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
Treatmen...
...al Question 1: What are the most effecti...
...For recommendations with multiple treatment...
...owth factor receptor (EGFR)...
...xon 19 deletion, Exon 21 L858R substi...
...s should offer osimertinib. ( EB ,...
...thers...
...r other activating EGFR alterations...
...or osimertinib. ( IC , , L , W )618...
...ndard treatment following the non-driver...
...fying Statement: Recommendation 1.2, 1.2.1,...
...activating EGFR alteration, regardless of program...
...xon 20 inserti...
....4. Clinicians may offer chemother...
...tamab is not available, clinicians should o...
...plastic lymphoma kinase (ALK)...
1.6. Clinicians should offer alectinib or briga...
...tinib, brigatinib, or lorlatinib are not availab...
...OS1...
1.8. Clinicians may offer crizotinib or entrectin...
...crizotinib or entrectinib are not a...
...FV600E...
...ns may offer dabrafenib and trameti...
...1. If dabrafenib and trametinib, or encora...
...on 14 skipping mutatio...
...Clinicians may offer capmatinib or tepotinib....
....13. If capmatinib or tepotinib is not av...
RET rearrangeme...
...4. Clinicians should offer selpercat...
...5. If selpercatinib is not available,...
...rcatinib or pralsetinib are not av...
Neurotrophic tyrosine receptor kinase (NTRK) r...
...icians may offer entrectinib or laro...
...entrectinib or larotrectinib are not av...
...ts with a poor performance status (PS), tyrosine...
...rehensive genomic biomarker test r...
...ying Statement: PDL-1 IHC alone should no...
...atients with advanced lung cancer should be...
...tion 2: What are the most effective second-line an...
NOTE: Due to development of potentially tar...
...GFR
...n 19 deletion, Exon 21 L858R substitutio...
...patients that develop EGFR T790M resistance a...
...2. For patients who have progressed on osimertinib...
...ying Statement: Anti-PD-(L)1 agent...
...ther...
...nts with an exon 20 insertion alteration who have...
...LK...
...ents who have previously received criz...
...For patients who have previously received...
...OS1...
...6. For patients who have previously r...
...linicians should offer platinum-ba...
...AFV600...
...patients who have not received BRAF therapy...
...patients who have previously received BRAF...
.... For BRAF alterations other than B...
MET exon 14 skipping mutation
...ts who have not received MET-targeted therap...
...or patients previously treated with MET-...
...rearrangement...
...13. For patients who have not received...
...f selpercatinib or pralsetinib is not ava...
...K rearrangemen...
...ients who have not received an NTRK inhibitor...
...f entrectinib or larotrectinib is not available,...
Human epidermal receptor fact...
...7. Clinicians may offer treatment with tr...
...RAS G12C...
...18. Clinicians may offer treatment with sotorasi...
...9. Clinicians may offer treatment with adagrasib....
...Statement: Note that adagrasib and sotorasib...
...-Line and Subsequent Treatment Opti...
...2. Treatment Options for Patients Wit...
...ure 3. First and Second Line Treatment Optio...
...ure 3. First and Second Line Treatment...