Stage IV Non-Small Cell Lung Cancer without Driver Alterations

Living guidelines are routinely updated guidelines that are developed for selected topic areas with rapidly evolving evidence that drives frequent change in clinical practice. These guidelines are updated on a regular schedule, based on the work of a standing panel that reviews the literature on a continuous basis.

Versioning and Numbering Statement
To ensure transparency and facilitate the tracking of evidence updates, ASCO has implemented a structured numbering system for living guidelines. This system reflects the status of the recommendations as follows:
1. Major Updates (eg, 2026.2.0): These represent full updates or significant revisions approved by the Expert Panel and the Evidence Based Medicine Committee (EBMC).
They typically incorporate comprehensive literature reviews and involves resubmission of the entire guideline.
2. Rapid Updates (eg, 2026.2.1): These “mini updates” serve as timely notifications of revised recommendations or supporting evidence, ensuring the guideline remains current between full update cycles.

This pocket guide is derived from recommendations in the American Society of Clinical Oncology Guideline. This resource is a practice tool based on ASCO® practice guidelines and is not intended to substitute for the independent professional judgment of the treating physician. Practice guidelines do not account for individual variation among patients. This pocket guide does not purport to suggest any particular course of medical treatment. Use of the practice guidelines and this resource are voluntary. The practice guidelines and additional information are available at www.asco.org/living-guidelines. Copyright © 2026 by American Society of Clinical Oncology. All rights reserved.