Abstract：
To provide evidence-based recommendations updating the 2021 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic therapy for patients with stage IV non-small-cell lung cancer (NSCLC) with driver alterations.
ASCO updated recommendations on the basis of an ongoing systematic review of randomized control trials from 2020 to 2021.
This guideline update reflects changes in evidence since the previous update. Two studies provide the evidence base. Outcomes of interest include efficacy and safety.
For patients with an anaplastic lymphoma kinase rearrangement, a performance status (PS) of 0-2, and previously untreated NSCLC, clinicians should offer alectinib or brigatinib or lorlatinib. For patients with an anaplastic lymphoma kinase rearrangement, a PS of 0-2, and previously untreated NSCLC, if alectinib, brigatinib, or lorlatinib are not available, clinicians should offer ceritinib or crizotinib. For patients with a RET rearrangement, a PS of 0-2, and previously untreated NSCLC, clinicians may offer selpercatinib or pralsetinib. In second line, for patients with a RET rearrangement who have not received RET-targeted therapy, clinicians may offer selpercatinib or pralsetinib.Additional information is available at www.asco.org/thoracic-cancer-guidelines.
ASCO updated recommendations on the basis of an ongoing systematic review of randomized control trials from 2020 to 2021.
This guideline update reflects changes in evidence since the previous update. Two studies provide the evidence base. Outcomes of interest include efficacy and safety.
For patients with an anaplastic lymphoma kinase rearrangement, a performance status (PS) of 0-2, and previously untreated NSCLC, clinicians should offer alectinib or brigatinib or lorlatinib. For patients with an anaplastic lymphoma kinase rearrangement, a PS of 0-2, and previously untreated NSCLC, if alectinib, brigatinib, or lorlatinib are not available, clinicians should offer ceritinib or crizotinib. For patients with a RET rearrangement, a PS of 0-2, and previously untreated NSCLC, clinicians may offer selpercatinib or pralsetinib. In second line, for patients with a RET rearrangement who have not received RET-targeted therapy, clinicians may offer selpercatinib or pralsetinib.Additional information is available at www.asco.org/thoracic-cancer-guidelines.
摘要：
提供基于证据的建议，更新2021ASCO和安大略省健康（安大略省癌症护理）指南，以治疗具有驱动改变的IV期非小细胞肺癌（NSCLC）患者的全身治疗。
ASCO根据对2020年至2021年随机对照试验的持续系统评价更新了建议。
本指南更新反映了自上次更新以来证据的变化。两项研究提供了证据基础。感兴趣的结果包括疗效和安全性。
对于有间变性淋巴瘤激酶重排的患者，性能状态（PS）为0-2，以前未治疗的非小细胞肺癌，临床医生应提供阿来替尼或布格替尼或洛拉替尼.对于有间变性淋巴瘤激酶重排的患者，PS为0-2，以前未经治疗的非小细胞肺癌，如果阿列替尼，布加替尼,或洛拉替尼不可用，临床医生应提供色瑞替尼或克唑替尼.对于RET重排的患者，PS为0-2，以前未经治疗的非小细胞肺癌，临床医生可提供selpercatinib或pralsetinib.在第二行，对于没有接受RET靶向治疗的RET重排患者，临床医生可提供selpercatinib或pralsetinib.其他信息可在www上获得。asco.org/胸癌指南。
ASCO根据对2020年至2021年随机对照试验的持续系统评价更新了建议。
本指南更新反映了自上次更新以来证据的变化。两项研究提供了证据基础。感兴趣的结果包括疗效和安全性。
对于有间变性淋巴瘤激酶重排的患者，性能状态（PS）为0-2，以前未治疗的非小细胞肺癌，临床医生应提供阿来替尼或布格替尼或洛拉替尼.对于有间变性淋巴瘤激酶重排的患者，PS为0-2，以前未经治疗的非小细胞肺癌，如果阿列替尼，布加替尼,或洛拉替尼不可用，临床医生应提供色瑞替尼或克唑替尼.对于RET重排的患者，PS为0-2，以前未经治疗的非小细胞肺癌，临床医生可提供selpercatinib或pralsetinib.在第二行，对于没有接受RET靶向治疗的RET重排患者，临床医生可提供selpercatinib或pralsetinib.其他信息可在www上获得。asco.org/胸癌指南。
