Chinese expert consensus on immunotherapy for advanced non-small lung cancer with oncogenic driver mutations (2023 edition).
10.3760/cma.j.cn112152-20230420-00179
- VernacularTitle:驱动基因阳性晚期非小细胞肺癌免疫治疗专家共识(2023版)
- Collective Name:Society of Cancer Precision Medicine of Chinese Anti-Cancer Association;Lung Cancer Expert Group of Chinese Medical Journal
- Publication Type:Journal Article
- Keywords:
Expert consensus;
Immunotherapy;
Lung neoplasms;
Oncogenic driver mutation;
Resistance to targeted therapy
- MeSH:
Humans;
Carcinoma, Non-Small-Cell Lung/genetics*;
Consensus;
Immunotherapy;
Lung Neoplasms/genetics*;
Mutation;
Tumor Microenvironment;
China
- From:
Chinese Journal of Oncology
2023;45(9):717-740
- CountryChina
- Language:Chinese
-
Abstract:
Non-small cell lung cancer (NSCLC) with oncogenic driver mutations was previously deemed " forbidden territory" for immunotherapy. With the growing understanding of the impact of target drugs on the immune microenvironment and the continuous generation of clinical evidence, immunotherapy is expected to bring new hope for the NSCLC with oncogenic driver mutations. This consensus is updated based on the Chinese expert consensus on immunotherapy for advanced non-small lung cancer with oncogenic driver mutations (2022 edition), and developed by the consensus expert panel through symposiums, combining the latest medical evidence and clinical practice. After thorough discussion, the expert panel reached new consensuses on 3 clinical questions: in patients with ALK fusion who are progressing on tyrosine kinase inhibitor(TKI) therapy, immune checkpoint inhibitors (ICIs)-based treatment is not recommended; ICIs-based treatment is recommended for patients with HER-2 mutations; ICIs-based treatment is recommended for NSCLC patients with MET exon 14 skipping after resistance to the targeted therapy. At the same time, with the continuous accumulation of clinical evidence, the recommendation levels of the three consensus opinions were adjusted in this update: the recommendation of ICIs combined with anti-angiogenesis therapy for patients with extensive progression after EGFR-TKIs resistance was adjusted to the level of strong; the ICIs recommendations for patients with advanced KRAS mutant and BRAF mutant NSCLC were adjusted to the level of consistent and strong, respectively. This updated consensus, combined with the latest evidence and clinical experience widely recognized by the expert panel in the immunotherapy of driver gene mutation advanced NSCLC, aims to provide standardized guidance for the clinical practice in China.
