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Supporting Oncologists at the Point of Care: ESMO Living Guidelines

10 May 2023

ESMO launched the ESMO Living Guidelines, a new tool designed to make the ESMO Clinical Practice Guidelines (CPGs) easier to use in oncologists’ routine clinical practice and support optimal decision-making in a rapidly evolving medical field.

The ESMO Living Guidelines come in an interactive, concise and updatable visual format. They are currently available for metastatic breast cancer and will soon be released for several other tumour types.

An evolving understanding of the tumour molecular landscape, the discovery of numerous targetable mutations, and more drugs approvals for the treatment of cancer in recent years have created a need for more frequent updates to the recommendations provided to clinicians. Since 2016, ESMO had been addressing this need with the publication of eUpdates to its CPGs, through which new evidence and modified recommendations were published online as they became available, referencing specific sections of the full guidelines.

The Living Guidelines are a leap forward in the evolution of this idea as they offer a complete overview of patient management, centred around clear visual representations of the decision-making algorithms and key recommendations defined within the CPGs. Updates will be undertaken as needed to reflect relevant changes that impact ESMO’s recommendations, such as practice-changing research results or new efficacy or toxicity data, and integrated seamlessly into the relevant guideline module to give oncologists a holistic picture of the current state of the art in a given disease.

The Living Guidelines are a handy addition to the official ESMO Clinical Practice Guidelines, which still remain the reference source for the optimal management of each tumour type and disease setting. They come in a more concise, less text-heavy format that can be accessed directly on the ESMO website and contains all the relevant scores of medicines on the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) as well as those of alteration-drug matches on the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT). Supporting information is provided via interactive page elements and embedded links.

Going forward, selected new ESMO Clinical Practice Guidelines, where there is an identified need for frequent update, will be followed by the release of corresponding Living Guidelines that oncologists can conveniently reach for in their day-to-day practice using any desktop or mobile device.

With several editions slated to be published this year, including for colorectal and gastric cancer, lung and early breast cancer, ESMO intends to build up a library of Living Guidelines that can transform the way the ESMO

CPGs can be used, in line with their ultimate purpose of ensuring high-quality care for all patients with cancer.

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