For a study, researchers updated the 2021 ASCO and Ontario Health (Cancer Care Ontario) guideline on systemic treatment for patients with stage IV non-small-cell lung cancer (NSCLC) with driver changes by offering evidence-based recommendations.

From 2020 to 2021, ASCO revised its guidelines in light of an ongoing systematic evaluation of randomized control trials.

The updated guideline took into account new evidence that has emerged since the last revision. The evidence basis was provided by two studies. A few interesting outcomes include effectiveness and safety.

Clinicians should prescribe alectinib, brigatinib, or lorlatinib for patients with an anaplastic lymphoma kinase rearrangement, a performance status (PS) of 0-2, and previously untreated NSCLC. If alectinib, brigatinib, or lorlatinib were not accessible to patients with an anaplastic lymphoma kinase rearrangement, a PS of 0-2, and previously untreated NSCLC, doctors should suggest ceritinib or crizotinib. Clinicians may prescribe selpercatinib or pralsetinib to patients with a RET rearrangement, a PS of 0–2, and untreated NSCLC prior to receiving treatment. Clinicians may prescribe selpercatinib or pralsetinib in the second line for patients with RET rearrangements who have not yet received RET-targeted treatment.

Reference: ascopubs.org/doi/full/10.1200/JCO.22.00824