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Oncology News Central (ONC)“Really Impactful” New Guidelines for Stage IV NSCLC with Driver Alterations

The American Society for Clinical Oncology (ASCO) recently updated its living guidelines for therapy in patients with stage IV non-small cell lung cancer (NSCLC) with driver alterations. Dr. Dwight H. Owen from the Ohio State University Comprehensive Cancer Center and Dr. Bob Figlin from Cedars-Sinai Cancer Center discuss the significant changes and their potential implications for patient care.

Key Points:

  • The updated guidelines include three new recommendations that are expected to directly improve patient care.
  • The first recommendation pertains to the KRAS G12C mutation, which is found in about a third of all NSCLC patients. The update provides data from the CodeBreak 200 study, a phase 3 randomized trial of sotorasib versus docetaxel in previously treated patients with NSCLC harboring a KRAS G12C mutation.
  • The other two recommendations relate to the EGFR exon 20 space, which is a subset of mutations that have few treatment options. The guidelines now include amivantamab, an antibody targeting both MET and EGFR, and mobocertinib, an oral tyrosine-kinase inhibitor (TKI).

Additional Points:

  • The guidelines are updated based on a critical evaluation of the available evidence, and they aim to minimize other influences and aspects.
  • The guidelines are designed to help oncologists interpret new data and apply it to patient care.
  • The guidelines are a living document, meaning they are regularly updated as new evidence becomes available.


  • The updated ASCO guidelines provide new recommendations for treating patients with stage IV NSCLC with driver alterations, potentially improving patient outcomes.

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“I think where — at least I personally and I think some of our colleagues — struggle is to try to culminate that data and bring it to what are you going to do in clinic.”

Dr. Dwight H. Owen
Ohio State University Comprehensive Cancer Center – James
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