ASCO GUIDELINES Bundle

NSCLC Stage III

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6 Diagnosis Treatment Adjuvant Therapy Recommendation 4.1 ➤ Patients with resected stage III NSCLC who did not receive neoadjuvant systemic therapy should be offered adjuvant platinum- based chemotherapy. (Strong recommendation; EB-B-H) Recommendation 4.2 ➤ Patients with resected stage III NSCLC with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R mutation may be offered adjuvant osimertinib after platinum-based chemotherapy. (Strong recommendation; EB-B-M) Recommendation 4.3 ➤ For patients with completely resected NSCLC with mediastinal N2 involvement without extracapsular extension who have received neoadjuvant or adjuvant platinum-based chemotherapy, postoperative radiation therapy should not be routinely offered. (Weak recommendation; EB-B/H-M) Unresectable Disease Recommendation 5.1 ➤ Patients with stage III NSCLC who are medically or surgically inoperable and good performance status should be offered concurrent instead of sequential chemotherapy and radiation therapy. (Strong recommendation; EB-B-H) Recommendation 5.2 ➤ Concurrent chemotherapy delivered with radiation therapy for definitive treatment of stage III NSCLC should include a platinum- based doublet, preferably cisplatin plus etoposide, carboplatin plus paclitaxel, cisplatin plus pemetrexed (non-squamous only), or cisplatin plus vinorelbine. (Strong recommendation; EB-B-H) Qualifying statement: Carboplatin may be substituted for cisplatin in patients with contraindications to or deemed ineligible for cisplatin.

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