ge 4 NSCLC
utation detected in tumor tissue
+
Single-agent EGFR TKI
(erlotinib or gefitinib)**
PS 2 vinorelbine, or gemcitabine)
Consider single agent (paclitaxel, docetaxel,
axel, elbine, or exed)
*If an EGFR mutation or ALK translocation is discovered after initiation of therapy, then give appropriate targeted therapy as switch maintenance or 2nd
-line treatment.
If other platinum combination, then 2 drugs are acceptable
combination chemotherapy at progression.
**Patients who receive single-agent TKI as 1st
-line therapy should consider 1st -line insufficiency, intolerable nausea despite optimal emesis prophylaxis, and intolerance of corticosteroids needed for
Stable disease but not responding to treatment after 4 cycles
or stop platinum ug therapy
on y.
b, patients ntil disease acceptable
platinum and continue single-drug therapy
Stop therapy, or stop Adequate PS
docetaxel, erlotinib, gefitinib, or pemetrexed
Begin 2nd Line at Progression Inadequate PS
Follow, clinical trial, and/ or palliative care
treatment of patients with locally advanced or metastatic NSCLC that is positive for a rearrangement in the anaplastic lymphoma kinase (ALK) gene as detected by an FDA- approved test.a
US FDA has approved crizotinib for the
