Based on the results of 3 recently published trials, the American Society of Clinical Oncology has updated its living guideline for systemic therapy for patients with stage IV non–small-cell lung cancer (NSCLC) with driver alterations. The trials were the CHRYSALIS phase 1 study, NCT02716116 phase 1/2 trial, and NCT04303780 (CodeBreaK 200) phase 3 trial of sotorasib versus docetaxel.
The updated recommendations are as follows:
• For patients with advanced NSCLC with an EGFR exon 20 insertion and a performance status of 0–2, who have received prior platinum-based chemotherapy, clinicians may offer amivantamab monotherapy (Type: Evidence based; benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak).
• For patients with advanced NSCLC with an EGFR exon 20 insertion and a performance status 0–2, who have received prior platinum-based chemotherapy, clinicians may offer mobocertinib monotherapy (Type: Evidence based; benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak).
• For patients with advanced NSCLC and a KRAS-G12C mutation who have received prior systemic therapy, clinicians may offer treatment with sotorasib monotherapy (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak).