12
Treatment
Summary of Recommendations
Recommendation # Description
4.1
4.2
4.3
For patients with stage IV NSCLC and driver alterations in ALK
• In the second-line setting, if alectinib or brigatinib was
given in the first-line setting, lorlatinib may be offered
(Moderate recommendation: IC-L).
• In the second-line setting, if crizotinib was given in the
first-line setting, then alectinib, brigatinib, or ceritinib
should be offered (Strong recommendation: EB-B-I).
• In the third-line setting, if crizotinib was given in the
first-line setting and either alectinib, brigatinib, or
ceritinib in the second-line setting, then lorlatinib may be
offered (Moderate recommendation: IC-L) or standard
treatment based on the ASCO/OH non-driver mutation
guideline may be offered (Weak recommendation: IC-L).
5.1
5.2
5.3
For patients with stage IV NSCLC and driver alterations in
ROS1
• In the first-line setting, crizotinib or entrectinib may be
offered (Moderate recommendation: IC-L) or standard
treatment based on the ASCO/OH non-driver mutation
guideline may be offered (Moderate recommendation:
IC-L) or ceritinib or lorlatinib may be offered (Weak
recommendation: IC-L).
6.1
6.2
For patients with stage IV NSCLC and driver alterations in
ROS1
• In the second-line setting, if ROS1-targeted therapy was
given in the first-line setting, standard treatment based on
the ASCO/OH non-driver mutation guideline should be
offered (Moderate recommendation: IC-L).
• In the second-line setting, if non-targeted therapy was
given in the first-line setting, crizotinib, ceritinib, or
entrectinib may be offered (Moderate recommendation:
IC-L).
7.1
7.2
For patients with stage IV NSCLC and driver alterations with
BRAF V600E mutation
• In the first-line setting, dabrafenib/trametinib may be
offered (Moderate recommendation: IC-L) or standard
first-line treatment based on the ASCO/OH non-
driver mutation guideline may be offered (Moderate
recommendation: IC-L).
(cont'd)
