On November 8, 2018, ASCO and the National Comprehensive Cancer Network® (NCCN®) held a meeting with key stakeholders with the goal of developing consistency and harmony among clinical practice guidelines for pain control in individuals with cancer-related pain, as well as to address the critical pain management needs of patients with sickle cell disease.
Amid the growing opioid abuse epidemic in the United States, ASCO, NCCN and the Centers for Disease Control and Prevention (CDC) have separately developed pain management guidelines to provide evidence-based guidance on the optimum management of cancer pain in the clinical setting. A JAMA Oncology article “Bridging the Critical Divide in Pain Management Guidelines from the CDC, NCCN, and ASCO for Cancer Survivors” noted “a need for key agencies and organizations to collaborate on resolving inconsistencies in guideline recommendations and communicating those recommendations in an accessible manner to oncology clinicians as well as primary care clinicians who may manage or co-manage cancer pain with oncologists.”
In addition to ASCO and NCCN leadership and guideline panel chairs, other participants in the meeting included representatives from CDC, who discussed the CDC guideline, and the American Society of Hematology, who discussed guideline needs for sickle cell patients. The researchers behind the original JAMA Oncology article, Salimah Meghani, PhD, MBE, RN, FAAN, and Neha Vapiwala, MD, both from the University of Pennsylvania, also played an integral part in the conversation. Food and Drug Administration Commissioner Scott Gottlieb, MD, provided opening remarks.
Meeting participants identified a range of issues that need to be addressed and, moving forward, will continue to work together to clarify pain management clinical treatment guidelines.
Congress, the Administration, and multiple federal agencies are involved in efforts aimed at preventing and responding to prescription drug abuse. While ASCO and NCCN fully support efforts to address the issues surrounding opioid misuse and abuse, the organizations have issued policy statements expressing concern that some of these initiatives could have the unintended consequence of limiting access to treatment of pain for cancer patients (see here for a statement from ASCO, here for NCCN’s response to an FDA citizen petition, and here for NCCN’s response to proposed CMS regulations).