NCCN乳腺癌指南2024年第3版更新内容详解

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NCCN乳腺癌指南2024年第3版更新内容详解

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http://www.360doc.com/content/24/0618/15/71281455_1126530113.shtml

2024年6月17日，时隔98天，美国国家综合癌症网络（NCCN）乳腺癌临床实践指南悄然由2024年第2版更新至2024年第3版，全文由256页增加至257页。

NCCN为全国综合癌症中心非国立联盟组织，1993年11月成立，1995年1月31日正式宣布成为全国联盟，最初由13个美国知名综合癌症中心组成，目前已经增至33个：

NCCN乳腺癌临床实践指南2024年第3版架构仍为临床路径＋循证解读＋参考文献，其依据主要来自权威学术期刊或学术会议最新发表的大样本多中心随机对照三期临床研究结果。此次更新具体如下（中划线为删除，下划线为新增）

封面

新增：NCCN认识到临床试验的重要性，并鼓励在适用并可用时参与。试验设计和入组条件应最大程度提高包容性和广泛代表性。

NCCN recognizes the importance of clinical trials and encourages participation when applicable and available. Trials should be designed to maximize inclusiveness and broad representative enrollment.

删除：NCCN认为对于任何癌症患者，最佳治疗就是临床试验。参与临床试验被特别鼓励。

Clinical Trials: NCCN believes that the best management for any patient with cancer is in a clinical trial. Participation in clinical trials is especially encouraged.

BINV-16

下方路径修改：术后帕博利珠单抗与术后卡培他滨与术后奥拉帕利之间的“或”改为“和/或”。

Bottom pathway clarification: "and/" added before "or" after both adjuvant pembrolizumab and adjuvant capecitabine.

脚注eee修改：对于符合帕博利珠单抗和卡培他滨、帕博利珠单抗或奥拉帕利治疗标准的患者，目前没有关于先后或同时用药的数据。不过，由于某些复发风险较高残癌患者复发风险较高，可以考虑先后或同时用药。

Footnote eee clarified: There are no data on sequencing or combining adjuvantpembrolizumab withcapecitabine, pembrolizumab and/ or olaparib in patients who meet criteria for treatment with one or more of these agents. However, their sequential/combined use may be consideredgiven high-risk of recurrenceincertain patients withresidual disease high-risk of recurrence.

MS-2

新增：敏感/包容性措辞

Sensitive/Inclusive Language Usage

NCCN指南力求采用能够促进实现公平、包容和代表性的措辞。NCCN指南力求采用以人为本的措辞；不带歧视性；反种族主义、反阶级主义、反厌女主义、反年龄歧视、反残疾歧视和反体重歧视；包容全部性取向和性别认同的个体。NCCN指南纳入非性别措辞，取代侧重特定器官的推荐意见。该措辞既较准确，也较有包容性，有助于充分满足全部性取向和性别认同的个体需求。NCCN指南引用未采用包容性术语组织或来源的统计、推荐意见或数据时，将仍采用男人、女任、女性和男性等术语。大多数研究未报告如何收集生理性别和心理性别数据，并且交替或不一致地采用这些术语。如果资料来源未将心理性别与出生时认定性别或现有器官区分，那么推定该信息主要代表心理性别与出生时认定性别一致的个体。NCCN鼓励研究人员将来开展研究时收集更具体的数据，并鼓励研究组织将来分析时采用更包容和更精准的措辞。

NCCN Guidelines strive to use language that advances the goals of equity, inclusion, and representation. NCCN Guidelines endeavor to use language that is person-first; not stigmatizing; anti-racist, anti-classist, anti-misogynist, anti-ageist, anti-ableist, and anti-weight-biased; and inclusive of individuals of all sexual orientations and gender identities. NCCN Guidelines incorporate non-gendered language, instead focusing on organ-specific recommendations. This language is both more accurate and more inclusive and can help fully address the needs of individuals of all sexual orientations and gender identities. NCCN Guidelines will continue to use the terms men, women, female, and male when citing statistics, recommendations, or data from organizations or sources that do not use inclusive terms. Most studies do not report how sex and gender data are collected and use these terms interchangeably or inconsistently. If sources do not differentiate gender from sex assigned at birth or organs present, the information is presumed to predominantly represent cisgender individuals. NCCN encourages researchers to collect more specific data in future studies and organizations to use more inclusive and accurate language in their future analyses.

修改：指南更新方法学

Guidelines Update Methodology

在更新该版NCCN乳腺癌指南之前，采用以下检索词进行电子检索获取乳腺癌关键文献：乳腺癌、乳腺肿瘤、导管原位癌、炎性乳腺癌、或叶状乳腺癌。

Prior to the updateof this version of the NCCN Guidelines for Breast Cancer, an electronic search of the PubMed database was performed to obtain key literaturein Breast Cancer using the following search terms: Breast Cancer, Breast Neoplasms, DCIS, Inflammatory Breast Cancer, OR Phyllodes.