Stage IV Non-Small Cell Lung Cancer without Driver Alterations

Publication Date: February 28, 2024

Key Points

Key Points

The treatment of advanced stage IV non-small-cell lung cancer (NSCLC) has evolved dramatically in the past decade.
This clinical practice guideline update addresses two overarching clinical questions:
  1. What are the most effective first-line treatment options for patients with stage IV NSCLC without driver alterations, based on cancer subtype?
  2. What are the most effective second-line and subsequent treatment options for patients with stage IV NSCLC without driver alterations based on cancer subtype?

Treatment

...atment...

...: For recommendations with multiple tr...


...ical Question 1: What are the most effecti...

...Squamous Cell Carcinoma (Non-SCC)...

...programmed death-ligand 1 or program...

...ents with a programmed death-ligand 1 o...

.... For patients with a programmed deat...

...tients with a programmed death-lig...

...s with a programmed death-ligand 1 or prog...

...For patients with a programmed death-ligand 1 o...

...ts with a programmed death-ligand 1 or programmed...

...ts with PD-L1 expression TPS, 1–49%:...

...For patients with PD-L1 expression T...

...atients with PD-L1 expression TPS, 1...

1.9. For patients with PD-L1 expression TPS,...

...ts with PD-L1 expression TPS, 1–4...

...1. For patients with PD-L1 expression TPS, 1...

....2. For patients who are ineligible for o...

...known or negative PD-L1 expression,...

...s with unknown or negative PD-L1 expression,...

....4. For patients with unknown or negativ...

...patients with unknown or negative PD-L1 expression...

...nts with unknown or negative PD-L1 express...

...r patients with unknown or negative PD-L1 expre...

...quamous Cell Carcinoma (SCC...

...s with PD-L1 expression, TPS ≥50%:...

...patients with PD-L1 expression, TPS ≥50%,, clin...

...tients with PD-L1 expression, TPS ≥50...

...atients with PD-L1 expression, TPS...

...ients with PD-L1 expression, TPS ≥...

...s with PD-L1 expression, TPS ≥50%,...

...s with PD-L1 expression TPS, 1–49%:...

...s with PD-L1 expression TPS, 1–49%, clinicians...

...tients with PD-L1 expression TPS,...

.... For patients with PD-L1 expressi...

3.9. For patients with PD-L1 expression T...

...ients with PD-L1 expression TPS, 1–49% wh...

...s with unknown or negative PD-L1 expressio...

...nts with unknown or negative PD-L1 expr...

...or patients with unknown or negative P...

...ts with unknown or negative PD-L1 expression, T...

...4. For patients with unknown or negat...

...nts with Unspecified Histology...

...atients with unknown or negative P...

...r patients with unknown or negative PD-L1...

...s with unknown or negative PD-L1 ex...

...ab should be avoided for patients with squ...

...h contraindications to bevacizumab:...

...ith Unspecified Histology

...should be avoided for patients with squ...

...aintenance bevacizumab given with pemetrexed...


...ion 2: What are the most effective second...

...reviously treated with immune checkp...

....0. For patients previously treated...

...ts previously treated with chemotherapy and...

...nts previously treated with chemotherapy an...

...s previously treated with chemotherapy and immu...


...igure 1. Second-Line and Subsequent T...


...-Line Treatment Options for Patients With...


...Line Treatment Options for Patients With Stage...