The American Society of Clinical Oncology (ASCO) is a professional organization representing physicians of all oncology sub-specialties who care for people with cancer. Founded in 1964 by Fred Ansfield, Harry Bisel, Herman Freckman, Arnoldus Goudsmit, Robert Talley, William Wilson, and Jane C. Wright, it has nearly 45,000 members worldwide.
PURPOSE:To update the ASCO guideline on use of hematopoietic colony-stimulating factors (CSFs) in patients with cancer. METHODS:A systematic review identified randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed use of CSFs for the prevention or treatment of neutropenic events, or for mobilization of stem cells, in adults with cancer. PubMed and the Cochrane Library were searched for articles published from September 1, 2014, to August 22, 2025. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS:The updated systematic review included 33 RCTs and 16 systematic reviews. Additions to the body of evidence include approval of new CSFs and additional biosimilars, and approval of an additional CXCR4 inhibitor that may be used with CSFs for the mobilization of hematopoietic stem cells. RECOMMENDATIONS:Prophylactic use of CSFs to reduce the risk of febrile neutropenia is warranted when the risk of febrile neutropenia from chemotherapy is approximately 20% or higher and no other equally effective and safe regimen that does not require CSFs is available. For patients receiving chemotherapy with a <20% risk of febrile neutropenia, primary prophylaxis with a CSF may be warranted if patients are at a high risk of febrile neutropenia based on age, medical history, or disease characteristics. For stem-cell mobilization, CSFs may be used either alone, after chemotherapy, or in combination with plerixafor or motixafortide. The guideline also provides information about the dosing and selection of CSFs.Additional information is available at www.asco.org/supportive-care-guidelines.
ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual. ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines.Clinical Practice Guidelines and other guidance ("Guidance") provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and Appendix 2 (online only) for more. PURPOSE:To provide guidance to oncology clinicians on using effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and caregiver well-being. METHODS:ASCO convened a multidisciplinary panel of medical oncologists, hematologists, nurses, hospice and palliative medicine clinicians, and communication skills and advocacy experts to develop recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review encompassed systematic reviews and randomized controlled trials (RCTs) published from October 1, 2016, through January 16, 2025. RESULTS:The systematic review identified 73 publications (54 systematic reviews and 19 RCTs). Included studies varied with respect to setting and the interventions and outcomes evaluated. Recommendations were developed using a formal consensus process. Draft recommendations underwent two rounds of consensus voting before being finalized. RECOMMENDATIONS:Recommendations address core communication skills and tasks that apply across the continuum of cancer care, as well as specific topics such as discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating involvement of the patient's support network, and clinician training in communication skills. In addition, new topics addressed by this update include telehealth, interprofessional communication, and boundary setting. Recommendations are accompanied by suggested strategies for implementation. Full implementation of communication best practices will require that health systems provide adequate time, training, and support for clinicians.Additional information is available at www.asco.org/supportive-care-guidelines.
PURPOSE:To provide guidance regarding the systemic treatment of patients with high-grade serous and/or endometrioid epithelial ovarian, fallopian tube, or primary peritoneal cancer (EOC) experiencing recurrence. METHODS:ASCO convened an Expert Panel to conduct a systematic review of relevant studies and develop recommendations for clinical practice. RESULTS:Eight hundred nineteen publications were identified in the literature search. After applying the eligibility criteria, 147 publications of randomized controlled trials and systematic reviews comprising the entire body of evidence remained, forming the evidentiary basis, of which 36 directly informed the guideline recommendations. RECOMMENDATIONS:For patients with recurrent platinum-sensitive EOC, clinicians should offer platinum-based combination regimens, specifically pegylated liposomal doxorubicin (PLD) plus carboplatin, paclitaxel plus carboplatin, or gemcitabine plus carboplatin. Bevacizumab may be added to a platinum-based doublet followed by bevacizumab maintenance. For patients who are not candidates for platinum-based therapy, clinicians may utilize recommendations for first-line treatment of patients with relapsed platinum-resistant disease. For patients with platinum-resistant or platinum-refractory EOC high-grade disease and validated folate receptor alpha (FRα) expression, mirvetuximab soravtansine is strongly recommended. Other recommended systemic options for this population include PLD monotherapy, paclitaxel (once weekly or once every 3 weeks), bevacizumab in combination with chemotherapy, or the combination of relacorilant and nab-paclitaxel; gemcitabine monotherapy remains a conditional alternative. Regarding surgical interventions, there is currently insufficient evidence to recommend secondary cytoreduction or hyperthermic intraperitoneal chemotherapy. Clinicians may discuss secondary cytoreduction for platinum-sensitive recurrences where complete gross resection is highly achievable. Post-treatment monitoring and specialty survivorship care should be offered on a case-by-case basis, potentially including physical exams, biochemical testing, and imaging. There is insufficient data to recommend one combination versus another.Additional information is available on the ASCO Publications website.Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients.Clinical Practice Guidelines and other guidance ("Guidance") provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases, or stages of diseases. Guidance is based on review and analysis of relevant literature and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in the Appendix (online only) for more.
9007 Background: Since transition to virtual interviews, application and interview inflation have increased the work burden of GME recruitment. In 2021, AAMC ERAS implemented a process that allows applicants to assign signals to top programs of interest. There is a paucity of guidance on optimal use of ERAS signals (ES), resulting in apprehension and uncertainty amongst applicants and program directors (PD). For the 2026 ERAS cycle, Hematology/Oncology programs (HOP) had the option to participate in ES, in which applicants are provided 5 gold (G) signals and 15 silver (S) signals. First-hand knowledge on how ES was utilized by HOP, as well as PD perceptions about ES, may guide best practices on ES. Methods: During the ASCO Oncology Training Program Leadership Retreat in November 2025, an anonymous survey, assessing HOP utilization and perception of ES, and the impact of ES on recruitment practices, was launched. One PD from each HOP was invited to complete the survey while onsite. Results: 88 HOP (46% of ACGME HOP) are represented. 97% (n=85) utilized ES. Of HOP who used ES, 74% are academic. 32% are small (1-9 fellows), 43% medium (10-19 fellows), and 25% large (20+ fellows). 79% received 400+ applications. 69% reviewed applications without signals but gave higher consideration to signaled applicants. 25% only reviewed applications with signals. 28% used ES when creating rank list; 45% think ES utilization is appropriate during ranking. 85% reported ES did not alter their approach to applicants requiring visa sponsorship. 78% felt ES made the interview selection process easier. 66% were more satisfied with this year’s recruitment process compared to years without ES. The most requested change to ES was reduction of allowed signals, especially silver. 98% will use ES next year. Conclusions: Despite limited knowledge on ES impact on recruitment, nearly all surveyed HOP participated in ES this past year and will continue. Most HOP view ES positively though many desire changes, particularly with the number of signals. Most HOP consider all applications regardless of ES. However, some HOP with larger applicant pool are using ES as inclusion criteria for interview consideration. Signals are a strong predictor for interview invitation when internal selection criteria are met. The “borderline” applicant may be the greatest benefactor from ES, viewed similarly to the non-signaled applicant who meets internal selection criteria. Sharing PD perspectives and real-life data from this year’s ES process breeds opportunities for further improvement and increased confidence with ES. Likelihood HOP offer interview invitation based on quality of application and signals (%, n=85). Internal Selection Criteria Signal Extremely Likely Likely Neutral Unlikely Extremely Unlikely Met G 73 22 5 0 0 S 42 47 8 2 1 None 8 27 24 22 19 Nearly met G 4 35 39 19 3 S 0 9 52 28 11 Not met G 0 2 12 41 45 S 1 1 6 30 62
OBJECTIVE:To explore stakeholder experiences with implementing the living guideline (LG) development framework in oncology, and to identify barriers, facilitators and solutions to support its uptake and sustainability. DESIGN:An exploratory sequential mixed methods design was used, beginning with qualitative semi-structured interviews with guideline development stakeholders, analysed thematically; and followed by a cross-sectional survey to quantitatively rate the importance of factors identified in phase one. SETTING:National and international oncology guideline development programmes using the LG development framework. PARTICIPANTS:Stakeholders involved in LG development, including expert panel co-chairs, panel members, patient representatives, methodologists and administrative staff. RESULTS:Nine stakeholders participated in qualitative interviews, and 45 completed the survey. Most participants were male (5/9:56% qualitative; 26/45:58% quantitative) and based in the US (7/9:78% and 29/45:64%, respectively). Overall, the results from both the qualitative and quantitative strand revealed seven themes (34 subthemes) as barriers and six themes (21 subthemes) as facilitators. Additionally, 9 themes were proposed as solutions. The most frequently reported barriers included evidence timeliness, interpretation and publication delays. Prominent facilitators included effective management, resource optimisation and panel engagement. Participants strongly endorsed investment in artificial intelligence enhanced tools to improve the speed and efficiency of evidence acquisition and review. CONCLUSION:While the LG framework provides strong methodological guidance, its practical application presents notable challenges, particularly in resource demands and implementation logistics. Successful adoption requires adequate infrastructure, expertise and oversight. These findings highlight critical considerations for developers aiming to implement sustainable LG models in oncology and beyond.
