Therapy for Stage IV Non–Small-Cell Lung Cancer With Driver Alterations: ASCO Living Guideline. Issue 28 (1st October 2022)

• Record Type: Journal Article
• Authors: Singh, Navneet; Temin, Sarah; Baker, Sherman; Blanchard, Elizabeth; Brahmer, Julie R.; Celano, Paul; Duma, Narjust; Ellis, Peter M.; Elkins, Ivy B.; Haddad, Rami Y.; Hesketh, Paul J.; Jain, Dharamvir; Johnson, David H.; Leighl, Natasha B.; Mamdani, Hirva; Masters, Gregory; Moffitt, Pamela R.; Phillips, Tanyanika; Riely, Gregory J.; Robinson, Andrew G.; Rosell, Rafael; Schiller, Joan H.; Schneider, Bryan J.; Spigel, David R.; Jaiyesimi, Ishmael A.
• Is Part Of: Journal of clinical oncology. Volume 40:Issue 28(2022)
• Page Start: 3310
• Page End: 3322
• Publication Date: 2022-10-01
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.22.00824
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : Living guidelines are routinely updated guidelines that are developed for selected topic areas with rapidly evolving evidence that drives frequent change in clinical practice. These guidelines are updated on a regular schedule, based on the work of a standing panel that reviews the literature on a continuous basis. Updates will be made regularly and can be found at https://ascopubs.org/nsclc-da-living-guideline . PURPOSE: To provide evidence-based recommendations updating the 2021 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non–small-cell lung cancer (NSCLC) with driver alterations. METHODS: ASCO updated recommendations on the basis of an ongoing systematic review of randomized control trials from 2020 to 2021. RESULTS: This guideline update reflects changes in evidence since the previous update. Two studies provide the evidence base. Outcomes of interest include efficacy and safety. RECOMMENDATIONS: For patients with an anaplastic lymphoma kinase rearrangement, a performance status (PS) of 0-2, and previously untreated NSCLC, clinicians should offer alectinib or brigatinib or lorlatinib. For patients with an anaplastic lymphoma kinase rearrangement, a PS of 0-2, and previously untreated NSCLC, if alectinib, brigatinib, or lorlatinib are not available, clinicians should offer ceritinib or crizotinib. For patients with a RET rearrangement, a PS of 0-2, and previously untreated NSCLC, clinicians may offer selpercatinib or pralsetinib. In second line, for patients with a RET rearrangement who have not received RET-targeted therapy, clinicians may offer selpercatinib or pralsetinib. Additional information is available at www.asco.org/thoracic-cancer-guidelines .