Check for updatesTherapy for Stage IV Non-Small-Cell LungCancer Without Driver Alterations:ASCO LivingGuideline,Version 2022.3Ishmael A.Jaiyesimi,DO,MS;Dwight H.Owen,MD,MS>;Nofisat Ismaila,MD,MSc;Elizabeth Blanchard,MD;Paul Celano,MD;Narjust Florez,MD;Dharamvir Jain,MD;and Navneet Singh,MD,DMidelineupdateLiving guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequentchange in recommended clinical practice.Living guidelines are updated on a regular schedule by a standingexpert panel that systematically reviews the health literature on a continuous basis,as described in the ASCOGuidelines Methodology Manual.ASCO Living Guidelines follow the ASCO Conflict of Interest PolicyImplementation for Clinical Practice Guidelines.Living Guidelines and updates are not intended to sub-stitute for independent professional judgment of the treating provider and do not account for individualvariation among patients.See appendix for disclaimers and other important information (Appendix 1 andAppendix 2,online only).Updates are published regularly and can be found at https://ascopubs.org/nsclc-non-da-living-guideline.Clin Oncol 00.2023 by American Society of Clinical OncologyASSOCIATEDBACKGROUNDmutational burden as assessed from the tumorCONTENTspecimen has led to pan-cancer approval for check-See accompanyingIn 2022,ASCO launched living clinical practicearticle doi:10.1200/guidelines for systemic therapy for patients with stagepoint blockade after prior therapy,blood-based tumorJC0.22.00825IV non-small-cell lung cancer (NSCLC)with!andmutational burden has not been established as aAppendixwithout driver alterations.and both have beenbiomarker for first-line immune checkpoint inhibitorAuthor affiliationsupdated recently.3.4 On the basis of routine literaturemonotherapy in NSCLC and it needs further evaluationand supportsearches (until November 3.2022).this version of thebefore incorporation to standard of care.A summary ofinformation (ifstage I NSCLC without driver alterations livingthe results of the updated literature search is providedapplicable)appearguideline reviews new evidence to assess if recom-in Appendix Table A2 (online only).Evidence sup-at the end of thisporting unchanged recommendations is reviewed inarticle.mendations are up to date.Accepted on Januaryprevious publications of this guideline.2.3 Refer to10,2023andRESULTSAppendix Table A3 (online only)for the full list ofpublished atrecommendations.ascopubs.org/joumal/Two studies were identified in the literature search.5.6ASCO believes that cancer clinical trials are vital tojco on February 21,After careful review of the identified publications.the2023:DOI https://doi.Expert Panel (Appendix Table A1,online only)con-inform medical decisions and improve cancer care and0rg/10.12000C0.22cluded that the study results do not affect the 2022.2that all patients should have the opportunity to02783guideline recommendations.3 The benefit of PD-1participate.Evidence-Based
