An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update, published by Hanna et al in the Journal of Clinical Oncology, also provides new recommendations on the use of targeted therapies for patients with changes in tumor EGFR, ALK, and ROS1 genes.
“Treatment for lung cancer has become increasingly complex over the past several years. This guideline update provides oncologists with the tools to choose therapies that are most likely to benefit their patients,” said Nasser Hanna, MD, Co-Chair of the expert panel that developed the guideline update.
ASCO published the last guideline on systemic therapy for stage IV NSCLC in 2015. To develop this update, an expert panel with multidisciplinary representation reviewed medical literature published between February 2014 and December 2016. A total of 14 randomized controlled clinical trials provided the evidence base for the recommendations.
“Our patients rely on us to keep up with the most effective and best tolerated therapies to help manage this devastating disease,” said Gregory Masters, MD, FACP, FASCO, Co-Chair of the expert panel that developed the guideline update. “Knowing when to use targeted therapies or immunotherapy in place of more toxic chemotherapy can help improve the quality of life of our patients.”
Key Recommendations
Key recommendations from the guideline update include:
First-Line Therapy
For patients with EGFR mutation–negative, ALK rearrangement–negative, and ROS1 rearrangement–negative tumors:
For patients with EGFR mutation–positive, ALK rearrangement–positive, or ROS1 rearrangement–positive tumors:
Second-Line Therapy
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.