LAUSR

The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines (CPGs), which have been produced since 1999, enable oncologists to embark on evidence-based, state-of-the-art management of their patients. The CPGs are produced by renowned multidisciplinary experts from all over the world, are independently reviewed by peers and are regularly updated either in the form of a concise electronic short section updating the parent guideline (e-Update) or as a new, full CPG. Their uptake and popularity has increased exponentially over the last decade; currently, CPGs are being downloaded >2 million times annually. In order to further build on their success, ESMO has reshaped them for better connection to the clinical reality that health care professionals face daily in oncology practice. The ESMO CPGs now contain flow charts on diagnosis and management, and every recommendation is accompanied by the level of evidence as well as two additional tool metrics developed by ESMO experts: the ESMO Magnitude of Clinical Benefit Score, which objectively quantifies the clinical benefit provided by an approved new therapy, and the ESMO Scale for Clinical Actionability of molecular Targets, which ranks molecularly aberrant drug pairs by their proven clinical utility. Despite these advances, some important questions remain: How implementable are our guideline recommendations in real-life settings? Are they taken up and applied similarly in tertiary/academic centres and in district general hospital/community settings? What about other world areas? Approximately 35% of the ESMO CPG downloads originate from users in Asia, Africa and the Americas. Consequently, what is the impact of the scientific and regulatory realities in those parts of the world on the uptake and implementation of the ESMO CPGs? What can ESMO do to survey and tackle these issues? The Pan-Asian Guideline Adaptation (PAGA) project was launched in 2017 jointly by ESMO and seven national oncology societies from China (Chinese Society of Clinical Oncology), India (Indian Society of Medical and Pediatric Oncology), Japan (Japanese Society of Medical Oncology), Korea (Korean Society of Medical Oncology), Malaysia (Malaysian Oncology Society), Singapore (Singapore Society of Oncology) and Taiwan (Taiwan Oncology Society), with a simple aim: to adapt the recommendations in