NCCN Guidelines for Head and Neck Cancers V.1.
2023 – Annual on 06/30/22
Guideline Page
and Request
SURG-A 8 of 8
External request:
Submission from Wei Sun, MD at The First Affiliated
Hospital, Sun Yat-sen University, Department of
Otolaryngology Head and Neck Surgery and the Institute of
Otolaryngology Head and Neck Surgery on February 25,
2022. Specifically:
• To consider the inclusion of a new reference on
SURG-A 8 of 8 in regards to page SUPRA-2 which
specifies T1-2 cN0 patients need neck dissection.
• To consider the inclusion of a new reference on
SURG-A 8 of 8 in regards to page ORPH-2 and
ORPHPV-2 which does not specify T1-2 cN0 patients
need neck dissection.
NASO-B 1 of 3, SALI-B 1 of 2, SYST-A 2 of 4
External request:
Submission from Bristol Myers Squibb on April 11, 2022.
Specifically:
• To consider the inclusion of nivolumab in
combination with ipilimumab as a treatment option for
patients with tissue TMB-H (tTMB-H) head and neck
cancers who are refractory to standard therapies or
have no standard treatment options available.
Institution Vote
Panel Discussion/References
YES NO ABSTAIN ABSENT
Based on a review of the data and discussion, the 0 29 0 3
panel consensus did not support the inclusion of a
new reference on SURG-A 8 of 8 in regards to
page SUPRA-2 which specifies T1-2 cN0 patients
need neck dissection.
Based on a review of the data and discussion, the 0 29 0 3
panel consensus did not support the inclusion of a
new reference on SURG-A 8 of 8 in regards to
page ORPH-2 and ORPHPV-2 which does not
specify T1-2 cN0 patients need neck dissection.
See Submission for references.
Based on a review of the data and discussion, the 0 29 0 3
panel consensus did not support the inclusion of
nivolumab in combination with ipilimumab as a
treatment option for patients with tissue TMB-H
(tTMB-H) head and neck cancers who are
refractory to standard therapies or have no
standard treatment options available.
See Submission for references.
NCCN Guidelines for Head and Neck Cancers V.1.2023 – Annual on 06/30/22

Guideline Page Institution Vote

Panel Discussion/References
and Request YES NO ABSTAIN ABSENT
NUTR-A 1 of 2 Based on a review of the data and discussion, the 0 29 0 3
External request: panel consensus did not support the inclusion of
adding a new bullet regarding mucositis duration:
Submission from Translational Medicine Clinic & Research Prescribe polymerized cross-linked sucralfate to
Center on May 20, 2021. Specifically: reduce the duration of oral, pharyngeal and
• To consider the inclusion of a new bullet under the pharyngo-esophageal mucositis as clinically
“Pain” bullet regarding mucositis duration indicated.
● Mucositis Duration
►Prescribe polymerized cross-linked sucralfate to
reduce the duration of oral, pharyngeal and
pharyngo-esophageal mucositis as clinically
indicated. See Submission for references.
ADV-3, SALI-4, SYST-A 1 of 4
External Request:

Submission from Guardant on June 1, 2022. Specifically:

• To consider suggesting that comprehensive genomic
profiling (CGP) be performed via either a tissue- or
blood-based assay that is well validated for patients
with advanced or metastatic cancer at diagnosis or
recurrence.
o ADV-3, modify footnote e: Use next-generation Based on a review of the data and discussion, the 0 29 0 3
genomic profiling via a tissue- or plasma-based panel consensus did not support the addition of
broad molecular panel for biomarker these specific recommendations into the Guidelines
identification
o SALI-4, modify footnote p: For salivary ductal Based on a review of the data and discussion, the 0 29 0 3
carcinomas and adenocarcinomas, use NGS panel consensus did not support the addition of
profiling via a tissue- or plasma-based broad these specific recommendations into the Guidelines
molecular panel and other appropriate biomarker
testing to check status of androgen receptor
(AR), HER2, NTRK, HRAS, PIK3CA, and tumor
mutational burden (TMB) prior to treatment.
o SYST-A 1 of 4, modify first bullet: The choice of Based on a review of the data and discussion, the 0 29 0 3
systemic therapy should be individualized panel consensus did not support the addition of
based on patient characteristics (eg, PS, goals of these specific recommendations into the Guidelines
therapy). Next-generation sequencing (NGS)
genomic profiling via a tissue- or plasma-based
broad molecular panel may be considered to
guide patient treatment options, including clinical See Submission for references.
trials.
NCCN Guidelines for Head and Neck Cancers V.1.2023 – Annual on 06/30/22

Guideline Page Institution Vote

Panel Discussion/References
and Request YES NO ABSTAIN ABSENT
ADV-2, ADV-4 Based on the review of the data, the panel 29 0 0 3
Internal Request consensus was to include single agent systemic
therapy to the ECOG 3 pathway for M1 disease on
Comment to consider the inclusion of single agent systemic ADV-2 and ADV-4.
therapy to the ECOG 3 pathway for M1 disease.
SALI-B (1 of 2) Based on the review of the data, the panel 29 0 0 3
Internal Request consensus was to include the addition of MSI-H
and dMMR to pembrolizumab for recurrent,
Comment to consider the addition of MSI-H and dMMR to unresectable, or metastatic salivary gland tumors
pembrolizumab for recurrent, unresectable, or metastatic (with no surgery or RT option)
salivary gland tumors (with no surgery or RT option).
SYST-A (2 of 4) Based on the review of the data, the panel 29 0 0 3
Internal Request consensus was that pembrolizumab as an option
for recurrent, unresectable, or metastatic non-
Comment to reassess the data for pembrolizumab as a nasopharyngeal cancer (with no surgery or RT
category 1 for CPS ≥ 1 as an option for First-Line therapy for option) and CPS ≥ 1 is supported by high-level
recurrent, unresectable, or metastatic non-nasopharyngeal evidence, and the category was changed from
cancer (with no surgery or RT option) under Preferred category 2A to a category 1 recommendation
Regimens.
SYST-A (2 of 4) Based on the review of the data, the panel 29 0 0 3
Internal Request consensus was to include pembrolizumab for TMB-
H recurrent, unresectable or metastatic (first- or
Comment to consider the inclusion of pembrolizumab for subsequent-line with no surgery or RT option) non-
TMB-H recurrent, unresectable or metastatic (first- or nasopharyngeal cancers.
subsequent-line with no surgery or RT option) non-
nasopharyngeal cancers