NCCN Chemotherapy Templates User Guide

USER GUIDE
NCCN Chemotherapy Order Templates

(NCCN Templates®)
Access to the NCCN Chemotherapy Order Templates (NCCN Templates®)

for non-commercial users is available via subscription.
Prior to accessing the NCCN Templates®, users must accept an End-User

License Agreement (EULA) and create a free account or login with an
existing account on NCCN.org.
About the NCCN Templates®

NCCN continues to add to the library of chemotherapy order templates to improve the safe use of drugs and
biologics in cancer care. NCCN Templates are intended for personal and practical use only. The information
contained in the NCCN Templates is based on the NCCN Clinical Practice Guidelines in Oncology (NCCN
Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®). The NCCN Templates
include chemotherapy, immunotherapy, supportive care agents, monitoring parameters, and safety
instructions. Special instructions for self-administered chemotherapeutic agents are also provided.
NCCN Templates enhance patient safety by allowing you to:
• Standardize patient care

• Reduce medication errors
• Anticipate and manage adverse events
An NCCN Template does not constitute an order. Any clinician seeking to treat a patient using the NCCN
Templates is expected to use independent medical judgement in the context of the individual clinical
circumstances specific to the patient’s care or treatment.
The NCCN Templates Committee and the NCCN Templates reviewers play a critical role in the development
and maintenance of the NCCN Templates. The NCCN Templates Committee and NCCN Templates reviewers
consist of physicians, pharmacists, and nurses from NCCN Member Institutions. They are selected based on
their clinical expertise with regard to systemic therapies as well as disease-specific subspecialty areas. NCCN
Template content is reviewed annually based on the NCCN Guidelines®, the NCCN Compendium®, published
drug information and research, and clinical experience.
NCCN recognizes and thanks committee members and volunteer reviewers for contributing their time and
expertise by listing their names on NCCN.org/templates.

NCCN.org/templates
NCCN Templates® 1
1 The NCCN Templates website contains a drop-down menu for displaying
the template library by cancer type and/or agent name.

Appendices A through G
provide supplementary
information about common 
topics across the library of
chemotherapy order templates.
Endorsed resources are listed 

that may be helpful in applying
the information contained in the
chemotherapy order templates.
NCCN Templates® 2
2 To display the template library for the cancer type or agent of your choice,
select any item from the drop-down menus.

Text can be entered into the “Search” box to 

narrow down the results using information in
any of the columns.

Click the “Sort” icon on any of the
columns to sort alphabetically.
Click on the Regimen Name


hyperlink to open a template.
NCCN Templates® 3
Below is an example of an NCCN Chemotherapy Order Template, CRV1:
3 PACLitaxel/CISplatin for Cervical Cancer. Each section is described in
more detail using the associated letters.

A. Template Header/
A
Regimen Name
The template header lists the cancer type

for which the regimen is recommended,
and is associated with a specific NCCN B C D
Guideline. The regimen name is listed
below the cancer type and includes the
regimen acronym (if applicable), the agents
included in the regimen, and may also
include the length of the regimen if the
same regimen has more than one option for
cycle length.
E
Tall Man lettering is included where
applicable, as described in more detail in
Appendix G: Tall Man Lettering.
B. Indication
The indication(s) is/are derived directly

from the associated NCCN Guidelines.
F
These are usually summarized, thus it is
recommended to refer to the associated
NCCN Guidelines for more detailed
information. NCCN Templates are also
linked to the corresponding entry (or
entries) in the NCCN Compendium.
C. References
The active links in this section include the

associated NCCN Guidelines as well as
published literature that supports the listed
regimen. Each reference is assigned a
superscript according to the classification
outlined in Appendix E: Regimen

References.
Continued on next page.
NCCN Templates® 4
more detail using the associated letters (continued).

Continued from previous page.
D. NCCN Supportive Care
This section addresses emetic risk and

febrile neutropenia risk levels.
Emetic Risk
D
The emetic risk level listed on the NCCN
Templates is based on recommendations
in the NCCN Guidelines for Antiemesis. The
highest emetic risk level for each day of
therapy is listed in this section and includes
all days of treatment.
For more information on emetic risk levels,

please refer to Appendix D: Nausea/
Vomiting.
Febrile Neutropenia Risk

The febrile neutropenia risk level listed
on the NCCN Templates is based on
recommendations in the NCCN Guidelines
for Myeloid Growth Factors. If the specific
regimen is not included in the NCCN
Guidelines for Myeloid Growth Factors,
NCCN may add a febrile neutropenia risk
level to the template if appropriate based
on a review of the literature.
Risk levels of either “High Risk” or

“Intermediate Risk” are called out
specifically in this section of the templates.
Regimens with unique considerations,
unknown risk, or low risk based on the
available literature refer back to the NCCN
Guidelines for consideration of additional
variables including patient- and disease-
specific factors.
For more information on febrile neutropenia

risk, please refer to Appendix C: Growth
Factors.

Continued next page.
NCCN Templates® 5

E. Chemotherapy Regimen
This section focuses on drug

administration, including cycle definition
(which contains the cycle length, number
of cycles, and other schedule-related
information), dosing, frequency, and routes
of administration. For standardization,
regimens with continuous daily dosing are
represented using a 28-day cycle length.
The NCCN Templates designate a specific

order of administration if conclusive
evidence is available to support a
suggested chemotherapy sequence based E
on improved efficacy, decreased toxicity, or
established clinical practice. Regimens with
a recommended order of administration are
designated with connecting phrases such
as “concurrent with” or “followed by” as
listed in CRV1 above. For more information,
please refer to Appendix F: Chemotherapy
Administration Sequence.
For more information regarding

chemotherapy calculations, please refer to
Appendix A: Chemotherapy Calculations.
For more information regarding carboplatin

dosing, please refer to Appendix B:
Carboplatin Dosing.

NCCN Templates® 6

F. Supportive Care
This section addresses specific

recommendations for Premedications,
Antiemetic Therapy, Myeloid Growth Factor
Therapy, and Other Supportive Therapy.
Only the sections that are relevant to
a particular regimen will display on the
template.
Premedications
This section includes specific
recommendations for premedication(s)
for reasons including, but not limited to,
infusion reactions/hypersensitivity, fluid
retention, and arachnoiditis. Doses may
appear as ranges if clinically appropriate,
to allow for provider or institutional
customization based on product availability
and other considerations.
Antiemetic Therapy
This section includes general guidance
for selection of antiemetic therapy based
F
on the emetic risk designated for the
regimen. Links to the NCCN Guidelines and
Appendix D: Nausea/Vomiting are included
for more information.
Myeloid Growth Factor Therapy

This section includes general guidance for
selection of prophylactic colony stimulating
factor (CSF) support based on the febrile
neutropenia risk level. Links to the NCCN
Guidelines and Appendix C: Growth
Factors are included for more information.

NCCN Templates® 7

F. Supportive Care (continued)
Other Supportive Therapy

This section includes general F
recommendations with examples for
supportive care medications, such
as hydration, anti-infectives, or anti-
diarrheals. These notes are not meant to
be prescriptive, but rather to alert clinicians G
that patients may require additional
treatment support.
G. Monitoring and Hold

Parameters
The information in this section includes

recommendations for monitoring found in
the NCCN Guidelines, drug package insert,
other drug information resources, and
clinical experience. Adverse effects,
including those listed as warnings and
precautions are assessed for frequency
H
of occurrence, as well as for actionable
measures that could be taken either via
routine monitoring or via treatment once the H. Safety Parameters and Special Instructions
adverse event has occurred.
This section reviews specific safety considerations as well as unique
When appropriate, recommendations for
administration instructions. Examples of the information in this section include
laboratory tests or other assessments to
use of filters or specific tubing requirements, vesicant/irritant properties, drug
monitor for toxicities and adverse reactions
interactions, administration of oral medications with or without food, and REMS
are provided in a general format to allow
program requirements.
for discretion of the ordering prescriber
or institutional preference as clinically
appropriate. The level of specificity may
vary depending on the available information,
and clinicians are encouraged to refer to
the package insert for more information.
Examples of adverse effects that are
generally excluded from the templates
include fatigue, weakness, and malaise.
Notes in this section may state that potential

dose modification or discontinuation may
be required based on toxicity or tolerability.
Dose modification refers to actions
including, but not limited to, dose reduction,
change in frequency, and/or holding the
drug for a period of time. Clinicians are
encouraged to review the package insert for
more detailed information.
NCCN Templates® 8
C-N-2269-0818

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USER GUIDE

NCCN Chemotherapy Order Templates

Access to the NCCN Chemotherapy Order Templates (NCCN Templates®)

Prior to accessing the NCCN Templates®, users must accept an End-User

About the NCCN Templates®

NCCN Templates enhance patient safety by allowing you to:

• Standardize patient care

Endorsed resources are listed 

Text can be entered into the “Search” box to 

Click on the Regimen Name

The template header lists the cancer type

The indication(s) is/are derived directly

The active links in this section include the

D. NCCN Supportive Care

This section addresses emetic risk and

For more information on emetic risk levels,

Febrile Neutropenia Risk

Risk levels of either “High Risk” or

For more information on febrile neutropenia

This section focuses on drug

The NCCN Templates designate a specific

For more information regarding

For more information regarding carboplatin

This section addresses specific

Myeloid Growth Factor Therapy

Continued on next page.

F. Supportive Care (continued)

Other Supportive Therapy

G. Monitoring and Hold

The information in this section includes

Notes in this section may state that potential

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