Treatment Options for Newly Diagnosed Stage IV, Relapsed, and Recurrent NSCLC (First-Line Therapy)

Cytotoxic combination chemotherapy with platinum (cisplatin or carboplatin) and paclitaxel, gemcitabine, docetaxel, vinorelbine, irinotecan, protein-bound paclitaxel, or pemetrexed.

Cytotoxic combination chemotherapy with platinum (cisplatin or carboplatin) and paclitaxel, gemcitabine, docetaxel, vinorelbine, irinotecan, protein-bound paclitaxel, or pemetrexed.

Combination chemotherapy.

Cytotoxic combination chemotherapy with platinum (cisplatin or carboplatin) and paclitaxel, gemcitabine, docetaxel, vinorelbine, irinotecan, protein-bound paclitaxel, or pemetrexed.

Drug and dose schedule.

Combination chemotherapy with monoclonal antibodies.

Combination chemotherapy with monoclonal antibodies.

Bevacizumab.

Combination chemotherapy with monoclonal antibodies.

Cetuximab.

Combination chemotherapy with monoclonal antibodies.

Necitumumab.

Maintenance therapy after first-line chemotherapy (for patients with stable or responding disease after four cycles of platinum-based combination chemotherapy).

Maintenance therapy after first-line chemotherapy (for patients with stable or responding disease after four cycles of platinum-based combination chemotherapy).

Maintenance therapy following first-line chemotherapy.

Maintenance therapy after first-line chemotherapy (for patients with stable or responding disease after four cycles of platinum-based combination chemotherapy).

Pemetrexed following first-line platinum-based combination chemotherapy.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Osimertinib alone.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Osimertinib plus chemotherapy.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Amivantamab plus lazertinib.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Dacomitinib.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Gefitinib.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Erlotinib.

EGFR tyrosine kinase inhibitors (TKIs) with or without chemotherapy (for patients with EGFR variants).

Afatinib.

EGFR-directed therapy (for patients with EGFR exon 20 insertions).

EGFR-directed therapy (for patients with EGFR exon 20 insertions).

Amivantamab.

ALK inhibitors (for patients with ALK translocations).

ALK inhibitors (for patients with ALK translocations).

Alectinib.

ALK inhibitors (for patients with ALK translocations).

Lorlatinib.

ALK inhibitors (for patients with ALK translocations).

Crizotinib.

ALK inhibitors (for patients with ALK translocations).

Ceritinib.

ALK inhibitors (for patients with ALK translocations).

Brigatinib.

BRAF V600E and MEK inhibitors (for patients with BRAF V600E variants).

BRAF V600E and MEK inhibitors (for patients with BRAF V600E variants).

Dabrafenib and trametinib.

ROS1 inhibitors (for patients with ROS1 rearrangements).

ROS1 inhibitors (for patients with ROS1 rearrangements).

Entrectinib.

ROS1 inhibitors (for patients with ROS1 rearrangements).

Crizotinib.

ROS1 inhibitors (for patients with ROS1 rearrangements).

Repotrectinib (for both ROS1 TKI-naïve and ROS1 TKI-treated patients).

NTRK inhibitors (for patients with NTRK fusions).

NTRK inhibitors (for patients with NTRK fusions).

Larotrectinib.

NTRK inhibitors (for patients with NTRK fusions).

Entrectinib.

RET inhibitors (for patients with RET fusions).

RET inhibitors (for patients with RET fusions).

Selpercatinib.

RET inhibitors (for patients with RET fusions).

Pralsetinib.

MET inhibitors (for patients with MET exon 14-skipping variants).

MET inhibitors (for patients with MET exon 14-skipping variants).

Tepotinib.

MET inhibitors (for patients with MET exon 14-skipping variants).

Capmatinib.

Immune checkpoint inhibitors with or without chemotherapy.

Immune checkpoint inhibitors with or without chemotherapy.

Pembrolizumab plus chemotherapy.

Immune checkpoint inhibitors with or without chemotherapy.

Pembrolizumab alone.

Immune checkpoint inhibitors with or without chemotherapy.

Cemiplimab-rwlc plus chemotherapy.

Immune checkpoint inhibitors with or without chemotherapy.

Cemiplimab-rwlc alone.

Immune checkpoint inhibitors with or without chemotherapy.

Tremelimumab.

Immune checkpoint inhibitors with or without chemotherapy.

Atezolizumab alone.

Immune checkpoint inhibitors with or without chemotherapy.

Atezolizumab plus chemotherapy.

Immune checkpoint inhibitors with or without chemotherapy.

Atezolizumab plus bevacizumab plus chemotherapy.

Immune checkpoint inhibitors with or without chemotherapy.

Nivolumab plus ipilimumab.

mTOR inhibitors (for patients with unresectable, locally advanced or metastatic, progressive, well-differentiated, nonfunctional, neuroendocrine tumors).

mTOR inhibitors (for patients with unresectable, locally advanced or metastatic, progressive, well-differentiated, nonfunctional, neuroendocrine tumors).

Everolimus.

Local therapies and special considerations.

Local therapies and special considerations.

Endobronchial laser therapy and/or brachytherapy (for obstructing lesions).[20]

Local therapies and special considerations.

External-beam radiation therapy (EBRT) (primarily for palliation of local symptomatic tumor growth).[21-23]

Local therapies and special considerations.

Treatment of second primary tumor.

Local therapies and special considerations.

Treatment of brain metastases.

Clinical trials can be considered as first-line therapy.