Guideline Update for 5/15/2025

National Cancer Comprehensive Network (NCCN)

The NCCN guidelines can be found at www.nccn.org.

Pediatric Aggressive Mature B-Cell Lymphomas Version 2.2025

In the latest version of these guidelines, the NCCN has updated the discussion section to reflect algorithm changes.

Soft Tissue Sarcoma Version 1.2025

The updated NCCN guidelines recommend a multidisciplinary approach for diagnosis, treatment planning, and management. Workup includes MRI/CT imaging and biopsy to determine histologic subtype and grade. Surgical resection with negative margins remains the cornerstone for localized disease, often combined with radiation therapy (neoadjuvant or adjuvant) depending on tumor size, grade, and location. Systemic therapy—primarily anthracycline-based regimens—is indicated for advanced, unresectable, or high-risk tumors, with regimens tailored to histologic subtype. For oligometastatic disease, local therapies such as metastasectomy, SBRT, or ablation may be considered. Follow-up protocols emphasize imaging and physical exams every 3–6 months for the first few years, then annually. Updates include expanded systemic therapy options, nuanced use of RT, and increased use of advanced imaging and ablative interventions in recurrent or metastatic settings.

US Preventive Services Task Force (USPSTF)

The USPSTF has published their update regarding syphilis infection screening during pregnancy. The USPSTF affirms an A recommendation for early, universal screening during pregnancy. They note no new studies addressing the effectiveness of such screening since their last recommendation on this topic in 2018.

Note: JAMA published a viewpoint discussing the possible threats to the USPSTF due to the new restructuring of the Department of Health and Human Services (HHS). This is not a recommendation from the USPSTF, but it is a very interesting discussion. You can check out the article on the JAMA website.

Prostate Cancer Foundation (PCF)

The Prostate Cancer Foundation’s white paper on combination therapy for metastatic hormone-sensitive prostate cancer (mHSPC) underscores combination treatment—including androgen deprivation therapy (ADT) plus androgen receptor pathway inhibitors (ARPIs), with or without docetaxel—as the standard of care for most patients based on robust evidence from multiple phase III trials (e.g., CHAARTED, STAMPEDE, PEACE-1, ARASENS). However, real-world adoption remains suboptimal, with 20%–60% of eligible patients receiving inadequate treatment due to systemic, financial, and geographic barriers. The report highlights disparities in access, particularly affecting older, non-White, and rural patients, and emphasizes the need for equitable care, education, standardized terminology, and policy advocacy. Notably, three-drug regimens (ADT + ARPI + docetaxel) have demonstrated superior efficacy compared to older doublet combinations. The PCF calls for coordinated efforts to bridge the implementation gap through targeted dissemination, real-world evidence synthesis, and enhanced inclusion of diverse populations in clinical trials to ensure all patients benefit from advances in mHSPC treatment.

American College of Rheumatology (ACR)

The 2025 ACR guideline for the treatment of systemic lupus erythematosus (SLE) emphasizes early diagnosis, disease activity monitoring, and a personalized treatment approach aiming for remission or low disease activity while minimizing glucocorticoid-related toxicity. Universal hydroxychloroquine use is strongly recommended unless contraindicated. Glucocorticoids should be used at the lowest effective dose and tapered promptly, with early initiation or escalation of immunosuppressive therapy when needed. For organ- or life-threatening disease, urgent combination therapy is advised. The guideline includes organ-specific recommendations (e.g., hematologic, neuropsychiatric, cutaneous, serositis) and supports a multidisciplinary, patient-centered approach.

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