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

...eatment...

...recommendations with multiple treatment op...


...linical Question 1: What are the most effe...

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

...ith programmed death-ligand 1 or progra...

1.1. For patients with a programmed...

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

...patients with a programmed death-...

...r patients with a programmed death-ligand 1...

...atients with a programmed death-li...

...or patients with a programmed death-ligand...

Patients with PD-L1 expression TPS...

...tients with PD-L1 expression TPS, 1–49...

...nts with PD-L1 expression TPS, 1–49%, cli...

...patients with PD-L1 expression TPS...

...patients with PD-L1 expression TPS, 1–49%, clini...

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

...patients who are ineligible for or declin...

...h unknown or negative PD-L1 expression, TPS...

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

...For patients with unknown or negative PD-L1 exp...

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

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

...atients with unknown or negative PD-L1 e...

...amous Cell Carcinoma (SCC)...

...h PD-L1 expression, TPS ≥50...

...ients with PD-L1 expression, TPS ≥50%,, clini...

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

...3. For patients with PD-L1 expression, TPS ≥5...

...For patients with PD-L1 expression, TPS â‰...

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

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

...For patients with PD-L1 expression TPS, 1–49%...

...ents with PD-L1 expression TPS, 1â...

...patients with PD-L1 expression TPS, 1–49%, clin...

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

...For patients with PD-L1 expression TPS, 1–4...

...ents with unknown or negative PD-L1...

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

4.2. For patients with unknown or negative...

...For patients with unknown or negative PD-...

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

...nts with Unspecified Histol...

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

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

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

...8. Bevacizumab should be avoided for patients with...

...atients with contraindications t...

...s with Unspecified Histology...

...izumab should be avoided for patients with squa...

....9. Maintenance bevacizumab given with pemetrex...


...cal Question 2: What are the most effecti...

...ients previously treated with immune c...

...s previously treated with immune checkpoint the...

...viously treated with chemotherapy...

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

5.2. In patients previously treated with chem...


...gure 1. Second-Line and Subsequent Treatment Opti...


Figure 2. First-Line Treatment Options for P...


...re 3. First-Line Treatment Options...