A range of updates to major oncology clinical practice guidelines have been released through 2025, with several new recommendations now incorporated into the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology and other expert guidance documents. These changes span multiple tumour types and reflect evolving evidence on therapy sequencing, novel agents, and precision-based care.
Non–Small Cell Lung Cancer (NSCLC)
-
The NCCN NSCLC guideline (Version 1.2026) has added datopotamab deruxtecan-dlnk (Dato-DXd; Datroway) as a preferred second-line regimen for patients with EGFR-mutated NSCLC who have progressed after frontline osimertinib-based therapy. It is also preferred as a third-line option after other initial regimens.
-
EGFR-targeted therapy pathways continue to evolve with integrated biomarker testing and expanded indications for precision agents.
Small Cell Lung Cancer (SCLC)
-
Updated SCLC guidance includes lurbinectedin added to atezolizumab as a maintenance option following standard first-line chemoimmunotherapy in extensive-stage disease. This reflects emerging data on improved outcomes with this combination.
-
The guidelines also note newer options in relapsed settings, such as DLL3-targeting agents, though specific recommendations depend on available clinical evidence.
Multiple Myeloma
-
Version 2.2026 of the NCCN multiple myeloma guideline now includes linvoseltamab-gcpt (Lynozyfic), a BCMA×CD3 bispecific antibody, as a preferred treatment option for patients after at least four prior therapies, including standard classes such as anti-CD38 mAbs, proteasome inhibitors,s and IMiDs.
Chronic Myeloid Leukaemia (CML)
-
The updated CML guideline highlights holistic patient assessment, including distress screening and consideration of drug interactions, individual TKI selection, and cost implications in treatment decisions.
-
This reflects a trend towards more patient-centred care beyond traditional risk scoring, though core molecular treatment pathways remain consistent with established practice.
Other Guideline Areas and Trends
-
NCCN continues to make regular guideline updates across tumour types, with recent versions released for colon, rectal, hepatocellular carcinoma, gastric, bladder, and other cancers.
-
A consolidated NCCN Guidelines Navigator was introduced to enhance accessibility of recommendations across cancer types and treatment domains.
Clinical Implications
These guideline revisions illustrate ongoing shifts in oncology practice:
-
New targeted and antibody-based therapies are being incorporated into standard treatment pathways based on emerging data.
-
Biomarker-driven selection is increasingly emphasised, particularly in lung cancer subtypes with actionable mutations.
-
Patient-centred elements, such as psychosocial assessment and treatment individualisation, are gaining prominence in haematologic disease guidance.
Clinicians are encouraged to review the full NCCN guideline documents for disease-specific nuances, as recommendations are regularly updated to reflect the latest evidence and regulatory changes.
Editor’s Note: The NCCN Guidelines Navigator provides interactive access to the latest NCCN Clinical Practice Guidelines in Oncology.
