ASCO Guidelines Update!

In 2017 , ASCO and Ontario Health - Cancer Care Ontario released a guideline on adjuvant therapy after resection for stage I-III non-small cell lung cancers ( NSCLCs ) .
Two randomized controlled trials (RCTs ) were published in 2020 and 2021 , respectively , and led to revisions to the 2017 guidelines .

In 2017 , ASCO ASCO and Ontario Health - Cancer Care Ontario released a guideline on the adjuvant treatment of NSCLC after resection of stage I-III non-small cell lung cancer ( NSCLC ) .

The guidelines published two randomized controlled trials (RCTs ) in 2020 and 2021 , respectively , and prompted revisions to the 2017 guidelines .

On February 15 , 2022 , the ASCO official website updated the ASCO guideline recommendation: Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I-IIIA Completely Resected Non–Small-Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update , emphasizing the revision of the 2017 ASCO Guidelines to disseminate the latest recommendations in a timely manner to better serve cancer care .

And this recommendation is supported by a review of evidence and follows the guideline development process outlined in the ASCO Guideline Methods Manual .

On February 15 , 2022 , the ASCO official website updated the ASCO guideline recommendation: Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I-IIIA Completely Resected Non–Small-Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update , emphasizing the revision of the 2017 ASCO Guidelines to disseminate the latest recommendations in a timely manner to better serve cancer care .
And this recommendation is supported by a review of evidence and follows the guideline development process outlined in the ASCO Guideline Methods Manual .

 

 

2021 Update Recommendations

2021 Update Recommendations

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Stage IB (3 < T ≥ 4 cm , NOM0) : For patients with sensitizing EGFR (Ex19del or L858R) mutations, adjuvant osimertinib is recommended
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( Type: evidence-based; quality of evidence: high; strength of recommendation: strong )

Stage IB (3 < T ≥ 4 cm , NOM0) : For patients with sensitizing EGFR (Ex19del or L858R) mutations, adjuvant osimertinib is recommended

▪Recommendation▪Recommendation 1.
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Cisplatin-based adjuvant chemotherapy and / or atezolizumab are not recommended for routine treatment in these patients

Postoperative multimodal evaluation, including consultation with a medical oncologist, is recommended to assess the benefits and risks of adjuvant therapy in each patient

The 2017 guideline section on adjuvant systemic therapy outlines factors other than tumor stage to consider when adjuvant therapy is recommended

▪Recommendation ▪Recommendation 1.
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Stages IIA , IIB , and IIIA : Adjuvant cisplatin-based chemotherapy is recommended for all patients
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Stages IIA , IIB , and IIIA : Adjuvant cisplatin-based chemotherapy is recommended for all patients
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Adjuvant osimertinib is recommended after chemotherapy in patients with tumors with sensitizing EGFR mutations, regardless of PD-L1 status .

Adjuvant osimertinib is recommended after chemotherapy in patients with tumors with sensitizing EGFR mutations, regardless of PD-L1 status .

Adjuvant atezolizumab is recommended for all patients with PD-L1 ≥ 1% after cisplatin-based chemotherapy, except for patients with sensitizing EGFR mutations .
(Type: evidence-based and expert panel consensus; quality of evidence: high; strength of recommendation: strong ) .

Note: The staging criteria used in this guideline are the 7th edition staging criteria used for research, not the current 8th edition staging criteria for lung cancer
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Note: The staging criteria used in this guideline are the 7th edition staging criteria used for research, not the current 8th edition staging criteria for lung cancer
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