Rapid Recommendation Update From ASCO for Stage IB-IIIA NSCLC

Mark G. Kris, MD


February 08, 2022

This transcript has been edited for clarity.

This is Mark Kris from Memorial Sloan-Kettering Cancer Center. Today I'm talking about a rapid recommendation update of the American Society of Clinical Oncology (ASCO) guidelines for stage I to IIIA non–small cell lung cancer (NSCLC), posted online on January 10, 2022. In this recommendation, the adjuvant guidelines were updated to include the use of osimertinib in patients with stage IB, II, and IIIA NSCLC that had EGFR mutations, and for the use of adjuvant atezolizumab after cisplatin-based therapy for patients with resected stage II and III lung cancers, and with PD-L1 status greater than 1%.

As a member of the guideline panel, I believe that this is an important addition to the guidelines, and I commend ASCO for quickly realizing that these studies — presented at major meetings, published in major medical journals (Felip and colleagues; Wu and colleagues), and the basis for US Food and Drug Administration approvals for these agents, for these indications —merited a quick response. In a matter of months, ASCO generated this response and made it available online to help oncologists plan therapy for their patients.

The published papers are important because they show that therapies, added to what we have now, can improve disease-free survival, which is a surrogate today for cure. Using osimertinib for patients with EGFR-mutant cancers, stages IB to IIIA, and using atezolizumab for patients with EGFR-negative, PD-L1–positive tumors is another standard-of-care change and gives patients a greater chance of being cured.

We now have a recommendation for stage IB NSCLC. We didn't have that before this recommendation of osimertinib for patients with EGFR-mutant tumors, so that's another step forward. New treatments are available; they quickly made it into the guidelines. I encourage physicians who see patients postoperatively to make sure that these recommendations are considered. Make sure the treatment with osimertinib and/or atezolizumab is on the table for appropriate patients.

Yet another advance. We are doing a better job in fighting lung cancer.

Mark G. Kris, MD, is chief of the thoracic oncology service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center in New York City. His research interests include targeted therapies for lung cancer, multimodality therapy, the development of new anticancer drugs, and symptom management with a focus on preventing emesis.

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