Interpretation of the 2026 version 1-3 update to the NCCN Clinical Practice Guidelines in Oncology: Non-small cell lung cancer and Chinese clinical practice
- VernacularTitle:《NCCN肿瘤临床实践指南：非小细胞肺癌》2026年V1～3版更新解读及中国实践
- Author:
Kejia ZHAO
1
;
Jiandong MEI
1
;
Lunxu LIU
1
Author Information
1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
National Comprehensive Cancer Network (NCCN);
clinical practice guidelines;
biomarkers;
targeted therapy;
immunotherapy;
conversion therapy;
Chinese population
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(04):535-542
- CountryChina
- Language:Chinese
-
Abstract:
The management of non-small cell lung cancer is rapidly advancing toward precision and individualized care. The National Comprehensive Cancer Network (NCCN) has recently released the 2026 version 1, 2, and 3 updates of the NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. These updated guidelines introduce significant revisions in several core areas, including the adoption of the AJCC 9th Edition TNM Staging System, optimization of recommendations for lung cancer screening and mediastinal staging, updates on perioperative immunotherapy and targeted therapy strategies, and the inclusion of emerging biomarkers such as neuregulin 1 (NRG1) fusions and mesenchymal-epithelial transition factor (MET) protein overexpression. This article provides a systematic interpretation of these key updates and focuses on integrating international guidelines with clinical practice in China. Specifically, considering the high prevalence of epidermal growth factor receptor (EGFR) mutations in the Chinese population, it analyzes the first-line positioning of osimertinib- and lazertinib-based combination regimens and evaluates the clinical value of domestic third-generation tyrosine kinase inhibitors. In response to the NCCN's cautious stance on “conversion therapy” for initially unresectable disease, the article elaborates on China’s exploratory efforts and the evolving evidence base for conversion strategies utilizing programmed death receptor 1 (PD-1) inhibitors (e.g., tislelizumab, toripalimab). Furthermore, it clarifies the “dual-track” diagnostic approach distinguishing MET pathway mutations from protein overexpression. Aimed at aligning with China’s clinical context, this review seeks to offer clinicians a practical reference that synthesizes cutting-edge international perspectives with local applicability.
