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One of the leading entities that issues physician guidelines for cancer medicines frequently recommends off-label uses beyond those endorsed by regulators, and relies on “weak evidence” to make its influential decisions, according to a new analysis published in BMJ.

Of 47 cancer drugs approved by the Food and Drug Administration between 2011 and 2015, the National Comprehensive Cancer Network recommended 113 uses for the medicines, while the agency endorsed the treatments for 69 uses. Of the 44 additional NCCN recommendations, 14, or 32 percent, permitted use for treating a cancer other than what was specified by the FDA.

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