ASCO生活指南(2023.1版)IV期非小细胞肺癌（无驱动改变）的治疗

Check for updatesTherapy for Stage IV Non-Small-Cell LungCancer Without Driver Alterations:ASCO LivingGuideline,Version 2023.10r9vqNavneet Singh,MD,DM';Ishmael A.Jaiyesimi,DO,MS2;Nofisat Ismaila,MD,MSc3;Natasha B.Leighl,MD;Hirva Mamdani,MD5:Tanyanika Phillips,MD,MPH5;and Dwight H.Owen,MD,MS7idelineupdatesLiving 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 atrastanding expert panel that systematically reviews the health literature on a continuous basis;as describedin the ASCO Guidelines Methodology Manual.ASCO Living Guidelines follow the ASCO Conflict of Interest PolicyImplementation for Clinical Practice Guidelines.Living Guidelines and updates are not intended to substitute forindependent professional judgment of the treating provider and do not account for individual variation amongpatients.See appendix for disclaimers and other important information (Appendix 1 and Appendix 2).Updatesare published regulary and can be found at https://ascopubs.org/nsclc-non-da-living-guideline.Clin Oncol 00.2023 by American Society of Clinical OncologyBACKGROUNDwithout known EGFR,ALK,or ROS-1 alterations,andIn 2022,ASCO launched living clinical practiceperformance status (PS)0-1?guidelines for systemic therapy for patients with stageThese updated recommendations are in addition toASSOCIATEDIV non-small-cell lung cancer (NSCLC)with'and2020 options.CONTENTwithout driver alterations?and both have been updatedRecommendation 2.8.For patients with non-SCC.See accompanyingrecently.36 Based on routine literature searches(up toarticle doi:10.1200/November 30,2022),this version of the stage IV NSCLCPD-L1 TPS 0%-49%and PS 0-1,clinicians may of-JC0.22.00825fer cemiplimab plus chemotherapy (Type:Evidencewithout driver alterations living guideline reviews newAppendixbased:Evidence quality:Moderate;Strength of rec-evidence to assess if recommendations are up to date.Data Supplementommendation:Weak).Author affiliationsRecommendation 2.9.For patients with non-SCC,PD-L1and supportRESULTSinformation (ifTPS 0%-49%and PS 0-1.clinicians may offer durvaTwo studies were identified in the literature search.78applicable)appearlumab and tremelimumab plus platinum-based cheat the end of thisThe guideline Expert Panel (Appendix Table A1)motherapy (Type:Evidence based;Evidence quality:article.reviewed the results from these studies and approvedModerate;Strength of recommendation:Weak).Accepted on Februarythe updated recommendations.Evidence supporting15,2023andunchanged recommendations is reviewed in previousQuestion 2published atpublications of this guideline.26What is the most effective first-line therapy for patientsascopubs.org/joumal/with SCC and PD-L1 TPS 0%-49%.without knownjco on April 6,2023:DOI https://doi.org/10.UPDATED RECOMMENDATIONSEGFR,ALK,or ROS-1 alterations,and PS 0-1?1200/0C0.23.00282Question 1These updated recommendations