Therapy for Stage IV Non–Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, 2026.3.0
Year: 2026
Type: article
Abstract: This guideline has been updated. This ASCO Living Guideline is reviewed on an eight-week cycle. Please see the online dynamic version for the latest updates. ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual . ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines . Clinical Practice Guidelines and other guidance (“Guidance”) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature, and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and Appendix 2 (online only) for more . PURPOSE To provide evidence-based recommendations for patients with stage IV non–small cell lung cancer with driver alterations. METHODS This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized controlled trials (RCTs), with the latest time frame spanning March-October 2025. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts was convened. The literature search included systematic reviews, meta-analyses, and RCTs. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Thirteen studies were identified in the latest search of literature to date. RECOMMENDATIONS Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients with driver alterations. Additional information is available at www.asco.org/thoracic-cancer-guidelines .
Source: Journal of Clinical Oncology
DOI: 10.1200/jco-25-02822
Authors: Sonam Puri, Natasha B. Leighl, Nofisat Ismaila, Fawzi Abu Rous, Amith Ahluwalia, Krishna Alluri, Ibrahim Hanna Azar, Toby Campbell, Greg Durm, Jill Feldman, Narjust Florez, Janet Freeman-Daily, Naoki Furuya, Shirish Gadgeel, Balazs Halmos, Hidehito Horinouchi, Sara Kuruvilla, Gary R. Macvicar, Narinder Malhotra, Kristen Ashley Marrone, Deebya Raj Mishra, Michael Mullane, Jarushka Naidoo, Dwight H. Owen, Bruna Pellini, Carolyn J. Presley, Angel Qin, Logan Roof, Erin L. Schenk, Lecia Sequist, Navneet Singh, Eric K. Singhi, Jennifer Marie Suga, Ana I. Velazquez, Yubao Wang, Paul Wheatley Price, Joshua E. Reuss, Lyudmila Bazhenova
Institutions: Moffitt Cancer Center, University Health Network, Princess Margaret Cancer Centre, American Society of Clinical Oncology, Henry Ford Health, Wenatchee Valley Hospital & Clinics, IHA Hematology Oncology Consultants, University of Wisconsin–Madison, Indiana University Health, Harvard University, Dana-Farber Cancer Institute, St. Marianna University School of Medicine, Montefiore Medical Center, Montefiore Einstein Comprehensive Cancer Center, National Cancer Center Hospital, London Health Sciences Centre, Illinois CancerCare, Johns Hopkins University, Johns Hopkins Hospital, B.P. Koirala Institute of Health Sciences, Aurora Health Care, Sidney Kimmel Comprehensive Cancer Center, The Ohio State University, Baptist Hospital of Miami, Baptist Health South Florida, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Michigan Medicine, University of Colorado Anschutz, Massachusetts General Hospital, Post Graduate Institute of Medical Education and Research, The University of Texas MD Anderson Cancer Center, Kaiser Permanente Vallejo Medical Center, University of California, San Francisco, John Muir Health, University of Ottawa, Ottawa Hospital Research Institute, Georgetown University, Moores Cancer Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, GlaxoSmithKline, Gilead Sciences, AstraZeneca Canada, Moffitt Cancer Center, Regeneron Pharmaceuticals, Merck KGaA, Taiho Pharmaceutical, Jazz Pharmaceuticals, Novocure, Mirati Therapeutics, BeiGene, Veracyte, Apollomics, Yuhan, Revolution Medicines, Seagen, Natera, Kyowa Hakko Kirin, Ono Pharmaceutical, Genentech, Chugai Pharmaceutical, Foundation Medicine, National Cancer Institute, Daiichi Sankyo Europe
OpenAlex ID: W7127437970