Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2023.3

Author:

Jaiyesimi Ishmael A.1,Leighl Natasha B.2ORCID,Ismaila Nofisat3ORCID,Alluri Krishna4ORCID,Florez Narjust5ORCID,Gadgeel Shirish6ORCID,Masters Gregory7ORCID,Schenk Erin L.8ORCID,Schneider Bryan J.9,Sequist Lecia10ORCID,Singh Navneet11ORCID,Bazhenova Lyudmila12ORCID,Blanchard Elizabeth13,Freeman-Daily Janet14ORCID,Furuya Naoki15ORCID,Halmos Balazs16ORCID,Azar Ibrahim Hanna17ORCID,Kuruvilla Sara18,Mullane Michael19,Naidoo Jarushka20ORCID,Reuss Joshua E.21ORCID,Spigel David R.22ORCID,Owen Dwight H.23ORCID,Patel Jyoti D.24ORCID

Affiliation:

1. Corewell Health William Beaumont University Hospital, Royal Oak and Oakland University William Beaumont School of Medicine, Rochester, MI

2. Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada

3. American Society of Clinical Oncology ASCO, Alexandria, VA

4. St Luke's Mountain States Tumor Institute, Boise, ID

5. Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA

6. Henry Ford Cancer Institute/Henry Ford Health System, Detroit, MI

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

8. University of Colorado Anschutz Medical Center, Aurora, CO

9. University of Michigan Health System, Ann Arbor, MI

10. Massachusetts General Hospital, Boston, MA

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

12. University of California San Diego Moores Cancer Center, San Diego, CA

13. Southcoast Centers for Cancer Care, New Bedford, MA

14. The ROS1ders, Seattle, WA

15. St Marianna University School of Medicine, Kawasaki, Japan

16. Montefiore Einstein Center for Cancer Care, Bronx, NY

17. IHA Hematology Oncology Consultants, Ypsilanti, MI

18. London Health Sciences Centre, London, ON, Canada

19. Aurora Cancer Care, Mount Pleasant, WI

20. Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD

21. Georgetown University, Washington, DC

22. Sarah Cannon Research Institute, Nashville, TN

23. Ohio State University, Columbus, OH

24. Northwestern University, Chicago, IL

Abstract

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual . ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines . Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See complete disclaimer in Appendix 1 and Appendix 2 for more. Updates are published regularly and can be found at https://ascopubs.org/nsclc-non-da-living-guideline . PURPOSE To provide evidence-based recommendations for patients with stage IV non–small cell lung cancer (NSCLC) without driver alterations. METHODS This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized clinical trials (RCTs), with the latest time frame spanning February to October 2023. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened. The literature search included systematic reviews, meta-analyses, and randomized controlled trials. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Ten new RCTs were identified in the latest search of the literature to date. RECOMMENDATIONS Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients without driver alterations. Additional information is available at www.asco.org/living-guidelines .

Publisher

American Society of Clinical Oncology (ASCO)

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