ASCO GUIDELINES Bundle

NSCLC Stage IV with Driver Alterations

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6 Treatment ROS1 First-line Recommendation 5.1 ➤ For patients with ROS1 rearrangement, a performance status of 0–2, previously untreated NSCLC, clinicians may offer crizotinib or entrectinib (Moderate recommendation; IC-L). Recommendation 5.2 ➤ For patients with ROS1 rearrangement, a performance status of 0–2, previously untreated NSCLC, clinicians may offer standard therapy based on the ASCO/OH non-driver mutation guideline (Moderate recommendation; IC-L). Recommendation 5.3 ➤ For patients with ROS1 rearrangement, a performance status of 0–2, previously untreated NSCLC, clinicians may offer ceritinib or lorlatinib (Weak recommendation; IC-L). ROS1 Second-line Recommendation 6.1 ➤ For patients with ROS1 rearrangement, a performance status of 0–2, previously treated with ROS1-targeted therapy, clinicians should offer standard therapy based on the ASCO/OH non-driver mutation guideline (Moderate recommendation; IC-L). Recommendation 6.2 ➤ For patients with ROS1 rearrangement, a performance status of 0–2, previously treated with non-targeted therapy first-line, clinicians may offer crizotinib or entrectinib or ceritinib (Moderate recommendation; IC-L). BRAF First-line Recommendation 7.1 ➤ For patients with a BRAF V600E mutation, clinicians may offer dabrafenib/trametinib as first-line treatment (Moderate recommendation; IC-L). Recommendation 7.2 ➤ For patients with a BRAF V600E mutation, clinicians may offer standard first-line therapy based on the ASCO/OH non-driver mutation guideline (Moderate recommendation; IC-L).

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