ASCO GUIDELINES Bundle

NSCLC Stage IV without Driver Alterations

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10 Treatment Figure 2. Second-Line Treatment Options for Patients with Stage IV NSCLC Without Driver Alterations Patients with stage IV NSCLC, PS 0–1 SCC or non-SCC Driver alteration a negative Received first-line platinum doublet chemotherapy Negative or unknown PD-L1 Positive PD-L1 S Single-agent nivolumab S Single-agent nivolumab S Single-agent atezolizumab S Single-agent atezolizumab S Single-agent pembrolizumab M Single-agent docetaxel (If not received in first-line) S S Single-agent pemetrexed (If not recieved in first-line) W W Paclitaxel + bevacizumab (If not received in first-line) M Single-agent docetaxel (If not received in first-line) Single-agent permetrexed (If not received in first-line) Paclitaxel + bevacizumab (If not received in first-line) For patients with contraindications to immunotherapy For patients with contraindications to immunotherapy For patients with non-SCC only For patients with non-SCC only

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