"Our primary recommendation for these patients is to investigate a clinical trial, but if one is not available or appropriate; data from clinical trials have shown that small molecule kinase inhibitors such as sorafenib and sunitinib can be effective," said Dr. Sherman.

Also new to the NCCN Guidelines is a page, Principles of Thyroid Stimulating Hormone (TSH) Suppression that provides recommendations for levothyroxine use for TSH Suppression throughout the Papillary, Follicular and Hurthle Cell Guidelines.

"Given the potential toxicities associated with TSH Suppression therapy that can have an effect on bone and heart health, it is best to use this therapy in a limited capacity," noted Sherman. "The new page in the NCCN Guidelines states that patients should be treated with the most conservative dose of hormone suppression therapy based on their level of disease plan. In addition, for those patients with recurrent thyroid carcinoma being administered TSH therapy, the NCCN Guidelines recommend decreasing the dose over time and encouraging adequate intake of calcium and vitamin D to prevent osteoporosis."

In addition, the procedures for evaluating thyroid nodules have been revised in the updated NCCN Guidelines particularly those for follicular or Hurthle cell neoplasms or for follicular lesions of undetermined significance, which cannot be diagnosed by fine needle aspiration (FNA). The diagnostic categories for FNA results have been revised in the new NCCN Guidelines and reflect recent data from the National Cancer Institute State of the Science Conference.

Dr. Sherman stressed the importance of evaluating suspicious nodules saying that, "ultrasound continues to be the single most useful imaging tool to diagnose palpable thyroid masses, however; there are no diagnostic features of a nodule that is benign."

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives.

The NCCN Member Institutions are: City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University, Columbus, OH; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer Center, Nashville, TN.

For more information on NCCN, please visit

SOURCE National Comprehensive Cancer Network
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