A Mission to Cure “All the Cancers”: Crystal Denlinger, MD, FACP, Named CEO of NCCN

This article updates a previous version that appeared August 23, 2023.

Crystal S. Denlinger, MD, FACP, who served for 2 years as senior vice president and chief scientific officer of the National Comprehensive Cancer Network (NCCN), on October 9, 2023, became CEO of the 28-year-old alliance, whose Clinical Practice Guidelines in Oncology (NCCN Guidelines) have become the gold standard for payers in making coverage decisions in cancer care and serve as the starting point for many clinical pathways tools.

NCCN announced Denlinger’s appointment in a statement August 23, 2023, following a national search for a successor to Robert W. Carlson, MD, who will retire after leading the organization for a decade. Carlson announced his retirement plans in January.¹

As CEO, Denlinger will oversee more than 150 employees at the NCCN global headquarters, located outside Philadelphia, Pennsylvania. The group’s chief job is maintaining the library of NCCN Guidelines, which outline clinical standards for managing all types of cancer, as well as policy directives. Panels made up of leaders from NCCN’s 33 member institutions meet regularly to review the latest research and update guidelines as needed.²

Denlinger

Carlson

Use of the NCCN Guidelines has expanded greatly over the past decade: There were 4.4 million downloads in 2012; that increased to 13.3 million in 2022, according to the organization.¹

In an interview with Evidence-Based Oncology (EBO), Denlinger said just keeping up with the ever-quickening pace of innovation is one of NCCN’s biggest challenges—and what makes the guidelines more important than ever.³

“We recognize our role in the oncology field, and we work to ensure that our guidelines remain up-to-date and reflective of the current evidence that defines appropriate care,” she said. NCCN must not only stay on top of the guidelines, Denlinger said, but the staff also oversees the NCCN Drugs and Biologics Compendium, which supports decision-making, and makes sure its other derivative products align with guideline updates.

“We recognize that oncologists, in academia and in the community, look at our guidelines to remain current with what the current standards of care are. And we want to rise to that challenge—we do rise to that challenge every day.”

Today’s other challenge, she said, “is ensuring that our guideline recommendations are accessible to the entire oncology community, including providers, payers, policymakers, and patients around the world.”

Learning Something New Every Day
Denlinger earned a combined BS/MD degree from The College of New Jersey and Rutgers New Jersey Medical School; she then completed a residency in internal medicine at Mount Sinai Medical Center and a hematology/oncology fellowship at Fox Chase Cancer Center/Temple University Hospital in Philadelphia, Pennsylvania. She stayed at Fox Chase, a founding member of NCCN, for 15 years before taking the position of chief scientific officer in 2021. Denlinger was associate professor and chief of gastrointestinal medical oncology when she came to NCCN full time; she still practices at Fox Chase 1 morning a week.^1,4
She has authored hundreds of clinical research articles and abstracts and received awards from organizations that include the American Society of Clinical Oncology Foundation and the American College of Physicians.

During her time at Fox Chase, Denlinger was named an NCCN Young Investigator Awardee, and in 2018, she received the NCCN Rodger Winn Award for exemplifying leadership, drive, and commitment in service to developing the NCCN Guidelines. She chaired the guidelines panel for survivorship and served on the bone, esophageal/gastric, and occult primary cancers panel, the panel for older adult oncology, the editorial board for Journal of the National Comprehensive Cancer Network, and numerous abstract and scientific review committees. Denlinger also took part in the development of the NCCN Harmonized Guidelines for Sub-Saharan Africa.¹

Given her familiarity with NCCN when she became chief scientific officer, was there anything that surprised her?

“I learn something new about NCCN every day that I’m here,” she said during the interview with EBO. “I continuously learn new things that surprise me about the breadth and the depth of the efforts that the NCCN staff [make] here at headquarters, as well as what our member institutions are doing in their own efforts across the country.”

For all her committee work during her Fox Chase years, Denlinger said, “I realized that was just the tip of the iceberg.” She’s come to fully appreciate the global impact of NCCN and the guidelines on cancer care, as well as cancer policy. “And I look forward to continuing to learn as CEO.”

An Active Chief Scientific Officer
In the past 2 years, Denlinger has overseen multiple initiatives related to diversity, equity, and inclusion, including the development of the Health Equity Report Card.⁵ The first-wave data are still being gathered, and Denlinger said she looks forward to reporting on them. She has overseen the NCCN Compendium, the Biomarkers Compendium, and the library of Chemotherapy Order Templates, as well as research grants through the NCCN Oncology Research Program.

“Dr Denlinger is the perfect person to build on Dr Carlson’s impressive and enduring work leading this premier oncology organization,” John W. Sweetenham, MD, FRCP, FACP, FASCO, professor of medicine and associate director for Cancer Network Clinical Affairs at the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern and chair of the NCCN Board of Directors, said in a statement.¹

“She has shown a career-long commitment to improving outcomes and experiences for all people with cancer. Dr Denlinger is beloved throughout NCCN and the larger oncology community. Her tireless efforts and excellence treating patients, advancing new research, forging partnerships, and advocating on Capitol Hill will help NCCN continue to define and advance high-quality, high-value, patient-centered cancer care globally for years to come.”

What’s Ahead for NCCN
The organization’s growth can be measured by the numbers seen over Carlson’s tenure: When he arrived NCCN oversaw 58 guidelines, along with 11 NCCN Guidelines for Patients, which are consumer-friendly versions designed to aid in shared decision-making. Today, there are 84 NCCN Guidelines and 67 Guidelines for Patients.¹

“We’re constantly working to improve and facilitate quality, effective, equitable, and accessible cancer care,” Denlinger said in the EBO interview. Recent efforts include expanding clinical practice guidelines in pediatric cancers and digitizing guidelines to make them easier to use, she said.

She also sees NCCN expanding its global efforts, with current expansion efforts in Vietnam and Poland, and ongoing efforts in Latin America, the Caribbean, North Africa, the Middle East, and sub-Saharan Africa. NCCN will continue its work to give patients the ability to engage in shared decision-making, as well as its focus on diversity and inclusion.

“As new issues and initiatives in oncology arise, we will be evaluating whether we would like to continue to add to our initiatives to ensure that equitable and accessible cancer care is delivered to everyone.”

Motivated by Her Family’s Story
“I have wanted to be a doctor since I was in first grade,” Denlinger said. Thoughts of private practice gave way to oncology when she was 17 years old. “My dad was diagnosed with kidney cancer. And at the time, there were not a lot of therapies for kidney cancer. In fact, he had surgery, and the oncologist at the time said, ‘I don’t know what to do. We’re just going to watch and see what happens.’ I was in medical school when he when he had his first recurrence, and over the course of the next 15 years, he had 10 surgeries; he went through clinical trials.

“Ultimately, toward the end of his life, standard therapies were developed for kidney cancer. But that moment [of diagnosis] was a defining moment for me, because I recognized that cancer was where I wanted to put my time and effort, and I set my sights on curing cancer at that point.”

Most academic oncologists, however, work on a single type of cancer. “It was hard to cure all the cancers. But I saw NCCN as a resource and a tool that can actually be utilized to affect a cure for cancer, and really affect outcomes,” she said. “And so, working here has been an absolute dream.” 

References
1. Crystal S. Denlinger, MD, FACP, named new CEO of the National Comprehensive Cancer Network; Robert W. Carlson, MD, retiring after 10 years leading global oncology nonprofit. News release. PR Newswire. August 23, 2023. Accessed September 8, 2023. https://bit.ly/3LbTQdF
2. NCCN names UChicago Medicine Comprehensive Cancer Center as 33rd member institution. News release. UChicago Medicine. April 4, 2023. Accessed September 8, 2023. https://bit.ly/3PyQtQI
3. Caffrey M, Klein HE. As incoming CEO, Dr Crystal Denlinger highlights NCCN guidelines, challenges, and treatment access. American Journal of Managed Care. August 23, 2023. Accessed September 8, 2023. https://bit.ly/489I4tW
4. Crystal Denlinger, LinkedIn. Accessed September 8, 2023. https://www.linkedin.com/in/crystal-denlinger-md/
5. Health equity report card pilot project to help close the care gap highlighted on World Cancer Day. News release. PR Newswire. February 4, 2023. Accessed September 8, 2023. https://prn.to/3r7cUCV

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