ASCO GUIDELINES Bundle

NSCLC Stage IV with Driver Alterations

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7 BRAF Second-line Recommendation 8.1 ➤ For patients with a BRAF V600E mutation who have had previous BRAF/MEK (dabrafenib/trametinib) targeted therapy, clinicians should offer standard first-line therapy based on the ASCO/OH non- driver mutation guideline (Moderate recommendation; IC-L). Recommendation 8.2 ➤ For patients with a BRAF V600E mutation, if BRAF-targeted therapy was not given in the first-line setting, clinicians may offer dabrafenib/trametinib (Moderate recommendation; IC-L) or dabrafenib alone (Weak recommendation; IC-L) or vemurafenib (Weak recommendation; IC-B-L). Recommendation 8.3 ➤ For patients with a BRAF V600E mutation who have had previous chemotherapy, immunotherapy, and/or BRAF-targeted therapy in the first- or subsequent-line setting, clinicians should offer standard treatment based on the ASCO/OH non-driver mutation guideline (Moderate recommendation; IC-L). Recommendation 8.4 ➤ For patients with BRAF mutations other than BRAF V600E mutations, clinicians should offer standard therapy based on the ASCO/OH non- driver mutation guideline (Moderate recommendation; IC-L). MET First-line Recommendation 9.1 ➤ For patients with a MET exon 14 skipping mutation, a performance status of 0–2, previously untreated NSCLC, clinicians may offer MET-targeted therapy with capmatinib or tepotinib (Moderate recommendation; IC-L). Recommendation 9.2 ➤ For patients with a MET exon 14 skipping mutation, a performance status of 0–2, previously untreated NSCLC, clinicians may offer standard first-line therapy based on the ASCO/OH non-driver mutations guideline (Moderate recommendation; IC-L).

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