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Presenters: Jane Yanagawa and Gregory J. Riely

For patients with resectable non–small cell lung cancer (NSCLC) as well as those with metastatic disease, there have been significant recent advances in therapies. In patients with resectable disease, new evidence supports use of neoadjuvant nivolumab + chemotherapy for eligible patients with resectable stage II–IIIA NSCLC. Separate data lead to the recommendation for adjuvant atezolizumab (after adjuvant chemotherapy) for eligible patients with completely resected stage II–IIIA NSCLC and PD-L1 expression ≥1%. Adjuvant osimertinib (± adjuvant chemotherapy) is an alternative for eligible patients with completely resected stage IB–IIIA NSCLC and EGFR mutations (exon 19 del or L858R). For patients with metastatic NSCLC, molecular testing is recommended for EGFR and BRAF mutations; MET exon skipping 14 alterations; ALK, ROS1, RET, and NTRK1/2/3 gene arrangements; and KRAS G12C mutations. First-line targeted therapies are available for many of these targets and, in the second-line setting, there are new targeted agents for KRAS G12C mutations and EGFR exon 20 insertions.

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David S. Ettinger, Douglas E. Wood, Dara L. Aisner, Wallace Akerley, Jessica R. Bauman, Ankit Bharat, Debora S. Bruno, Joe Y. Chang, Lucian R. Chirieac, Thomas A. D’Amico, Thomas J. Dilling, Jonathan Dowell, Scott Gettinger, Matthew A. Gubens, Aparna Hegde, Mark Hennon, Rudy P. Lackner, Michael Lanuti, Ticiana A. Leal, Jules Lin, Billy W. Loo Jr, Christine M. Lovly, Renato G. Martins, Erminia Massarelli, Daniel Morgensztern, Thomas Ng, Gregory A. Otterson, Sandip P. Patel, Gregory J. Riely, Steven E. Schild, Theresa A. Shapiro, Aditi P. Singh, James Stevenson, Alda Tam, Jane Yanagawa, Stephen C. Yang, Kristina M. Gregory, and Miranda Hughes

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non–Small Cell Lung Cancer (NSCLC) address all aspects of management for NSCLC. These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines regarding targeted therapies, immunotherapies, and their respective biomarkers.

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David S. Ettinger, Douglas E. Wood, Dara L. Aisner, Wallace Akerley, Jessica R. Bauman, Ankit Bharat, Debora S. Bruno, Joe Y. Chang, Lucian R. Chirieac, Thomas A. D’Amico, Malcolm DeCamp, Thomas J. Dilling, Jonathan Dowell, Scott Gettinger, Travis E. Grotz, Matthew A. Gubens, Aparna Hegde, Rudy P. Lackner, Michael Lanuti, Jules Lin, Billy W. Loo Jr., Christine M. Lovly, Fabien Maldonado, Erminia Massarelli, Daniel Morgensztern, Thomas Ng, Gregory A. Otterson, Jose M. Pacheco, Sandip P. Patel, Gregory J. Riely, Jonathan Riess, Steven E. Schild, Theresa A. Shapiro, Aditi P. Singh, James Stevenson, Alda Tam, Tawee Tanvetyanon, Jane Yanagawa, Stephen C. Yang, Edwin Yau, Kristina Gregory, and Miranda Hughes

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non–Small Cell Lung Cancer (NSCLC) provide recommended management for patients with NSCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. Patients with metastatic lung cancer who are eligible for targeted therapies or immunotherapies are now surviving longer. This selection from the NCCN Guidelines for NSCLC focuses on targeted therapies for patients with metastatic NSCLC and actionable mutations.