-
Sections Non-Small Cell Lung Cancer (NSCLC)
- Overview
- Presentation
- DDx
- Workup
- Approach Considerations
- Laboratory Studies
- Chest Radiography
- Computed Tomography
- Magnetic Resonance Imaging
- Bone Scintigraphy
- Positron Emission Tomography
- Sputum Cytologic Studies
- Bronchoscopy
- Biopsy
- Needle Thoracentesis (Ultrasound Guided)
- Thoracoscopy and Mediastinoscopy
- Molecular Testing
- Histologic Findings
- Staging
- Workup for Special Populations
- Screening
- Show All
- Treatment
- Guidelines
- Medication
- Medication Summary
- Antineoplastic Agents
- Antineoplastics, Anaplastic Lymphoma Kinase Inhibitors
- PD-1/PD-L1 Inhibitors
- Anti-CLTA4 Antibodies
- Antineoplastics, EGFR Inhibitor
- Antineoplastics, Anti-HER2
- Antineoplastics, BRAF Kinase Inhibitors
- Antineoplastics, Tyrosine Kinase Inhibitors
- RET Kinase Inhibitors
- MET Tyrosine Kinase Inhibitors
- Antineoplastics, KRAS Inhibitors
- Antineoplastics, Monoclonal Antibodies
- Antiemetic Agents
- Show All
- Questions & Answers
- Media Gallery
- References
Diagnostic Considerations
Non–small cell lung cancer (NSCLC) must be differentiated from small cell lung cancer (SCLC) in order to plan appropriate treatment. SCLC is usually more aggressive than NSCLC and presents as a central lesion with hilar and mediastinal invasion along with regional adenopathy. Many patients with SCLC already have metastatic disease at initial diagnosis. The most common sites of metastasis of lung cancer are the bones, liver, adrenal glands, pericardium, brain, and spinal cord. [44]
Other conditions to be considered include the following:
-
Benign lung tumors
-
Carcinoid lung tumors
-
Granuloma
-
Hamartoma
-
Metastatic cancer
-
Pneumomediastinum
-
Pneumonia, empyema, and abscess
-
Pneumothorax, tension and traumatic
Differential Diagnoses
-
Mycoplasmal Pneumonia
[Guideline] Rivera MP, Mehta AC, Wahidi MM. Establishing the diagnosis of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May. 143 (5 Suppl):e142S-e165S. [QxMD MEDLINE Link]. [Full Text].
Rowell NP, Williams CJ. Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable): a systematic review. Thorax. 2001 Aug. 56(8):628-38. [QxMD MEDLINE Link].
Strand TE, Brunsvig PF, Johannessen DC, et al. Potentially curative radiotherapy for non-small-cell lung cancer in Norway: a population-based study of survival. Int J Radiat Oncol Biol Phys. 2011 May 1. 80(1):133-41. [QxMD MEDLINE Link].
Wang HM, Liao ZX, Komaki R, et al. Improved survival outcomes with the incidental use of beta-blockers among patients with non-small-cell lung cancer treated with definitive radiation therapy. Ann Oncol. 2013 Jan 8. [QxMD MEDLINE Link].
Rosen G. A History of Public Health: Expanded Edition. Baltimore, MD.: The Johns Hopkins University Press; 1993.
Cancer Facts & Figures 2023. American Cancer Society. Available at https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf. Accessed: February 15, 2023.
National Research Council, Committee on Health Risks of Exposure to Radon, Board on Radiation Effects Research, Commission on Life Sciences. Health effects of exposure to radon (BEIR VI). Washington, DC.: National Academy Press.; 1999.
Ito H, Matsuo K, Tanaka H, et al. Nonfilter and filter cigarette consumption and the incidence of lung cancer by histological type in Japan and the United States: analysis of 30-year data from population-based cancer registries. Int J Cancer. 2011 Apr 15. 128(8):1918-28. [QxMD MEDLINE Link].
Zhang J, Fujimoto J, Zhang J, et al. Intratumor heterogeneity in localized lung adenocarcinomas delineated by multiregion sequencing. Science. 2014 Oct 10. 346(6206):256-9. [QxMD MEDLINE Link].
de Bruin EC, McGranahan N, Mitter R, et al. Spatial and temporal diversity in genomic instability processes defines lung cancer evolution. Science. 2014 Oct 10. 346(6206):251-6. [QxMD MEDLINE Link].
Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008 May. 83(5):584-94. [QxMD MEDLINE Link]. [Full Text].
Nelson R. Lung Cancer Rates Surging in Never-Smokers. Medscape Medical News. Available at http://www.medscape.com/viewarticle/850708. September 9, 2015; Accessed: February 15, 2023.
Beckett WS. Epidemiology and etiology of lung cancer. Clin Chest Med. 1993 Mar. 14(1):1-15. [QxMD MEDLINE Link].
Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and lung cancer risk in never smokers: a meta-analysis. Ann Oncol. 2011 Dec. 22(12):2631-9. [QxMD MEDLINE Link].
Current Cigarette Smoking Among Adults in the United States. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. March 17, 2022; Accessed: February 15, 2023.
GBD 2019 Tobacco Collaborators. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021 Jun 19. 397 (10292):2337-2360. [QxMD MEDLINE Link]. [Full Text].
Ginsberg RJ, Vokes EE, Raben A. Non-small cell lung cancer. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, Pa: Lippincott-Raven;. 1997:858-911.
Vainshelboim B, Lima RM, Kokkinos P, Myers J. Cardiorespiratory Fitness, Lung Cancer Incidence, and Cancer Mortality in Male Smokers. Am J Prev Med. 2019 Nov. 57 (5):659-666. [QxMD MEDLINE Link].
Zhong L, Goldberg MS, Parent ME, Hanley JA. Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis. Lung Cancer. 2000 Jan. 27(1):3-18. [QxMD MEDLINE Link].
Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May. 143(5 Suppl):e1S-29S. [QxMD MEDLINE Link].
Hou W, Fu J, Ge Y, Du J, Hua S. Incidence and risk of lung cancer in HIV-infected patients. J Cancer Res Clin Oncol. 2013 Nov. 139(11):1781-94. [QxMD MEDLINE Link].
Cortes-Jofre M, Rueda JR, Corsini-Munoz G, Fonseca-Cortes C, Caraballoso M, Bonfill Cosp X. Drugs for preventing lung cancer in healthy people. Cochrane Database Syst Rev. 2012 Oct 17. 10:CD002141. [QxMD MEDLINE Link].
Ries L, Eisner M, Kosary C. Cancer statistics review, 1975-2002. National Cancer Institute.; 2005.
World Health Organization, International Agency for Research on Cancer. Globocan 2020: Lung Cancer. International Agency for Research on Cancer. Available at http://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-fact-sheet.pdf. Accessed: February 15, 2023.
Jemal A, Miller KD, Ma J, Siegel RL, Fedewa SA, Islami F, et al. Higher Lung Cancer Incidence in Young Women Than Young Men in the United States. N Engl J Med. 2018 May 24. 378 (21):1999-2009. [QxMD MEDLINE Link].
SEER Stat Fact Sheets: Lung and Bronchus Cancer. Surveillance, Epidemiology, and End Results Program. Available at http://seer.cancer.gov/statfacts/html/lungb.html. Accessed: February 15, 2023.
Jonnalagadda S, Smith C, Mhango G, Wisnivesky JP. The Number of Lymph Node Metastases as a Prognostic Factor in Patients With N1 Non-small Cell Lung Cancer. Chest. 2011 Aug. 140(2):433-40. [QxMD MEDLINE Link]. [Full Text].
Mostertz W, Stevenson M, Acharya C, et al. Age- and sex-specific genomic profiles in non-small cell lung cancer. JAMA. 2010 Feb 10. 303(6):535-43. [QxMD MEDLINE Link].
Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ. 2010 Jan 21. 340:b5569. [QxMD MEDLINE Link]. [Full Text].
Ferketich AK, Niland JC, Mamet R, et al. Smoking status and survival in the national comprehensive cancer network non-small cell lung cancer cohort. Cancer. 2012 Sep 28. [QxMD MEDLINE Link].
Chlebowski RT, Schwartz AG, Wakelee H, Anderson GL, Stefanick ML, Manson JE, et al. Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial. Lancet. 2009 Oct 10. 374 (9697):1243-51. [QxMD MEDLINE Link]. [Full Text].
Bouchardy C, Benhamou S, Schaffar R, et al. Lung cancer mortality risk among breast cancer patients treated with anti-estrogens. Cancer. 2011 Mar 15. 117(6):1288-95. [QxMD MEDLINE Link].
Rothwell PM, Fowkes GR, Belch JF, Ogawa H, Warlow CP, Meade TW. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomized trials. Lancet. Dec 7/2010; Early online publication. [Full Text].
Hofman V, Bonnetaud C, Ilie MI, et al. Preoperative circulating tumor cell detection using the isolation by size of epithelial tumor cell method for patients with lung cancer is a new prognostic biomarker. Clin Cancer Res. 2011 Feb 15. 17(4):827-35. [QxMD MEDLINE Link].
Wicha MS, Hayes DF. Circulating tumor cells: not all detected cells are bad and not all bad cells are detected. J Clin Oncol. 2011 Apr 20. 29(12):1508-11. [QxMD MEDLINE Link].
Lopez Guerra JL, Gomez DR, Lin SH, et al. Risk factors for local and regional recurrence in patients with resected N0-N1 non-small-cell lung cancer, with implications for patient selection for adjuvant radiation therapy. Ann Oncol. 2012 Sep 20. [QxMD MEDLINE Link].
Kadota K, Nitadori JI, Sarkaria IS, et al. Thyroid transcription factor-1 expression is an independent predictor of recurrence and correlates with the IASLC/ATS/ERS histologic classification in patients with stage I lung adenocarcinoma. Cancer. 2012 Oct 23. [QxMD MEDLINE Link].
Nitadori J, Bograd AJ, Kadota K, et al. Impact of Micropapillary Histologic Subtype in Selecting Limited Resection vs Lobectomy for Lung Adenocarcinoma of 2cm or Smaller. J Natl Cancer Inst. 2013 Aug 21. 105(16):1212-20. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Lung Cancer Screening Guidelines. American Cancer Society. Available at https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.html. 2022; Accessed: February 15, 2023.
Corner J, Hopkinson J, Fitzsimmons D, Barclay S, Muers M. Is late diagnosis of lung cancer inevitable? Interview study of patients' recollections of symptoms before diagnosis. Thorax. 2005 Apr. 60(4):314-9. [QxMD MEDLINE Link]. [Full Text].
Ejaz S, Vassilopoulou-Sellin R, Busaidy NL, et al. Cushing syndrome secondary to ectopic adrenocorticotropic hormone secretion: the University of Texas MD Anderson Cancer Center Experience. Cancer. 2011 Oct 1. 117(19):4381-9. [QxMD MEDLINE Link]. [Full Text].
Fadel E, Missenard G, Court C, et al. Long-term outcomes of en bloc resection of non-small cell lung cancer invading the thoracic inlet and spine. Ann Thorac Surg. 2011 Sep. 92(3):1024-30; discussion 1030. [QxMD MEDLINE Link].
Patel AM, Davila DG, Peters SG. Paraneoplastic syndromes associated with lung cancer. Mayo Clin Proc. 1993 Mar. 68(3):278-87. [QxMD MEDLINE Link].
Sher T, Dy GK, Adjei AA. Small cell lung cancer. Mayo Clin Proc. 2008 Mar. 83(3):355-67. [QxMD MEDLINE Link].
Annema JT, van Meerbeeck JP, Rintoul RC, et al. Mediastinoscopy vs endosonography for mediastinal nodal staging of lung cancer: a randomized trial. JAMA. 2010 Nov 24. 304(20):2245-52. [QxMD MEDLINE Link].
Oken MM, Hocking WG, Kvale PA, et al. Screening by chest radiograph and lung cancer mortality: the Prostate, Lung, Colorectal, and Ovarian (PLCO) randomized trial. JAMA. 2011 Nov 2. 306(17):1865-73. [QxMD MEDLINE Link].
[Guideline] Mazzone PJ, Silvestri GA, Souter LH, Caverly TJ, Kanne JP, Katki HA, et al. Screening for Lung Cancer: CHEST Guideline and Expert Panel Report. Chest. 2021 Nov. 160 (5):e427-e494. [QxMD MEDLINE Link]. [Full Text].
Foster BB, Muller NL, Miller RR, et al. Neuroendocrine carcinomas of the lung: clinical, radiologic and pathologic correlation. Radiology. 1989. 170:441-445.
Alpert JB, Fantauzzi JP, Melamud K, Greenwood H, Naidich DP, Ko JP. Clinical Significance of Lung Nodules Reported on Abdominal CT. AJR Am J Roentgenol. 2012 Apr. 198(4):793-9. [QxMD MEDLINE Link].
Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA. 2001 Feb 21. 285(7):914-24. [QxMD MEDLINE Link].
Deppen SA, Blume JD, Kensinger CD, et al. Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis. JAMA. 2014 Sep 24. 312(12):1227-36. [QxMD MEDLINE Link].
Erkilic S, Ozsarac C, Kullu S. Sputum cytology for the diagnosis of lung cancer. Comparison of smear and modified cell block methods. Acta Cytol. 2003 Nov-Dec. 47(6):1023-7. [QxMD MEDLINE Link].
Billah S, Stewart J, Staerkel G, et al. EGFR and KRAS mutations in lung carcinoma: molecular testing by using cytology specimens. Cancer Cytopathol. 2011 Apr 25. 119(2):111-7. [QxMD MEDLINE Link].
Arroliga AC, Matthay RA. The role of bronchoscopy in lung cancer. Clin Chest Med. 1993 Mar. 14(1):87-98. [QxMD MEDLINE Link].
Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003 Jan. 123(1 Suppl):115S-128S. [QxMD MEDLINE Link].
He J, Shao W, Cao C, et al. Long-term outcome and cost-effectiveness of complete versus assisted video-assisted thoracic surgery for non-small cell lung cancer. J Surg Oncol. 2011 Aug 1. 104(2):162-8. [QxMD MEDLINE Link].
Mentzer SJ, Swanson SJ, DeCamp MM, Bueno R, Sugarbaker DJ. Mediastinoscopy, thoracoscopy, and video-assisted thoracic surgery in the diagnosis and staging of lung cancer. Chest. 1997 Oct. 112(4 Suppl):239S-241S. [QxMD MEDLINE Link].
[Guideline] Lindeman NI, Cagle PT, Aisner DL, Arcila ME, Beasley MB, Bernicker EH, et al. Updated Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment With Targeted Tyrosine Kinase Inhibitors: Guideline From the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. Arch Pathol Lab Med. 2018 Mar. 142 (3):321-346. [QxMD MEDLINE Link]. [Full Text].
Chustecka Z. FDA approves companion genetic diagnostic test for Tarceva in NSCLC. Medscape Medical News. May 14, 2013. [Full Text].
Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012 Mar. 13(3):239-46. [QxMD MEDLINE Link].
American Joint Committee on Cancer. Lung. Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, et al, eds. AJCC Cancer Staging Handbook. 8th ed. Chicago, Ill: Springer; 2017. Chapter 25.
Tintinalli JE. Emergency complications of malignancy. Emergency Medicine: A Comprehensive Guide. 2004. 1319-1368.
Halfdanarson TR, Hogan WJ, Moynihan TJ. Oncologic emergencies: diagnosis and treatment. Mayo Clin Proc. 2006 Jun. 81(6):835-48. [QxMD MEDLINE Link].
National Lung Screening Trial Research Team., Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4. 365 (5):395-409. [QxMD MEDLINE Link]. [Full Text].
[Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Lung Cancer Screening. Available at http://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf. Version 2.2023 — May 17, 2023; Accessed: June 7, 2023.
[Guideline] U.S. Preventive Services Task Force. Final Recommendation Statement: Lung Cancer: Screening. Available at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/lung-cancer-screening. March 9, 2021; Accessed: June 7, 2023.
Cheung LC, Katki HA, Chaturvedi AK, Jemal A, Berg CD. Preventing Lung Cancer Mortality by Computed Tomography Screening: The Effect of Risk-Based Versus U.S. Preventive Services Task Force Eligibility Criteria, 2005–2015. Ann Intern Med. 2 January 2018. [Full Text].
Kumar V, Cohen JT, van Klaveren D, Soeteman DI, Wong JB, Neumann PJ, et al. Risk-Targeted Lung Cancer Screening: A Cost-Effectiveness Analysis. Ann Intern Med. 2 January 2018. [Full Text].
Pastorino U, Silva M, Sestini S, Sabia F, Boeri M, Cantarutti A, et al. Prolonged lung cancer screening reduced 10-year mortality in the MILD trial: new confirmation of lung cancer screening efficacy. Ann Oncol. 2019 Jun 5. [QxMD MEDLINE Link]. [Full Text].
Patz EF Jr, Pinsky P, Gatsonis C, et al. Overdiagnosis in low-dose computed tomography screening for lung cancer. JAMA Intern Med. 2013 Dec 9. [QxMD MEDLINE Link].
Patz EF Jr, Greco E, Gatsonis C, Pinsky P, Kramer BS, Aberle DR. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial. Lancet Oncol. 2016 Mar 18. [QxMD MEDLINE Link].
Kinsinger LS, Anderson C, Kim J, Larson M, Chan SH, King HA, et al. Implementation of Lung Cancer Screening in the Veterans Health Administration. JAMA Intern Med. 2017 Jan 30. [QxMD MEDLINE Link]. [Full Text].
Katki HA, Kovalchik SA, Petito LC, Cheung LC, Jacobs E, Jemal A, et al. Implications of Nine Risk Prediction Models for Selecting Ever-Smokers for Computed Tomography Lung Cancer Screening. Ann Intern Med. 15 May 2018. [Full Text].
Integrative Analysis of Lung Cancer Etiology and Risk (INTEGRAL) Consortium for Early Detection of Lung Cancer., Guida F, Sun N, Bantis LE, et al. Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins. JAMA Oncol. 2018 Jul 12. e182078. [QxMD MEDLINE Link].
Arriagada R, Bergman B, Dunant A, Le Chevalier T, Pignon JP, Vansteenkiste J. Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med. 2004 Jan 22. 350(4):351-60. [QxMD MEDLINE Link].
Saw SPL, Ong BH, Chua KLM, Takano A, Tan DSW. Revisiting neoadjuvant therapy in non-small-cell lung cancer. Lancet Oncol. 2021 Nov. 22 (11):e501-e516. [QxMD MEDLINE Link].
FDA approves neoadjuvant nivolumab and platinum-doublet chemotherapy for early-stage non-small cell lung cancer. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-neoadjuvant-nivolumab-and-platinum-doublet-chemotherapy-early-stage-non-small-cell-lung. March 4, 2022; Accessed: April 27, 2023.
Forde PM, et al; CheckMate 816 Investigators. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022 May 26. 386 (21):1973-1985. [QxMD MEDLINE Link]. [Full Text].
Greer JA, Jackson VA, Meier DE, Temel JS. Early integration of palliative care services with standard oncology care for patients with advanced cancer. CA Cancer J Clin. 2013 Sep. 63(5):349-63. [QxMD MEDLINE Link].
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010 Aug 19. 363(8):733-42. [QxMD MEDLINE Link].
[Guideline] Detterbeck FC, Lewis SZ, Diekemper R, Addrizzo-Harris D, Alberts WM. Executive Summary: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May. 143(5 Suppl):7S-37S. [QxMD MEDLINE Link]. [Full Text].
Yang CF, Kumar A, Gulack BC, Mulvihill MS, Hartwig MG, Wang X, et al. Long-term outcomes after lobectomy for non-small cell lung cancer when unsuspected pN2 disease is found: A National Cancer Data Base analysis. J Thorac Cardiovasc Surg. 2016 May. 151 (5):1380-8. [QxMD MEDLINE Link].
Okada M, Nakayama H, Okumura S, et al. Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma. J Thorac Cardiovasc Surg. 2011 Jun. 141(6):1384-91. [QxMD MEDLINE Link].
Ma Z, Dong A, Fan J, Cheng H. Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis. Eur J Cardiothorac Surg. 2007 Jul. 32(1):20-8. [QxMD MEDLINE Link].
Kates M, Swanson S, Wisnivesky JP. Survival following lobectomy and limited resection for the treatment of stage I non-small cell lung cancer<=1 cm in size: a review of SEER data. Chest. 2011 Mar. 139(3):491-6. [QxMD MEDLINE Link].
Altorki N, Wang X, Kozono D, Watt C, Landrenau R, Wigle D, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9. 388 (6):489-498. [QxMD MEDLINE Link].
Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer. National Cancer Institute. Available at https://clinicaltrials.gov/ct2/show/NCT00499330. November 17, 2022; Accessed: April 27, 2023.
Yendamuri S, Sharma R, Demmy M, et al. Temporal trends in outcomes following sublobar and lobar resections for small (= 2 cm) non-small cell lung cancers--a Surveillance Epidemiology End Results database analysis. J Surg Res. 2013 Jul. 183(1):27-32. [QxMD MEDLINE Link].
Okami J, Ito Y, Higashiyama M, et al. Sublobar resection provides an equivalent survival after lobectomy in elderly patients with early lung cancer. Ann Thorac Surg. 2010 Nov. 90(5):1651-6. [QxMD MEDLINE Link].
Wolf AS, Richards WG, Jaklitsch MT, et al. Lobectomy versus sublobar resection for small (2 cm or less) non-small cell lung cancers. Ann Thorac Surg. 2011 Nov. 92(5):1819-23; discussion 1824-5. [QxMD MEDLINE Link].
Cattaneo SM, Park BJ, Wilton AS, et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008 Jan. 85(1):231-5; discussion 235-6. [QxMD MEDLINE Link].
[Guideline] National Comprehensive Cancer Network. National Comprehensive Cancer Network. Non-Small Cell Lung Cancer. NCCN. Available at https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Version 1.2022 — December 7, 2021; Accessed: February 9, 2022.
Swanson SJ, Herndon JE 2nd, D'Amico TA, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study. J Clin Oncol. 2007 Nov 1. 25(31):4993-7. [QxMD MEDLINE Link].
Darling GE, Allen MS, Decker PA, et al. Number of lymph nodes harvested from a mediastinal lymphadenectomy: results of the randomized, prospective American College of Surgeons Oncology Group Z0030 trial. Chest. 2011 May. 139(5):1124-9. [QxMD MEDLINE Link]. [Full Text].
Allen JW, Farooq A, O'Brien TF, Osarogiagbon RU. Quality of surgical resection for nonsmall cell lung cancer in a US metropolitan area. Cancer. 2011 Jan 1. 117(1):134-42. [QxMD MEDLINE Link].
Yun YH, Kim YA, Min YH, et al. Health-Related Quality of Life in Disease-Free Survivors of Surgically Treated Lung Cancer Compared With the General Population. Ann Surg. 2012 Mar 30. [QxMD MEDLINE Link].
Dosoretz DE, Katin MJ, Blitzer PH, et al. Radiation therapy in the management of medically inoperable carcinoma of the lung: results and implications for future treatment strategies. Int J Radiat Oncol Biol Phys. 1992. 24(1):3-9. [QxMD MEDLINE Link].
Jeremic B, Milicic B, Milisavljevic S. Clinical prognostic factors in patients with locally advanced (stage III) nonsmall cell lung cancer treated with hyperfractionated radiation therapy with and without concurrent chemotherapy: single-Institution Experience in 600 Patients. Cancer. 2011 Jan 10. [QxMD MEDLINE Link].
Sigel K, Lurslurchachai L, Bonomi M, et al. Effectiveness of radiation therapy alone for elderly patients with unresected stage III non-small cell lung cancer. Lung Cancer. 2013 Sep 4. [QxMD MEDLINE Link].
Topalian SL, Hodi FS, Brahmer JR, et al. Safety, activity, and immune correlates of anti-PD-1 antibody in cancer. N Engl J Med. 2012 Jun 28. 366(26):2443-54. [QxMD MEDLINE Link]. [Full Text].
Onishi H, Shirato H, Nagata Y, Hiraoka M, Fujino M, Gomi K. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol. 2007 Jul. 2(7 Suppl 3):S94-100. [QxMD MEDLINE Link].
Grills IS, Mangona VS, Welsh R, et al. Outcomes after stereotactic lung radiotherapy or wedge resection for stage I non-small-cell lung cancer. J Clin Oncol. 2010 Feb 20. 28(6):928-35. [QxMD MEDLINE Link].
Lencioni R, Crocetti L, Cioni R, Suh R, Glenn D, Regge D. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol. 2008 Jul. 9(7):621-8. [QxMD MEDLINE Link].
Muirhead R, van der Weide L, van Sornsen de Koste JR, Cover KS, Senan S. Use of megavoltage cine-images for studying intra-thoracic motion during radiotherapy for locally advanced lung cancer. Radiother Oncol. 2011 May. 99(2):155-60. [QxMD MEDLINE Link].
PORT Meta-analysis Trialists Group. Postoperative radiotherapy in non-small-cell lung cancer: systematic review and meta-analysis of individual patient data from nine randomised controlled trials. Lancet. 1998 Jul 25. 352(9124):257-63. [QxMD MEDLINE Link].
Rusch VW, Albain KS, Crowley JJ, et al. Surgical resection of stage IIIA and stage IIIB non-small-cell lung cancer after concurrent induction chemoradiotherapy. A Southwest Oncology Group trial. J Thorac Cardiovasc Surg. 1993 Jan. 105(1):97-104; discussion 104-6. [QxMD MEDLINE Link].
Azzoli CG, Temin S, Aliff T, et al. 2011 Focused Update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer. J Clin Oncol. 2011 Oct 1. 29(28):3825-31. [QxMD MEDLINE Link]. [Full Text].
Rosell R, Gomez-Codina J, Camps C, et al. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer. N Engl J Med. 1994. 330:153-158. [QxMD MEDLINE Link].
Roth JA, Fossella F, Komaki R, et al. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. J Natl Cancer Inst. 1994. 86:673-680. [QxMD MEDLINE Link].
Sigel K, Mhango G, Cohen J, et al. Outcomes After Adjuvant Platinum-based Chemotherapy in Elderly NSCLC Patients with T4 Disease. Ann Surg Oncol. 2012 Nov 1. [QxMD MEDLINE Link].
NSCLC Meta-Analyses collaborative Group. Chemotherapy in addition to supportive care improves survival in advanced non-small-cell lung cancer: a systematic review and meta-analysis of individual patient data from 16 randomized controlled trials. J Clin Oncol. 2008 Oct 1. 26(28):4617-25. [QxMD MEDLINE Link].
Marino P, Pampallona S, Preatoni A, et al. Chemotherapy vs supportive care in advanced non-small-cell lung cancer. Results of a meta-analysis of the literature. Chest. 1994 Sep. 106(3):861-5. [QxMD MEDLINE Link].
Wanders R, Steevens J, Botterweck A, et al. Treatment with curative intent of stage III non-small cell lung cancer patients of 75 years: a prospective population-based study. Eur J Cancer. 2011 Dec. 47(18):2691-7. [QxMD MEDLINE Link].
Wisnivesky JP, Smith CB, Packer S, et al. Survival and risk of adverse events in older patients receiving postoperative adjuvant chemotherapy for resected stages II-IIIA lung cancer: observational cohort study. BMJ. 2011 Jul 14. 343:d4013. [QxMD MEDLINE Link]. [Full Text].
Weick JK, Crowley J, Natale RB, et al. A randomized trial of five cisplatin-containing treatments in patients with metastatic non-small-cell lung cancer: a Southwest Oncology Group study. J Clin Oncol. 1991 Jul. 9(7):1157-62. [QxMD MEDLINE Link].
Rajeswaran A, Trojan A, Burnand B, Giannelli M. Efficacy and side effects of cisplatin- and carboplatin-based doublet chemotherapeutic regimens versus non-platinum-based doublet chemotherapeutic regimens as first line treatment of metastatic non-small cell lung carcinoma: a systematic review of randomized controlled trials. Lung Cancer. 2008 Jan. 59(1):1-11. [QxMD MEDLINE Link].
Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med. 2002 Jan 10. 346 (2):92-8. [QxMD MEDLINE Link]. [Full Text].
Socinski MA, Bondarenko I, Karaseva NA, et al. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol. 2012 Jun 10. 30(17):2055-62. [QxMD MEDLINE Link].
Le Chevalier T, Scagliotti G, Natale R, et al. Efficacy of gemcitabine plus platinum chemotherapy compared with other platinum containing regimens in advanced non-small-cell lung cancer: a meta-analysis of survival outcomes. Lung Cancer. 2005 Jan. 47(1):69-80. [QxMD MEDLINE Link].
Quoix E, Zalcman G, Oster JP, et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. Lancet. 2011 Sep 17. 378(9796):1079-88. [QxMD MEDLINE Link].
Pallis AG, Karampeazis A, Vamvakas L, et al. Efficacy and treatment tolerance in older patients with NSCLC: a meta-analysis of five phase III randomized trials conducted by the Hellenic Oncology Research Group. Ann Oncol. 2011 Nov. 22(11):2448-55. [QxMD MEDLINE Link].
Scagliotti GV, Parikh P, von Pawel J, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol. 2008 Jul 20. 26(21):3543-51. [QxMD MEDLINE Link].
Holm B, Mellemgaard A, Skov T, Skov BG. Different impact of excision repair cross-complementation group 1 on survival in male and female patients with inoperable non-small-cell lung cancer treated with carboplatin and gemcitabine. J Clin Oncol. 2009 Sep 10. 27(26):4254-9. [QxMD MEDLINE Link].
FDA approves atezolizumab as adjuvant treatment for non-small cell lung cancer. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-atezolizumab-adjuvant-treatment-non-small-cell-lung-cancer. October 15, 2021; Accessed: February 16, 2023.
Garon EB, Ciuleanu TE, Arrieta O, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): a multicentre, double-blind, randomised phase 3 trial. Lancet. 2014 Aug 23. 384(9944):665-73. [QxMD MEDLINE Link].
Fidias PM, Dakhil SR, Lyss AP, et al. Phase III study of immediate compared with delayed docetaxel after front-line therapy with gemcitabine plus carboplatin in advanced non-small-cell lung cancer. J Clin Oncol. 2009 Feb 1. 27(4):591-8. [QxMD MEDLINE Link].
Hanna N, Shepherd FA, Fossella FV, et al. Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol. 2004 May 1. 22(9):1589-97. [QxMD MEDLINE Link].
Ramlau R, Gorbunova V, Ciuleanu TE, et al. Aflibercept and Docetaxel versus Docetaxel alone after platinum failure in patients with advanced or metastatic non-small-cell lung cancer: a randomized, controlled phase III trial. J Clin Oncol. 2012 Oct 10. 30(29):3640-7. [QxMD MEDLINE Link].
Dillman RO, Seagren SL, Propert KJ, et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer. N Engl J Med. 1990 Oct 4. 323(14):940-5. [QxMD MEDLINE Link].
Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients. J Natl Cancer Inst. 1991 Mar 20. 83(6):417-23. [QxMD MEDLINE Link].
Albain KS, Rusch VW, Crowley JJ, et al. Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB non-small-cell lung cancer: mature results of Southwest Oncology Group phase II study 8805. J Clin Oncol. 1995 Aug. 13(8):1880-92. [QxMD MEDLINE Link].
Schaake-Koning C, van den Bogaert W, Dalesio O, et al. Effects of concomitant cisplatin and radiotherapy on inoperable non- small-cell lung cancer. N Engl J Med. 1992 Feb 20. 326(8):524-30. [QxMD MEDLINE Link].
Albain KS, Swann RS, Rusch VR, et al. Phase III study of concurrent chemotherapy and radiotherapy (CT/RT) vs CT/RT followed by surgical resection for stage IIIA(pN2) non-small cell lung cancer (NSCLC): Outcomes update of North American Intergroup 0139 (RTOG 9309). J Clin Oncol. 2005. 23:624s.
Curran WJ, Scott C, Langer C, et al. Long-term benefit is observed in a phase III comparison of sequential vs concurrent chemo-radiation for patients with unresected stage III non small cell lung cancer: RTOG 9410 (abstract). Proc Am Soc Clin Oncol. 2003. 22:621a.
Curran WJ, Scott C, Langer C, et al. Phase III Comparison of Sequential vs Concurrent Chemoradiation for Patients (Pts) with Unresected Stage III Non-Small Cell Lung Cancer (NSCLC): Initial Report of Radiation Therapy Oncology Group (RTOG) 9410. Proc Am Soc Clin Oncol. 2000. 19:484a.
Belani CP, Choy H, Bonomi P, et al. Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol. J Clin Oncol. 2005 Sep 1. 23(25):5883-91. [QxMD MEDLINE Link].
Johnson DH, Paul DM, Hande KR, et al. Paclitaxel plus carboplatin in advanced non-small-cell lung cancer: a phase II trial. J Clin Oncol. 1996 Jul. 14(7):2054-60. [QxMD MEDLINE Link].
Langer CJ, Leighton JC, Comis RL, et al. Paclitaxel and carboplatin in combination in the treatment of advanced non-small-cell lung cancer: a phase II toxicity, response, and survival analysis. J Clin Oncol. 1995 Aug. 13(8):1860-70. [QxMD MEDLINE Link].
Hanna N, Neubauer M, Yiannoutsos C, et al. Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology. J Clin Oncol. 2008 Dec 10. 26(35):5755-60. [QxMD MEDLINE Link].
Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst. 2011 Oct 5. 103(19):1452-60. [QxMD MEDLINE Link]. [Full Text].
Antonia SJ, et al; PACIFIC Investigators. Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. N Engl J Med. 2017 Nov 16. 377 (20):1919-1929. [QxMD MEDLINE Link].
Gray JE, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Three-Year Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC-Update from PACIFIC. J Thorac Oncol. 2020 Feb. 15 (2):288-293. [QxMD MEDLINE Link]. [Full Text].
Schumacher A, Riesenbeck D, Braunheim M, et al. Combined modality treatment for locally advanced non-small cell lung cancer: preoperative chemoradiation does not result in a poorer quality of life. Lung Cancer. 2004 Apr. 44(1):89-97. [QxMD MEDLINE Link].
van Meerbeeck JP, Kramer GW, Van Schil PE, Legrand C, Smit EF, Schramel F, et al. Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small-cell lung cancer. J Natl Cancer Inst. 2007 Mar 21. 99 (6):442-50. [QxMD MEDLINE Link].
Daly BD, Ebright MI, Walkey AJ, et al. Impact of neoadjuvant chemoradiotherapy followed by surgical resection on node-negative T3 and T4 non-small cell lung cancer. J Thorac Cardiovasc Surg. 2011 Jun. 141(6):1392-7. [QxMD MEDLINE Link].
[Guideline] Adjuvant Chemotherapy and Adjuvant Radiation Therapy for Stages I-IIIA Resectable Non-Small Cell Lung Cancer. American Society of Clinical Oncology. Available at https://www.asco.org/practice-patients/guidelines/thoracic-cancer#/10226. January 10, 2022; Accessed: February 9, 2022.
Li BT, Smit EF, Goto Y, and the, DESTINY-Lung01 Trial Investigators. Trastuzumab Deruxtecan in HER2-Mutant Non-Small-Cell Lung Cancer. N Engl J Med. 2022 Jan 20. 386 (3):241-251. [QxMD MEDLINE Link]. [Full Text].
Nassar AH, Adib E, Kwiatkowski DJ. Distribution of KRASG12C Somatic Mutations across Race, Sex, and Cancer Type. N Engl J Med. 2021 Jan 14. 384 (2):185-187. [QxMD MEDLINE Link].
Ahn MJ, BCC, Siena S, Drilon A, et al. Entrectinib in patients with locally advanced or metastatic ROS1 fusion-positive non-small cell lung cancer (NSCLC) Abstract OA14.06. Presented at the IASLC 18th World Conference on Lung Cancer; Yokohama, Japan. 2017. J Thoracic Onc. 2017 Nov;12(11; suppl 2):S1783.
Drilon A, Barlesi F, DeBraud F, Cho BC, Ahn MJ, Seina S, et al. Entrectinib in locally advanced or metastatic ROS1 fusion-positive non-small cell lung cancer (NSCLC): Integrated analysis of ALKA-372-001, STARTRK-1 and STARTRK-2 (abstract CT192). Presented at the American Association for Cancer Research (AACR) Annual Meeting 2019 March 29-April 3. Atlanta, GA. [Full Text].
FDA Approves Cemiplimab-rwlc for Patients With NSCLC and High PD-L1 Expression. The ASCO Post. Available at https://ascopost.com/news/february-2021/fda-approves-cemiplimab-rwlc-for-patients-with-nsclc-and-high-pd-l1-expression/. February 22, 2021; Accessed: March 4, 2021.
Rosell R, Moran T, Queralt C, et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med. 2009 Sep 3. 361(10):958-67. [QxMD MEDLINE Link].
Sequist LV, Yang JC, Yamamoto N, et al. Phase III Study of Afatinib or Cisplatin Plus Pemetrexed in Patients With Metastatic Lung Adenocarcinoma With EGFR Mutations. J Clin Oncol. 2013 Jul 1. [QxMD MEDLINE Link].
Gilotrif (afatinib [package insert]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. January, 2018. Available at [Full Text].
Soria JC, Felip E, Cobo M, Lu S, Syrigos K, Lee KH, et al. Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2015 Aug. 16 (8):897-907. [QxMD MEDLINE Link].
Lynch TJ, Bell DW, Sordella R. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med. 2004 May 20. 350(21):2129-39. [QxMD MEDLINE Link].
Thatcher N, Chang A, Parikh P, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet. 2005 Oct 29-Nov 4. 366(9496):1527-37. [QxMD MEDLINE Link].
Douillard JY, Ostoros G, Cobo M, Ciuleanu T, McCormack R, Webster A, et al. First-line gefitinib in Caucasian EGFR mutation-positive NSCLC patients: a phase-IV, open-label, single-arm study. Br J Cancer. 2014 Jan 7. 110 (1):55-62. [QxMD MEDLINE Link]. [Full Text].
Maemondo M, Inoue A, Kobayashi K, Sugawara S, Oizumi S, Isobe H, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010 Jun 24. 362 (25):2380-8. [QxMD MEDLINE Link]. [Full Text].
Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009 Sep 3. 361(10):947-57. [QxMD MEDLINE Link].
Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker Analyses and Final Overall Survival Results From a Phase III, Randomized, Open-Label, First-Line Study of Gefitinib Versus Carboplatin/Paclitaxel in Clinically Selected Patients With Advanced Non-Small-Cell Lung Cancer in Asia (IPASS). J Clin Oncol. 2011 Jul 20. 29(21):2866-74. [QxMD MEDLINE Link].
Shepherd FA, Pereira J, Ciuleanu TE, et al. A randomized placebo-controlled trial of erlotinib in patients with advanced non-small cell lung cancer (NSCLC) following failure of 1st line or 2nd line chemotherapy. A National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) trial. J Clin Oncol. 2004. Vol 22, No 14S (July 15 Supplement):Abstract 7022.
Shepherd FA, Rodrigues Pereira J, Ciuleanu T, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med. 2005 Jul 14. 353(2):123-32. [QxMD MEDLINE Link].
Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011 Aug. 12(8):735-42. [QxMD MEDLINE Link].
Gridelli C, Ciardiello F, Gallo C, et al. First-Line Erlotinib Followed by Second-Line Cisplatin-Gemcitabine Chemotherapy in Advanced Non-Small-Cell Lung Cancer: The TORCH Randomized Trial. J Clin Oncol. 2012 Aug 20. 30(24):3002-11. [QxMD MEDLINE Link].
Herbst RS, Ansari R, Bustin F, et al. Efficacy of bevacizumab plus erlotinib versus erlotinib alone in advanced non-small-cell lung cancer after failure of standard first-line chemotherapy (BeTa): a double-blind, placebo-controlled, phase 3 trial. Lancet. 2011 May 28. 377(9780):1846-54. [QxMD MEDLINE Link].
Hirsch FR, Kabbinavar F, Eisen T, et al. A randomized, phase II, biomarker-selected study comparing erlotinib to erlotinib intercalated with chemotherapy in first-line therapy for advanced non-small-cell lung cancer. J Clin Oncol. 2011 Sep 10. 29(26):3567-73. [QxMD MEDLINE Link]. [Full Text].
Nakagawa K, Garon EB, Seto T, et al. Ramucirumab plus erlotinib in patients with untreated, EGFR-mutated, advanced non-small-cell lung cancer (RELAY): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 Dec. 20 (12):1655-1669. [QxMD MEDLINE Link].
Tagrisso (osimertinib) [package insert]. Wilmington, DE 19850: AstraZeneca Pharmaceuticals LP. December 2020. Available at [Full Text].
Soria JC, Ohe Y, Vansteenkiste J, Reungwetwattana T, Chewaskulyong B, et al. Osimertinib in Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer. N Engl J Med. 2018 Jan 11. 378 (2):113-125. [QxMD MEDLINE Link]. [Full Text].
Wu YL, et al; ADAURA Investigators. Osimertinib in Resected EGFR-Mutated Non-Small-Cell Lung Cancer. N Engl J Med. 2020 Oct 29. 383 (18):1711-1723. [QxMD MEDLINE Link].
Tsuboi M, Herbst RS, John T, and the, ADAURA Investigators. Overall Survival with Osimertinib in Resected EGFR-Mutated NSCLC. N Engl J Med. 2023 Jun 4. [QxMD MEDLINE Link].
Wu YL, Cheng Y, Zhou X, Lee KH, Nakagawa K, Niho S, et al. Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, phase 3 trial. Lancet Oncol. 2017 Nov. 18 (11):1454-1466. [QxMD MEDLINE Link].
Mok TS, Cheng Y, Zhou X, Lee KH, Nakagawa K, Niho S, et al. Improvement in Overall Survival in a Randomized Study That Compared Dacomitinib With Gefitinib in Patients With Advanced Non-Small-Cell Lung Cancer and EGFR-Activating Mutations. J Clin Oncol. 2018 Aug 1. 36 (22):2244-2250. [QxMD MEDLINE Link].
Pirker R, Szczesna A, von Pawel J, et al. FLEX: A randomized, multicenter, phase III study of cetuximab in combination with cisplatin/vinorelbine (CV) versus CV alone in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). J Clin Oncol. 2008. 26:1006s (Abstract).
Pirker R, Pereira JR, von Pawel J, et al. EGFR expression as a predictor of survival for first-line chemotherapy plus cetuximab in patients with advanced non-small-cell lung cancer: analysis of data from the phase 3 FLEX study. Lancet Oncol. 2012 Jan. 13(1):33-42. [QxMD MEDLINE Link].
FDA grants accelerated approval to amivantamab-vmjw for metastatic non-small cell lung cancer. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-amivantamab-vmjw-metastatic-non-small-cell-lung-cancer. May 21, 2021; Accessed: July 15, 2021.
Ramalingam SS, Zhou C, Kim TM, et al. Mobocertinib (TAK-788) in EGFR exon 20 insertion (ex20ins)+ metastatic NSCLC (mNSCLC): additional results from platinum-pretreated patients (pts) and EXCLAIM cohort of phase 1/2 study (abstract 9014). J Clin Oncol. 2021. 39(suppl 15):[Full Text].
Enhertu (trastuzumab deruxtecan) [package insert]. Basking Ridge, NJ: Daiichi Sankyo, Inc. August 2022. Available at [Full Text].
Skoulidis F, Li BT, Dy GK, Price TJ, Falchook GS, Wolf J, et al. Sotorasib for Lung Cancers with KRAS p.G12C Mutation. N Engl J Med. 2021 Jun 24. 384 (25):2371-2381. [QxMD MEDLINE Link].
Jänne PA, Riely GJ, Gadgeel SM, Heist RS, Ou SI, Pacheco JM, et al. Adagrasib in Non-Small-Cell Lung Cancer Harboring a KRAS(G12C) Mutation. N Engl J Med. 2022 Jul 14. 387 (2):120-131. [QxMD MEDLINE Link].
Paz-Ares L, Luft A, Vicente D, Tafreshi A, Gümüş M, Mazières J, et al. Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer. N Engl J Med. 2018 Nov 22. 379 (21):2040-2051. [QxMD MEDLINE Link].
de Boer RH, Arrieta O, Yang CH, et al. Vandetanib Plus Pemetrexed for the Second-Line Treatment of Advanced Non-Small-Cell Lung Cancer: A Randomized, Double-Blind Phase III Trial. J Clin Oncol. 2011 Mar 10. 29(8):1067-74. [QxMD MEDLINE Link].
Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006 Dec 14. 355(24):2542-50. [QxMD MEDLINE Link].
Reck M, von Pawel J, Zatloukal P, et al. Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil. J Clin Oncol. 2009 Mar 10. 27(8):1227-34. [QxMD MEDLINE Link].
Soria JC, Mauguen A, Reck M, et al. Systematic review and meta-analysis of randomised, phase II/III trials adding bevacizumab to platinum-based chemotherapy as first-line treatment in patients with advanced non-small-cell lung cancer. Ann Oncol. 2012 Nov 23. [QxMD MEDLINE Link].
Stark, Angela. FDA approves first biosimilar for the treatment of cancer. FDA News Release. 09/14/2017. Available at https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm576112.htm.
Garon EB, Ciuleanu TE, Arrieta O, Prabhash K, Syrigos KN, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): a multicentre, double-blind, randomised phase 3 trial. Lancet. 2014 Aug 23. 384 (9944):665-73. [QxMD MEDLINE Link].
Kwak EL, Bang YJ, Camidge DR, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med. 2010 Oct 28. 363(18):1693-703. [QxMD MEDLINE Link]. [Full Text].
Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013 Jun 20. 368(25):2385-94. [QxMD MEDLINE Link].
Shaw AT, Ou SH, Bang YJ, Camidge DR, Solomon BJ, Salgia R, et al. Crizotinib in ROS1-rearranged non-small-cell lung cancer. N Engl J Med. 2014 Nov 20. 371 (21):1963-71. [QxMD MEDLINE Link]. [Full Text].
Kim DW, Tiseo M, Ahn MJ, Reckamp KL, Hansen KH, Kim SW, et al. Brigatinib in Patients With Crizotinib-Refractory Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer: A Randomized, Multicenter Phase II Trial. J Clin Oncol. 2017 May 5. JCO2016715904. [QxMD MEDLINE Link].
Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014 Mar 27. 370(13):1189-97. [QxMD MEDLINE Link]. [Full Text].
Soria JC, Tan DS, Chiari R, Wu YL, Paz-Ares L, Wolf J, et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study. Lancet. 2017 Mar 4. 389 (10072):917-929. [QxMD MEDLINE Link].
Cho BC, et al. ASCEND-8: A Randomized Phase 1 Study of Ceritinib, 450 mg or 600 mg, Taken with a Low-Fat Meal versus 750 mg in Fasted State in Patients with Anaplastic Lymphoma Kinase (ALK)-Rearranged Metastatic Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol. 2017 Sep. 12 (9):1357-1367. [QxMD MEDLINE Link]. [Full Text].
Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, et al. Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2017 Aug 31. 377 (9):829-838. [QxMD MEDLINE Link]. [Full Text].
Hida T, Nokihara H, Kondo M, Kim YH, Azuma K, Seto T, et al. Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX): an open-label, randomised phase 3 trial. Lancet. 2017 Jul 1. 390 (10089):29-39. [QxMD MEDLINE Link]. [Full Text].
Solomon BJ, Besse B, Bauer TM, Felip E, Soo RA, Camidge DR, et al. Lorlatinib in patients with ALK-positive non-small-cell lung cancer: results from a global phase 2 study. Lancet Oncol. 2018 Nov 6. [QxMD MEDLINE Link].
FDA approves lorlatinib for metastatic ALK-positive NSCLC. FDA. Available at https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-lorlatinib-metastatic-alk-positive-nsclc. March 3, 2021; Accessed: March 4, 2021.
Reck M, Schenker M, Lee KH, Provencio M, Nishio M, Lesniewski-Kmak K, et al. Nivolumab plus ipilimumab versus chemotherapy as first-line treatment in advanced non-small-cell lung cancer with high tumour mutational burden: patient-reported outcomes results from the randomised, open-label, phase III CheckMate 227 trial. Eur J Cancer. 2019 Jul. 116:137-147. [QxMD MEDLINE Link]. [Full Text].
Paz-Ares LG, Ramalingam SS, Ciuleanu TE, et al. First-Line Nivolumab Plus Ipilimumab in Advanced NSCLC: 4-Year Outcomes From the Randomized, Open-Label, Phase 3 CheckMate 227 Part 1 Trial. J Thorac Oncol. 2022 Feb. 17 (2):289-308. [QxMD MEDLINE Link]. [Full Text].
Paz-Ares L, Ciuleanu TE, Cobo M, et al. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Feb. 22 (2):198-211. [QxMD MEDLINE Link]. [Full Text].
Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med. 2015 Jul 9. 373 (2):123-35. [QxMD MEDLINE Link]. [Full Text].
Garon EB, Rizvi NA, Hui R, Leighl N, Balmanoukian AS, Eder JP, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 2015 May 21. 372 (21):2018-28. [QxMD MEDLINE Link].
Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2016 Oct 8. [QxMD MEDLINE Link]. [Full Text].
Mok TSK, Wu YL, Kudaba I, Kowalski DM, Cho BC, Turna HZ, et al. Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial. Lancet. 2019 Apr 4. [QxMD MEDLINE Link].
Langer CJ, Gadgeel SM, Borghaei H, Papadimitrakopoulou VA, Patnaik A, Powell SF, et al. Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study. Lancet Oncol. 2016 Nov. 17 (11):1497-1508. [QxMD MEDLINE Link].
Herbst RS, Baas P, Kim DW, Felip E, Pérez-Gracia JL, Han JY, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2016 Apr 9. 387 (10027):1540-50. [QxMD MEDLINE Link].
Gandhi L, et al; KEYNOTE-189 Investigators. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. N Engl J Med. 2018 May 31. 378(22):2078-2092. [QxMD MEDLINE Link]. [Full Text].
Fehrenbacher L, Spira A, Ballinger M, Kowanetz M, Vansteenkiste J, Mazieres J, et al. Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial. Lancet. 2016 Apr 30. 387 (10030):1837-46. [QxMD MEDLINE Link].
Barlesi F, Park K, Ciardiello F, von Pawel J, Gadgeel S, Hida T, et al. A randomized phase 3 study of atezolizumab (an engineered anti-PDL1 antibody) compared to docetaxel in patients with locally advanced or metastatic non-small cell lung cancer who have failed platinum therapy - "OAK". ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT02008227. January 9, 2019; Accessed: June 15, 2019.
Tecentriq (atezolizumab) [package insert]. South San Francisco, CA: Genentech, Inc. May 2020. Available at [Full Text].
Johnson ML, Cho BC, Luft A, and the, POSEIDON investigators. Durvalumab With or Without Tremelimumab in Combination With Chemotherapy as First-Line Therapy for Metastatic Non-Small-Cell Lung Cancer: The Phase III POSEIDON Study. J Clin Oncol. 2022 Nov 3. JCO2200975. [QxMD MEDLINE Link]. [Full Text].
Planchard D, Besse B, Groen HJM, Souquet PJ, et al. Dabrafenib plus trametinib in patients with previously treated BRAF(V600E)-mutant metastatic non-small cell lung cancer: an open-label, multicentre phase 2 trial. Lancet Oncol. 2016 Jul. 17 (7):984-993. [QxMD MEDLINE Link]. [Full Text].
Retevmo (selpercatinib) [package insert]. Indianapolis, IN: Eli Lilly. 2020 May. Available at [Full Text].
Gavreto (pralsetinib) [package insert]. Cambridge, MA: Blueprint Medicines Corporation. September 2020. Available at [Full Text].
FDA Approves First Targeted Therapy to Treat Aggressive Form of Lung Cancer. U.S. Food & Drug Administration. Available at https://www.fda.gov/news-events/press-announcements/fda-approves-first-targeted-therapy-treat-aggressive-form-lung-cancer. May 6, 2020; Accessed: May 12, 2020.
FDA grants accelerated approval to tepotinib for metastatic non-small cell lung cancer. FDA. Available at https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-tepotinib-metastatic-non-small-cell-lung-cancer. February 3, 2021; Accessed: February 24, 2021.
Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2016 Nov 10. 375 (19):1823-1833. [QxMD MEDLINE Link]. [Full Text].
Berner F, Bomze D, Diem S, et al. Association of Checkpoint Inhibitor-Induced Toxic Effects With Shared Cancer and Tissue Antigens in Non-Small Cell Lung Cancer. JAMA Oncol. 2019 Apr 25. [QxMD MEDLINE Link]. [Full Text].
[Guideline] National Comprehensive Cancer Network. Management of Immunotherapy-Related Toxicities. NCCN. Available at https://www.nccn.org/professionals/physician_gls/pdf/immunotherapy.pdf. Version 4.2021 — September 27, 2021; Accessed: February 9, 2022.
[Guideline] Donington J, et al, for the Thoracic Oncology Network of the American College of Chest Physicians and the Workforce on Evidence-Based Surgery of the Society of Thoracic Surgeons. American College of Chest Physicians and Society of Thoracic Surgeons consensus statement for evaluation and management for high-risk patients with stage I non-small cell lung cancer. Chest. 2012 Dec. 142 (6):1620-1635. [QxMD MEDLINE Link]. [Full Text].
Pignon JP, Tribodet H, Scagliotti GV, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol. 2008 Jul 20. 26(21):3552-9. [QxMD MEDLINE Link].
Strauss GM, Herndon JE 2nd, Maddaus MA, et al. Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups. J Clin Oncol. 2008 Nov 1. 26(31):5043-51. [QxMD MEDLINE Link]. [Full Text].
Gore EM, Bae K, Wong SJ, et al. Phase III comparison of prophylactic cranial irradiation versus observation in patients with locally advanced non-small-cell lung cancer: primary analysis of radiation therapy oncology group study RTOG 0214. J Clin Oncol. 2011 Jan 20. 29(3):272-8. [QxMD MEDLINE Link].
Sun A, Bae K, Gore EM, et al. Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non-small-cell lung cancer: neurocognitive and quality-of-life analysis. J Clin Oncol. 2011 Jan 20. 29(3):279-86. [QxMD MEDLINE Link].
Lynch TJ, Patel T, Dreisbach L, et al. Cetuximab and first-line taxane/carboplatin chemotherapy in advanced non-small-cell lung cancer: results of the randomized multicenter phase III trial BMS099. J Clin Oncol. 2010 Feb 20. 28(6):911-7. [QxMD MEDLINE Link].
Biesma B, Wymenga AN, Vincent A, et al. Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin-gemcitabine or carboplatin-paclitaxel: NVALT-3 a phase III study. Ann Oncol. 2011 Jul. 22(7):1520-7. [QxMD MEDLINE Link].
Raz DJ, Lanuti M, Gaissert HC, et al. Outcomes of patients with isolated adrenal metastasis from non-small cell lung carcinoma. Ann Thorac Surg. 2011 Nov. 92(5):1788-92; discussion 1793. [QxMD MEDLINE Link].
Ciuleanu T, Brodowicz T, Zielinski C, et al. Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study. Lancet. 2009 Oct 24. 374(9699):1432-40. [QxMD MEDLINE Link].
Belani CP, Brodowicz T, Ciuleanu TE, et al. Quality of life in patients with advanced non-small-cell lung cancer given maintenance treatment with pemetrexed versus placebo (H3E-MC-JMEN): results from a randomised, double-blind, phase 3 study. Lancet Oncol. 2012 Mar. 13(3):292-9. [QxMD MEDLINE Link].
Paz-Ares L, de Marinis F, Dediu M, et al. Maintenance therapy with pemetrexed plus best supportive care versus placebo plus best supportive care after induction therapy with pemetrexed plus cisplatin for advanced non-squamous non-small-cell lung cancer (PARAMOUNT): a double-blind, phase 3, randomised controlled trial. Lancet Oncol. 2012 Mar. 13(3):247-55. [QxMD MEDLINE Link].
[Guideline] Hanna N, Johnson D, Temin S, Baker S Jr, Brahmer J, Ellis PM, et al. Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2017 Aug 14. JCO2017746065. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Hanna NH, Schneider BJ, Temin S, Baker S Jr, Brahmer J, Ellis PM, et al. Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO and OH (CCO) Joint Guideline Update. J Clin Oncol. 2020 May 10. 38 (14):1608-1632. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Hanna NH, Robinson AG, Temin S, Baker S Jr, Brahmer JR, Ellis PM, et al. Therapy for Stage IV Non-Small-Cell Lung Cancer With Driver Alterations: ASCO and OH (CCO) Joint Guideline Update. J Clin Oncol. 2021 Feb 16. JCO2003570. [QxMD MEDLINE Link]. [Full Text].
Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med. 1999 Mar 4. 340(9):685-91. [QxMD MEDLINE Link].
Mallin R. Smoking cessation: integration of behavioral and drug therapies. Am Fam Physician. 2002 Mar 15. 65(6):1107-14. [QxMD MEDLINE Link].
Moysich KB, Menezes RJ, Ronsani A, et al. Regular aspirin use and lung cancer risk. BMC Cancer. 2002 Nov 26. 2:31. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Eberhardt WE, De Ruysscher D, Weder W, Le Péchoux C, De Leyn P, Hoffmann H, et al. 2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-small-cell lung cancer. Ann Oncol. 2015 Aug. 26 (8):1573-88. [QxMD MEDLINE Link].
[Guideline] Kalemkerian GP, Narula N, Kennedy EB, Biermann WA, Donington J, Leighl NB, et al. Molecular Testing Guideline for the Selection of Patients With Lung Cancer for Treatment With Targeted Tyrosine Kinase Inhibitors: American Society of Clinical Oncology Endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology Clinical Practice Guideline Update. J Clin Oncol. 2018 Mar 20. 36 (9):911-919. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Rodrigues G, Choy H, Bradley J, Rosenzweig KE, Bogart J, Curran WJ Jr, et al. Adjuvant radiation therapy in locally advanced non-small cell lung cancer: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline. Pract Radiat Oncol. 2015 May-Jun. 5 (3):149-55. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Rodrigues G, Choy H, Bradley J, Rosenzweig KE, Bogart J, Curran WJ Jr, et al. Definitive radiation therapy in locally advanced non-small cell lung cancer: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline. Pract Radiat Oncol. 2015 May-Jun. 5 (3):141-8. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Bezjak A, Temin S, Franklin G, Giaccone G, Govindan R, Johnson ML, et al. Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline. J Clin Oncol. 2015 Jun 20. 33 (18):2100-5. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Hendriks L E, Kerr K, Menis J, et al. on behalf of the ESMO Guidelines Committee. Oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO. Available at https://www.esmo.org/guidelines/guidelines-by-topic/lung-and-chest-tumours/oncogene-addicted-metastatic-non-small-cell-lung-cancer. January 23, 2023; Accessed: February 22, 2023.
[Guideline] Schneider BJ, Ismaila N, Aerts J, et al. Lung Cancer Surveillance After Definitive Curative-Intent Therapy. American Society of Clinical Oncology. Available at https://old-prod.asco.org/practice-patients/guidelines/thoracic-cancer#/142246. December 12, 2019; Accessed: February 20, 2023.
Planchard D, Kim TM, Mazieres J, Quoix E, Riely G, Barlesi F, et al. Dabrafenib in patients with BRAF(V600E)-positive advanced non-small-cell lung cancer: a single-arm, multicentre, open-label, phase 2 trial. Lancet Oncol. 2016 May. 17 (5):642-50. [QxMD MEDLINE Link]. [Full Text].
Jaklitsch MT, Jacobson FL, Austin JH, Field JK, Jett JR, Keshavjee S, et al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012 Jul. 144 (1):33-8. [QxMD MEDLINE Link].
FDA Approves Pembrolizumab as Adjuvant Treatment for NSCLC. The ASCO Post. Available at https://ascopost.com/news/january-2023/fda-approves-pembrolizumab-as-adjuvant-treatment-for-nsclc/?utm_source=TAP%2DEN%2D012723&utm_medium=email&utm_term=046fca8ed7062b1f9d17ba521501b8c9. January 27, 2023; Accessed: February 15, 2023.
FDA approves osimertinib as adjuvant therapy for non-small cell lung cancer with EGFR mutations. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-osimertinib-adjuvant-therapy-non-small-cell-lung-cancer-egfr-mutations. December 18, 2020; Accessed: June 7, 2023.
-
Non–small cell lung cancer. Symptoms and signs of lung cancer.
-
Non–small cell lung cancer. Diagnostic approach for possible lung cancer.
-
Staging workup for non–small cell lung cancer.
-
Treatment recommendations and future research directions in the management of non–small cell lung cancer.
-
Non–small cell lung cancer. Performance status scales for patients with cancer.
-
Non–small cell lung cancer. Prognostic factors for lung cancer.
-
Non–small cell lung cancer. Bronchoscopy. A large central lesion was diagnosed as non–small cell carcinoma.
-
Non–small cell lung cancer. Left pleural effusion and volume loss secondary to non–small cell carcinoma of the left lower lobe. The pleural effusion was sampled and found to be malignant; therefore, the lesion is inoperable.
-
Non–small cell lung cancer. Left upper collapse is almost always secondary to endobronchial bronchogenic carcinoma.
-
Non–small cell lung cancer. Complete left lung collapse secondary to bronchogenic carcinoma of left mainstem bronchus.
-
Non–small cell lung cancer. A cavitating right lower lobe squamous cell carcinoma.
-
Non–small cell lung cancer. CT scan shows cavitation and air-fluid level.
-
Non–small cell lung cancer. Patient has right lower lobe opacity. This is not well circumscribed and was found to be a squamous cell carcinoma.
-
Lung cancer, small cell. Contrast-enhanced CT scan of the chest shows a large left lung and a hilar mass, with invasion of the left pulmonary artery.
-
Lung cancer, small cell. Coronal positron emission tomogram shows abnormal areas of increased metabolic activity in the left hilar and left adrenal regions consistent with a hilar tumor with left adrenal metastasis.
-
Lung cancer, small cell. Whole-body nuclear medicine bone scanning with anterior and posterior images reveal multiple abnormal areas of increased radiotracer activity in the pelvis, spine, ribs, and left scapula. These findings are consistent with bony metastatic disease. The bones are commonly affected in patients with small-cell lung cancer.
-
Lung squamous carcinoma 4x: low power magnification of moderately differentiated squamous cell carcinoma showing irregular nests of tumor cells with focal areas of keratinization (pink-orange areas).
-
Lung squamous carcinoma 20x: higher power magnification of moderately differentiated squamous cell carcinoma showing focal areas of keratinization (pink-orange areas) just to the right of center.
-
Lung adenocarcinoma 4x: low power magnification of moderately differentiated adenocarcinoma showing rounded nests of pale staining tumor cells with gland lumina within some of the clusters.
Tables
Winston W Tan, MD, FACP Associate Professor of Medicine, Mayo Medical School; Consultant and Person-in-Charge of Genitourinary Oncology-Medical Oncology, Division of Hematology/Oncology, Department of Internal Medicine, Mayo Clinic Jacksonville; Vice Chairman, Division of Hematology/Oncology Education, Chair, Cancer Survivorship Program, Associate Chair, Department of Medicine Faculty Development, Mayo Clinic Florida; Vice President, Florida Society of Clinical Oncology
Winston W Tan, MD, FACP is a member of the following medical societies: American College of Physicians, American Society of Clinical Oncology, American Society of Hematology, Philippine Medical Association, Texas Medical Association
Disclosure: Nothing to disclose.
Syed Huq, MD Fellow, Division of Hematology-Oncology, Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Ellis Fischel Cancer Center
Syed Huq, MD is a member of the following medical societies: American Medical Informatics Association, American Society of Clinical Oncology, American Society of Hematology
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Nagla Abdel Karim, MD, PhD Director of Early Therapeutics, Inova Schar Cancer Institute; Professor of Medicine, University of Virginia School of Medicine
Nagla Abdel Karim, MD, PhD is a member of the following medical societies: American Medical Association, American Society of Clinical Oncology, Egyptian American Medical Association, Egyptian Cancer Society, International Association for the Study of Lung Cancer
Disclosure: Nothing to disclose.
Jeffrey L Arnold, MD, FACEP Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center
Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians
Disclosure: Nothing to disclose.
Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Gino A Farina, MD, FACEP, FAAEM Associate Professor of Emergency Medicine, Hofstra North Shore LIJ School of Medicine and Albert Einstein College of Medicine; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center
Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Edmond A Hooker II, MD, DrPH, FAAEM Associate Professor, Department of Health Services Administration, Xavier University, Cincinnati, Ohio; Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine
Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.
Irfan Maghfoor, MD Consulting Oncologist, Department of Oncology, King Faisal Specialist Hospital and Research Center, Saudi Arabia
Irfan Maghfoor, MD is a member of the following medical societies: American Society of Hematology
Disclosure: Nothing to disclose.
Tamas Peredy, MD Assistant Professor, Department of Emergency Medicine, Maine Medical Center
Disclosure: Nothing to disclose.
Michael Perry, MD, MS, MACP Nellie B Smith Chair of Oncology Emeritus, Director, Division of Hematology and Medical Oncology, Deputy Director, Ellis Fischel Cancer Center, University of Missouri-Columbia School of Medicine
Michael Perry, MD, MS, MACP is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society of Clinical Oncology, American Society of Hematology, International Association for the Study of Lung Cancer, and Missouri State Medical Association
Disclosure: Nothing to disclose.
Peter T Porrello, MD, FACEP Clinical Instructor, Department of Emergency Medicine, Yale University School of Medicine; Chief Medical Informatics Officer, Consulting Staff, Waterbury Hospital
Disclosure: Nothing to disclose.
Mityanand Ramnarine, MD Chief Resident Physician, Department of Emergency Medicine, Albert Einstein College of Medicine at Long Island Jewish Medical Center
Mityanand Ramnarine, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
What would you like to print?
-
Sections Non-Small Cell Lung Cancer (NSCLC)
- Overview
- Presentation
- DDx
- Workup
- Approach Considerations
- Laboratory Studies
- Chest Radiography
- Computed Tomography
- Magnetic Resonance Imaging
- Bone Scintigraphy
- Positron Emission Tomography
- Sputum Cytologic Studies
- Bronchoscopy
- Biopsy
- Needle Thoracentesis (Ultrasound Guided)
- Thoracoscopy and Mediastinoscopy
- Molecular Testing
- Histologic Findings
- Staging
- Workup for Special Populations
- Screening
- Show All
- Treatment
- Guidelines
- Medication
- Medication Summary
- Antineoplastic Agents
- Antineoplastics, Anaplastic Lymphoma Kinase Inhibitors
- PD-1/PD-L1 Inhibitors
- Anti-CLTA4 Antibodies
- Antineoplastics, EGFR Inhibitor
- Antineoplastics, Anti-HER2
- Antineoplastics, BRAF Kinase Inhibitors
- Antineoplastics, Tyrosine Kinase Inhibitors
- RET Kinase Inhibitors
- MET Tyrosine Kinase Inhibitors
- Antineoplastics, KRAS Inhibitors
- Antineoplastics, Monoclonal Antibodies
- Antiemetic Agents
- Show All
- Questions & Answers
- Media Gallery
- References
