Therapy for Stage IV Non–Small-Cell Lung Cancer With Driver Alterations: ASCO and OH (CCO) Joint Guideline Update

Author:

Hanna Nasser H.1,Robinson Andrew G.2ORCID,Temin Sarah3ORCID,Baker Sherman4,Brahmer Julie R.5,Ellis Peter M.6,Gaspar Laurie E.78,Haddad Rami Y.9,Hesketh Paul J.10ORCID,Jain Dharamvir11,Jaiyesimi Ishmael12,Johnson David H.13,Leighl Natasha B.14ORCID,Moffitt Pamela R.15,Phillips Tanyanika16,Riely Gregory J.17ORCID,Rosell Rafael18ORCID,Schiller Joan H.19ORCID,Schneider Bryan J.20,Singh Navneet21ORCID,Spigel David R.22ORCID,Tashbar Joan23,Masters Gregory24ORCID

Affiliation:

1. Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN

2. Kingston General Hospital, School of Medicine, Queen's University, ON, Canada

3. American Society of Clinical Oncology, Alexandria, VA

4. Virginia Commonwealth University, Richmond, VA

5. Sidney Kimmel CCC at JHU, Baltimore, MD

6. Juravinski Cancer Centre, Hamilton, ON, Canada

7. University of Colorado School of Medicine, Denver, CO

8. Banner MDA Cancer Center, Greeley, CO

9. Affiliated Oncologists, LLC, Chicago Ridge, IL

10. Lahey Hospital and Medical Center, Burlington, MA

11. Houston Methodist Cancer Center, Houston, TX

12. William Beaumont Hospital, Royal Oak, MI

13. University of Texas Southwestern Medical Center, Dallas, TX

14. Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

15. ALLIANCE For Clinical Trials in Oncology, Galva, IA

16. City of Hope, City of Duarte, CA

17. Memorial Sloan Kettering Cancer Center, New York, NY

18. Catalan Institute of Oncology, Barcelona, Catalonia, Spain

19. Inova Schar Cancer Institute, Falls Church, VA

20. Univ of MI Health System, Ann Arbor, MI

21. Postgraduate Institute of Medical Education and Research, Chandigarh, India

22. Sarah Cannon Research Institute, Nashville, TN

23. Circle of Hope for Cancer Research, Orlando, FL

24. Helen F. Graham Cancer Center and Research Institute, Newark, DE

Abstract

PURPOSE To provide evidence-based recommendations updating the 2017 ASCO guideline on systemic therapy for patients with stage IV non–small-cell lung cancer (NSCLC) with driver alterations. A guideline update for systemic therapy for patients with stage IV NSCLC without driver alterations was published separately. METHODS The American Society of Clinical Oncology and Ontario Health (Cancer Care Ontario) NSCLC Expert Panel updated recommendations based on a systematic review of randomized controlled trials (RCTs) from December 2015 to January 2020 and meeting abstracts from ASCO 2020. RESULTS This guideline update reflects changes in evidence since the previous update. Twenty-seven RCTs, 26 observational studies, and one meta-analysis provide the evidence base (total 54). Outcomes of interest included efficacy and safety. Additional literature suggested by the Expert Panel is discussed. RECOMMENDATIONS All patients with nonsquamous NSCLC should have the results of testing for potentially targetable mutations (alterations) before implementing therapy for advanced lung cancer, regardless of smoking status recommendations, when possible, following other existing high-quality testing guidelines. Most patients should receive targeted therapy for these alterations: Targeted therapies against ROS-1 fusions, BRAF V600e mutations, RET fusions, MET exon 14 skipping mutations, and NTRK fusions should be offered to patients, either as initial or second-line therapy when not given in the first-line setting. New or revised recommendations include the following: Osimertinib is the optimal first-line treatment for patients with activating epidermal growth factor receptor mutations (exon 19 deletion, exon 21 L858R, and exon 20 T790M); alectinib or brigatinib is the optimal first-line treatment for patients with anaplastic lymphoma kinase fusions. For the first time, to our knowledge, the guideline includes recommendations regarding RET, MET, and NTRK alterations. Chemotherapy is still an option at most stages. Additional information is available at www.asco.org/thoracic-cancer-guidelines .

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3