Therapy for Stage IV Non-Small-Cell Lung Cancer With Driver Alterations
Key Points
Key Points
- The treatment of advanced stage IV non-small-cell lung cancer (NSCLC) has evolved dramatically in the past decade.
- The identification of actionable oncogenic driver alterations has allowed for the emergence of new, effective targeted treatments, that have resulted in significant survival gains.
Treatment
...atment
Summary of All Recomm...
...recommendations with multiple treatment options o...
...l Question 1: What are the most effective fir...
...ermal growth factor receptor (EG...
...19 deletion, Exon 21 L858R substitu...
...icians should offer osimertinib. (, , M, S )...
....1.Clinicians may offer osimertinib wit...
...ther...
...activating EGFR alterations, (G719X,...
...other activating EGFR alterations, (G719X, L861Q,...
....For other activating EGFR alterations,...
...activating EGFR alteration, regardless of pro...
...on 20 insert...
...ns may offer chemotherapy and amiv...
...ab is not available, clinicians should offer stand...
...lymphoma kinase (ALK)...
...Clinicians should offer alectinib or brigat...
...f alectinib, brigatinib, or lorlatin...
ROS1
...8.Clinicians may offer repotrectinib, entrectin...
...rizotinib, entrectinib, or repotrecti...
...AFV600E...
...inicians may offer dabrafenib and trametinib, or...
...dabrafenib and trametinib, or encora...
...TÂ exon 14 skipping mut...
...may offer capmatinib or tepotinib...
...nib or tepotinib is not available, clinici...
... rearrangemen...
...nicians should offer selpercatinib....
...percatinib is not available, clinicians m...
...lpercatinib or pralsetinib are not...
...otrophic tyrosine receptor kinase (NTRK) r...
....Clinicians may offer entrectinib or la...
...nib or larotrectinib are not available, clinici...
....For patients with a poor performance status...
...prehensive genomic biomarker test results...
....Patients with advanced lung cancer shoul...
...inical Question 2: What are the most effectiv...
...: Due to development of potentially targetab...
...GFR
...9 deletion, Exon 21 L858R substit...
...or patients that develop EGFR T790M resis...
...tients who have progressive disease on...
...For patients who progressed on osimer...
....2.For patients who have progressi...
...thers...
...tients with an exon 20 insertion a...
AL...
...tients who have previously received crizotinib,...
...patients who have previously received other ALK...
ROS...
...patients who have previously rece...
...s who have received multiple ROS-1 inhibitors...
...FV600E
...atients who have not received BRAF thera...
...atients who have previously received BRAF or MEK t...
...For BRAF alterations other than BRAFV60...
... exon 14 skipping mutation
...or patients who have not received MET-targeted t...
....12.For patients previously treated with MET-targe...
...rearrangement...
...or patients who have not received a...
...rcatinib or pralsetinib is not available, c...
... rearrangement...
...patients who have not received an NTRK inhib...
...trectinib or larotrectinib is not available...
...pidermal receptor factor 2 (...
...may offer treatment with trastuzumab...
...SÂ G12C...
...inicians may offer treatment with so...
...nicians may offer treatment with adagras...
...ond-Line and Subsequent Treatment Option...
...eatment Options for Patients With Stage IV NSCLC...
...re 3. First and Second Line Treatment...
...re 3. First and Second Line Treatment Opti...