Therapy for Stage IV Non–Small-Cell Lung Cancer With Driver Alterations: ASCO Living Guideline
Cet article présente la mise à jour des recommandations 2021 de l'"American Society of Clinical Oncology" concernant le traitement d'un cancer du poumon non à petites cellules de stade IV présentant une altération génétique "conductrice" (réarrangement du gène ALK ou RET)
PURPOSE : 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.
METHODS : ASCO updated recommendations on the basis of an ongoing systematic review of randomized control trials from 2020 to 2021.
RESULTS : This guideline update reflects changes in evidence since the previous update. Two studies provide the evidence base. Outcomes of interest include efficacy and safety.
RECOMMENDATIONS : 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.
Journal of Clinical Oncology , article en libre accès, 2021