Guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026)

Weidong WANG; Yongbin LIN; Hui TIAN; Gaofeng LI; Shun XU; Yongde LIAO; Haitao MA; Junfeng LIU; Chundong GU; Xiaolong YAN; Shumin WANG; Daqiang SUN; Jianyang LIU; Tao XUE; Shaohua MA; Zhigang LI; Shuanghu YUAN; Gen LIN; Ling CAI; Jianping ZHOU; Wenzhao ZHONG; Naixin LIANG; Yi HAN; Junfeng WANG; Weidong ZHANG; Xin WANG; Lianjuan CHEN; Lunxu LIU; Xiuyi ZHI; Lanjun ZHANG

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Guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026)

VernacularTitle:驱动基因阳性非小细胞肺癌围术期诊疗指南（2026版）
Author: Weidong WANG ¹ ; Yongbin LIN ¹ ; Hui TIAN ² ; Gaofeng LI ³ ; Shun XU ⁴ ; Yongde LIAO ⁵ ; Haitao MA ⁶ ; Junfeng LIU ⁷ ; Chundong GU ⁸ ; Xiaolong YAN ⁹ ; Shumin WANG ¹⁰ ; Daqiang SUN ¹¹ ; Jianyang LIU ¹² ; Tao XUE ¹³ ; Shaohua MA ¹⁴ ; Zhigang LI ¹⁵ ; Shuanghu YUAN ¹⁶ ; Gen LIN ¹⁷ ; Ling CAI ¹ ; Jianping ZHOU ¹⁸ ; Wenzhao ZHONG ¹⁹ ; Naixin LIANG ²⁰ ; Yi HAN ¹⁷ ; Junfeng WANG ²¹ ; Weidong ZHANG ²² ; Xin WANG ²³ ; Lianjuan CHEN ¹ ; Lunxu LIU ²⁴ ; Xiuyi ZHI ²⁵ ; Lanjun ZHANG ¹
Author Information

1. Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China
2. Department of Thoracic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250011, P. R. China
3. Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, 650000, P. R. China
4. Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110000, P. R. China
5. Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China
6. Department of Thoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, 215000, P. R. China
7. Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China
8. Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, P. R. China
9. Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, P. R. China
10. Department of Thoracic and Cardiovascular Surgery, General Hospital of Northern Theater Command of the Chinese PLA, Shenyang, 110016, P. R. China
11. Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300051, P. R. China
12. Department of Thoracic Surgery, Jilin Cancer Hospital, Changchun, 130103, P. R. China
13. Department of Thoracic Surgery, Zhongda Hospital, Southeast University, Nanjing, 210009, P. R. China
14. Department of Thoracic Oncology Surgery, Peking University Cancer Hospital, Beijing, 100142, P. R. China
15. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200030, P. R. China
16. Department of Radiation Oncology, Anhui Cancer Hospital, Hefei, 230088, P. R. China
17. Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, P. R. China
18. Department of Thoracic Surgery, Dongguan People’s Hospital, Dongguan, 523059, Guangdong, P. R. China
19. Department of Pulmonary Surgery, Guangdong Provincial People’s Hospital, Guangzhou, 510080, P. R. China
20. Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, P. R. China
21. Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150081, P. R. China
22. Department of Thoracic Surgery, Tianjin First Central Hospital, Tianjin, 300192, P. R. China
23. Clinical Trial Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100031, P. R. China
24. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
25. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China
Collective Name:Lung Cancer Medical Education Committee of Chinese Medical Education Association
Publication Type:Journal Article
Keywords: Oncogene-driven non-small cell lung cancer; molecular testing; perioperative treatment; targeted therapy; guidelines
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(09):1337-1353
CountryChina
Language:Chinese
Abstract: Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.