What are the ASCO recommendations for first-line therapy for negative or unknown tumor EGFR-sensitizing mutation, ALK or ROS1 gene rearrangement status in non–small cell lung cancer (NSCLC)?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

First-line therapy recommendations for patients with negative or unknown tumor EGFR-sensitizing mutation, ALK or ROS1 gene rearrangement status, and PS 0-1 (or possibly PS 2) include the following [222] :

  • For patients with high programmed death ligand–1 (PDL-1) expression (tumor proportion score [TPS] ≥50%), single-agent pembrolizumab should be used, if the patient has no contraindications to immune checkpoint therapy

  • Patients with low PDL-1 expression (TPS < 50%) should be offered standard chemotherapy with a cisplatin- or carboplatin-based two-drug combination, unless they are not considered candidates for platinum-based therapy


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