Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline
To provide evidence-based recommendations updating the 2020 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer without driver alterations. ASCO updated recommendations on the basis of an ongoing systematic review of rando...
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| Vydáno v: | Journal of clinical oncology Ročník 40; číslo 28; s. 3323 |
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| Médium: | Journal Article |
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01.10.2022
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| ISSN: | 1527-7755, 1527-7755 |
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| Abstract | To provide evidence-based recommendations updating the 2020 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer without driver alterations.
ASCO updated recommendations on the basis of an ongoing systematic review of randomized clinical trials from 2018 to 2021.
This guideline update reflects changes in evidence since the previous update. Five randomized clinical trials provide the evidence base. Outcomes of interest include efficacy and safety.
In addition to 2020 options for patients with high programmed death ligand-1 (PD-L1) expression (tumor proportion score [TPS] ≥ 50%), nonsquamous cell carcinoma (non-SCC), and performance status (PS) 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression (TPS ≥ 50%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilumumab alone or nivolumab and ipilimumab plus chemotherapy. With negative (0%) and low positive PD-L1 expression (TPS 1%-49%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or nivolumab and ipilimumab plus chemotherapy. With high PD-L1 expression, SCC, and PS 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression, squamous cell carcinoma (SCC), and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With negative and low positive PD-L1 expression, SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With non-SCC who received an immune checkpoint inhibitor and chemotherapy as first-line therapy, clinicians may offer second-line paclitaxel plus bevacizumab. With non-SCC, who received chemotherapy with or without bevacizumab and immune checkpoint inhibitor therapy, clinicians should offer the options of third-line single-agent pemetrexed, docetaxel, or paclitaxel plus bevacizumab.Additional information is available at www.asco.org/thoracic-cancer-guidelines. |
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| AbstractList | To provide evidence-based recommendations updating the 2020 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer without driver alterations.
ASCO updated recommendations on the basis of an ongoing systematic review of randomized clinical trials from 2018 to 2021.
This guideline update reflects changes in evidence since the previous update. Five randomized clinical trials provide the evidence base. Outcomes of interest include efficacy and safety.
In addition to 2020 options for patients with high programmed death ligand-1 (PD-L1) expression (tumor proportion score [TPS] ≥ 50%), nonsquamous cell carcinoma (non-SCC), and performance status (PS) 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression (TPS ≥ 50%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilumumab alone or nivolumab and ipilimumab plus chemotherapy. With negative (0%) and low positive PD-L1 expression (TPS 1%-49%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or nivolumab and ipilimumab plus chemotherapy. With high PD-L1 expression, SCC, and PS 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression, squamous cell carcinoma (SCC), and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With negative and low positive PD-L1 expression, SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With non-SCC who received an immune checkpoint inhibitor and chemotherapy as first-line therapy, clinicians may offer second-line paclitaxel plus bevacizumab. With non-SCC, who received chemotherapy with or without bevacizumab and immune checkpoint inhibitor therapy, clinicians should offer the options of third-line single-agent pemetrexed, docetaxel, or paclitaxel plus bevacizumab.Additional information is available at www.asco.org/thoracic-cancer-guidelines. To provide evidence-based recommendations updating the 2020 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer without driver alterations.PURPOSETo provide evidence-based recommendations updating the 2020 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer without driver alterations.ASCO updated recommendations on the basis of an ongoing systematic review of randomized clinical trials from 2018 to 2021.METHODSASCO updated recommendations on the basis of an ongoing systematic review of randomized clinical trials from 2018 to 2021.This guideline update reflects changes in evidence since the previous update. Five randomized clinical trials provide the evidence base. Outcomes of interest include efficacy and safety.RESULTSThis guideline update reflects changes in evidence since the previous update. Five randomized clinical trials provide the evidence base. Outcomes of interest include efficacy and safety.In addition to 2020 options for patients with high programmed death ligand-1 (PD-L1) expression (tumor proportion score [TPS] ≥ 50%), nonsquamous cell carcinoma (non-SCC), and performance status (PS) 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression (TPS ≥ 50%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilumumab alone or nivolumab and ipilimumab plus chemotherapy. With negative (0%) and low positive PD-L1 expression (TPS 1%-49%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or nivolumab and ipilimumab plus chemotherapy. With high PD-L1 expression, SCC, and PS 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression, squamous cell carcinoma (SCC), and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With negative and low positive PD-L1 expression, SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With non-SCC who received an immune checkpoint inhibitor and chemotherapy as first-line therapy, clinicians may offer second-line paclitaxel plus bevacizumab. With non-SCC, who received chemotherapy with or without bevacizumab and immune checkpoint inhibitor therapy, clinicians should offer the options of third-line single-agent pemetrexed, docetaxel, or paclitaxel plus bevacizumab.Additional information is available at www.asco.org/thoracic-cancer-guidelines.RECOMMENDATIONSIn addition to 2020 options for patients with high programmed death ligand-1 (PD-L1) expression (tumor proportion score [TPS] ≥ 50%), nonsquamous cell carcinoma (non-SCC), and performance status (PS) 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression (TPS ≥ 50%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilumumab alone or nivolumab and ipilimumab plus chemotherapy. With negative (0%) and low positive PD-L1 expression (TPS 1%-49%), non-SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or nivolumab and ipilimumab plus chemotherapy. With high PD-L1 expression, SCC, and PS 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression, squamous cell carcinoma (SCC), and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With negative and low positive PD-L1 expression, SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With non-SCC who received an immune checkpoint inhibitor and chemotherapy as first-line therapy, clinicians may offer second-line paclitaxel plus bevacizumab. With non-SCC, who received chemotherapy with or without bevacizumab and immune checkpoint inhibitor therapy, clinicians should offer the options of third-line single-agent pemetrexed, docetaxel, or paclitaxel plus bevacizumab.Additional information is available at www.asco.org/thoracic-cancer-guidelines. |
| Author | Ellis, Peter M Spigel, David R Haddad, Rami Y Leighl, Natasha B Mamdani, Hirva Riely, Gregory J Phillips, Tanyanika Brahmer, Julie R Johnson, David H Masters, Gregory Singh, Navneet Elkins, Ivy B Celano, Paul Moffitt, Pamela R Schiller, Joan H Hesketh, Paul J Duma, Narjust Schneider, Bryan J Jain, Dharamvir Blanchard, Elizabeth Baker, Jr, Sherman Rosell, Rafael Robinson, Andrew G Jaiyesimi, Ishmael A Temin, Sarah |
| Author_xml | – sequence: 1 givenname: Navneet orcidid: 0000-0002-8389-0701 surname: Singh fullname: Singh, Navneet organization: Postgraduate Institute of Medical Education and Research, Chandigarh, India – sequence: 2 givenname: Sarah orcidid: 0000-0002-1834-0551 surname: Temin fullname: Temin, Sarah organization: American Society of Clinical Oncology, Alexandria, VA – sequence: 3 givenname: Sherman surname: Baker, Jr fullname: Baker, Jr, Sherman organization: Virginia Commonwealth University, Richmond, VA – sequence: 4 givenname: Elizabeth surname: Blanchard fullname: Blanchard, Elizabeth organization: Southcoast Centers for Cancer Care, New Bedford, MA – sequence: 5 givenname: Julie R orcidid: 0000-0002-2443-8395 surname: Brahmer fullname: Brahmer, Julie R organization: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD – sequence: 6 givenname: Paul surname: Celano fullname: Celano, Paul organization: The Cancer Center at GBMC, Townson, MD – sequence: 7 givenname: Narjust orcidid: 0000-0002-7814-1773 surname: Duma fullname: Duma, Narjust organization: Dana-Farber Cancer Institute, Boston, MA – sequence: 8 givenname: Peter M surname: Ellis fullname: Ellis, Peter M organization: Juravinski Cancer Centre, Hamilton, Ontario, Canada – sequence: 9 givenname: Ivy B surname: Elkins fullname: Elkins, Ivy B organization: EGFR Resisters, Buffalo Grove, IL – sequence: 10 givenname: Rami Y surname: Haddad fullname: Haddad, Rami Y organization: Affiliated Oncologists, LLC, Chicago Ridge, IL – sequence: 11 givenname: Paul J orcidid: 0000-0003-3099-5427 surname: Hesketh fullname: Hesketh, Paul J organization: Lahey Hospital and Medical Center, Burlington, MA – sequence: 12 givenname: Dharamvir surname: Jain fullname: Jain, Dharamvir organization: Houston Methodist Cancer Center, Houston, TX – sequence: 13 givenname: David H orcidid: 0000-0001-6851-6888 surname: Johnson fullname: Johnson, David H organization: University of Texas Southwestern Medical Center, Dallas, TX – sequence: 14 givenname: Natasha B orcidid: 0000-0002-3249-4602 surname: Leighl fullname: Leighl, Natasha B organization: Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada – sequence: 15 givenname: Hirva orcidid: 0000-0003-3874-8703 surname: Mamdani fullname: Mamdani, Hirva organization: Karmanos Cancer Institute/Wayne State University, Detroit, MI – sequence: 16 givenname: Gregory orcidid: 0000-0002-8538-3826 surname: Masters fullname: Masters, Gregory organization: Helen F. Graham Cancer Center and Research Institute, Newark, DE – sequence: 17 givenname: Pamela R surname: Moffitt fullname: Moffitt, Pamela R organization: Patient Advocate, Galva, IA – sequence: 18 givenname: Tanyanika surname: Phillips fullname: Phillips, Tanyanika organization: City of Hope, Duarte, CA – sequence: 19 givenname: Gregory J orcidid: 0000-0001-5357-4313 surname: Riely fullname: Riely, Gregory J organization: Memorial Sloan Kettering Cancer Center, New York, NY – sequence: 20 givenname: Andrew G orcidid: 0000-0003-0888-5109 surname: Robinson fullname: Robinson, Andrew G organization: Kingston General Hospital, Queen's University, Ontario, Canada – sequence: 21 givenname: Rafael orcidid: 0000-0003-0817-3400 surname: Rosell fullname: Rosell, Rafael organization: Catalan Institute of Oncology, Barcelona, Catalonia, Spain – sequence: 22 givenname: Joan H orcidid: 0000-0003-0990-1211 surname: Schiller fullname: Schiller, Joan H organization: Inova Schar Cancer Institute, Falls Church, VA – sequence: 23 givenname: Bryan J surname: Schneider fullname: Schneider, Bryan J organization: University of Michigan Health System, Ann Arbor, MI – sequence: 24 givenname: David R orcidid: 0000-0003-3215-9465 surname: Spigel fullname: Spigel, David R organization: Sarah Cannon Research Institute, Nashville, TN – sequence: 25 givenname: Ishmael A surname: Jaiyesimi fullname: Jaiyesimi, Ishmael A organization: Beaumont Health Royal Oak and Oakland University William Beaumont School of Medicine, Royal Oak, MI |
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| References | 36809066 - J Clin Oncol. 2023 Apr 10;41(11):e21-e30 36534935 - J Clin Oncol. 2023 Feb 10;41(5):e1-e9 37023387 - J Clin Oncol. 2023 Apr 6;:JCO2300282 |
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| SubjectTerms | Antineoplastic Combined Chemotherapy Protocols - therapeutic use B7-H1 Antigen Bevacizumab - therapeutic use Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Squamous Cell - drug therapy Docetaxel - therapeutic use Humans Immune Checkpoint Inhibitors Ipilimumab - therapeutic use Lung Neoplasms - pathology Nivolumab - therapeutic use Paclitaxel - therapeutic use Pemetrexed - therapeutic use |
| Title | Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline |
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