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
...eatmen...
...ummary of All Recommendations...
...r recommendations with multiple tre...
...linical Question 1: What are the most effecti...
...mal growth factor receptor (EGFR)...
...deletion, Exon 21 L858R substitution...
...cians should offer osimertinib. (, ,...
...icians may offer osimertinib with platinum d...
...thers
...other activating EGFR alterations, (G719X...
...1.For other activating EGFR alterations,...
1.2.2.For other activating EGFR alterations, (G71...
...ivating EGFR alteration, regardless of progr...
...xon 20 inserti...
...linicians may offer chemotherapy and amiv...
...tamab is not available, clinicians sho...
...lastic lymphoma kinase (ALK...
...ians should offer alectinib or brigatinib or lor...
....7.If alectinib, brigatinib, or lo...
...OS1...
...may offer repotrectinib, entrectinib, or cr...
...crizotinib, entrectinib, or repotrec...
...FV600E...
...0.Clinicians may offer dabrafenib and tra...
...dabrafenib and trametinib, or encorafenib and...
...TÂ exon 14 skipping mut...
...s may offer capmatinib or tepotinib. (, , L , S...
....If capmatinib or tepotinib is not available,...
... rearrangement...
...icians should offer selpercatinib. (, , H...
1.15.If selpercatinib is not available, clinicia...
...elpercatinib or pralsetinib are not available...
Neurotrophic tyrosine receptor kinase (...
...may offer entrectinib or larotrect...
...ctinib or larotrectinib are not available, clin...
...patients with a poor performance status (PS),...
....20.Comprehensive genomic biomarker te...
...1.Patients with advanced lung canc...
...l Question 2: What are the most effective second-...
...E: Due to development of potent...
EGFR
...19 deletion, Exon 21 L858R substitution
....1.For patients that develop EGFR T790M resistan...
...r patients who have progressive dise...
...ients who progressed on osimertini...
...r patients who have progressive disease on EGFR...
...ther...
...atients with an exon 20 insertion alteration...
...LK
....For patients who have previously received c...
....For patients who have previously received oth...
ROS1
....For patients who have previously...
....For patients who have received multip...
...FV600E...
...tients who have not received BRAF...
...nts who have previously received BRAF or MEK tar...
...lterations other than BRAFV600E alterati...
...exon 14 skipping mutation...
2.11.For patients who have not received MET-tar...
...or patients previously treated with MET-targ...
... rearrangement
...ents who have not received a RET inhibitor, clin...
...ercatinib or pralsetinib is not available, clin...
...TRKÂ rearrangem...
...or patients who have not received an NTRK in...
....If entrectinib or larotrectinib is not a...
...an epidermal receptor factor...
...ans may offer treatment with trastuzumab der...
...SÂ G12C...
....18.Clinicians may offer treatment with...
...may offer treatment with adagrasib. (, , L , S...
...1. Second-Line and Subsequent Treatment Options...
.... Treatment Options for Patients With Stage...
...3. First and Second Line Treatment Opti...
...rst and Second Line Treatment Option...