Therapy for Stage IV Non–Small-Cell Lung Cancer Without Driver Alterations: ASCO and OH (CCO) Joint Guideline Update

作者：Nasser H. Hanna, Bryan James Schneider, Sarah Temin, Sherman Baker, Julie Renee Brahmer, Peter M. Ellis, Laurie E. Gaspar, Rami Y. Haddad, Paul Joseph Hesketh, Dharamvir Jain, Ishmael A. Jaiyesimi, David H. Johnson, Natasha B. Leighl, Tanyanika Phillips, Gregory J. Riely, Andrew George Robinson, Rafael Rosell, Joan H. Schiller, Navneet Singh, David Robert Spigel, Janis O. Stabler, Joan Tashbar, Gregory A. Masters · 发表于：Journal of Clinical Oncology · 年份：2020 · DOI：10.1200/jco.19.03022 · 被引用次数：459 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment、Lung Cancer Treatments and Mutations

PURPOSE: The aim of this work is to provide evidence-based recommendations updating the 2017 ASCO guideline on systemic therapy for patients with stage IV non-small-cell lung cancer (NSCLC) without driver alterations. A guideline update for patients with stage IV NSCLC with driver alterations will be published separately. METHODS: The American Society of Clinical Oncology and Ontario Health (Cancer Care Ontario) NSCLC Expert Panel made updated recommendations based on a systematic review of randomized controlled trials from December 2015 to 2019. RESULTS: This guideline update reflects changes in evidence since the previous guideline update. Five randomized controlled trials provide the evidence base. Additional literature suggested by the Expert Panel is discussed. RECOMMENDATIONS: Recommendations apply to patients without driver alterations in epidermal growth factor receptor or ALK. For patients with high programmed death ligand 1 (PD-L1) expression (tumor proportion score [TPS] ≥ 50%) and non-squamous cell carcinoma (non-SCC), the Expert Panel recommends single-agent pembrolizumab. Additional treatment options include pembrolizumab/carboplatin/pemetrexed, atezolizumab/carboplatin/paclitaxel/bevacizumab, or atezolizumab/carboplatin/nab-paclitaxel. For most patients with non-SCC and either negative (0%) or low positive (1% to 49%) PD-L1, the Expert Panel recommends pembrolizumab/carboplatin/pemetrexed. Additional options are atezolizumab/carboplatin/nab-paclitaxel, atezoliz...