Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2023.3

Area of Science:

• Medical Oncology
• Clinical Guidelines
• Lung Cancer Research

Background:

• Stage IV non-small cell lung cancer (NSCLC) with driver alterations presents complex treatment challenges.
• Personalized medicine approaches are crucial for optimizing patient outcomes.

Purpose of the Study:

• To provide updated, evidence-based treatment recommendations for patients with stage IV NSCLC and driver alterations.
• To guide clinical decision-making for first, second, and subsequent lines of therapy.

Main Methods:

• An ongoing systematic review of randomized clinical trials (RCTs) from February to October 2023.
• An Expert Panel synthesized evidence from RCTs, systematic reviews, and meta-analyses.
• Recommendations were developed using available evidence and expert consensus.

Main Results:

• The guideline consolidates previous updates and incorporates new evidence.
• Eight new RCTs were identified in the latest literature search.
• Updated recommendations address treatment sequencing based on targetable driver alterations.

Conclusions:

• Evidence-based recommendations are updated for various treatment settings in stage IV NSCLC with driver alterations.
• The guideline supports tailored treatment strategies for patients with specific molecular profiles.