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
Treatment
...f All Recommendations...
...For recommendations with multipl...
...ical Question 1: What are the most effectiv...
...idermal growth factor receptor (EGFR)...
...deletion, Exon 21 L858R substitutio...
...Clinicians should offer osimertinib. (, , M,...
...Clinicians may offer osimertinib with platinum...
...hers
...other activating EGFR alterations, (G719X,...
...r other activating EGFR alterations, (G719X, L861...
...2.2.For other activating EGFR alterations...
...3.For any activating EGFR alteration, regardles...
...xon 20 insertio...
...may offer chemotherapy and amivantamab. (, , M,...
...5.If amivantamab is not available, clinicians sh...
...aplastic lymphoma kinase (ALK...
....6.Clinicians should offer alectinib or brigatinib...
...f alectinib, brigatinib, or lorlatinib are n...
ROS...
...ay offer repotrectinib, entrectini...
...If crizotinib, entrectinib, or repotrectinib...
...FV600E...
...may offer dabrafenib and trametinib, or enco...
...11.If dabrafenib and trametinib, or encorafe...
...exon 14 skipping mutation
...12.Clinicians may offer capmatinib or te...
...pmatinib or tepotinib is not available, clini...
...ETÂ rearrangemen...
....Clinicians should offer selpercatinib. (...
...f selpercatinib is not available, clinicians may...
...6.If selpercatinib or pralsetinib are not availa...
...c tyrosine receptor kinase (NTRK) re...
1.17.Clinicians may offer entrectinib or larotre...
...ectinib or larotrectinib are not avail...
...or patients with a poor performance status (P...
...omprehensive genomic biomarker test results sh...
...1.Patients with advanced lung cancer...
...uestion 2: What are the most effecti...
...Due to development of potentially...
EGF...
...n 19 deletion, Exon 21 L858R substitution...
...ients that develop EGFR T790M resistance alterati...
...atients who have progressive disease...
...tients who progressed on osimertinib (...
...ients who have progressive disease...
...hers...
...ients with an exon 20 insertion alteratio...
ALK
...s who have previously received crizotinib, clin...
...ents who have previously received other...
ROS1
....6.For patients who have previously rece...
2.7.For patients who have received mult...
...RAFV600E...
...nts who have not received BRAF therapy, clinician...
....9.For patients who have previously re...
....10.For BRAF alterations other than BRAFV600...
METÂ exon 14 skippin...
....11.For patients who have not received MET-targete...
...s previously treated with MET-targeted t...
... rearrangement...
....For patients who have not received a RET inhibito...
...selpercatinib or pralsetinib is not a...
... rearrangement...
...ents who have not received an NTRK inhi...
2.16.If entrectinib or larotrectin...
...ermal receptor factor 2 (HER2)...
....Clinicians may offer treatment with trastuzumab...
...ASÂ G12C...
...icians may offer treatment with sotorasib. (, , M...
...ns may offer treatment with adagra...
...e 1. Second-Line and Subsequent Treatme...
...e 2. Treatment Options for Patients Wit...
...and Second Line Treatment Options for Pat...
...3. First and Second Line Treatment Optio...