ASCO指南更新!I-IIIA期肺癌术后辅助治疗推荐

2022-03-31 医学论坛网 医学论坛网

一睹为快!

2017年,ASCO与安大略省健康——安大略省癌症护理发布了一项关于I-III期非小细胞肺癌(NSCLCs)切除后辅助治疗的指南2020年和2021年分别发布了两项随机对照试验(RCTs),并促成对2017年指南的修订。

2022215日,ASCO官网更新了ASCO指南推荐:Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I-IIIA Completely Resected Non–Small-Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update,重在强调修订2017ASCO指南,及时传播最新的建议,以更好服务癌症护理。并且该推荐由证据审查支持,并遵循ASCO指南方法手册中概述的指南开发流程。

图片 

2021年更新建议

建议1.2

IB(3T ≥ 4 cmN0M0):对于有致敏性EGFR(Ex19delL858R)突变的患者,建议用奥希替尼辅助治疗。(类型:循证;证据质量:高;推荐力度:强)

建议1.2.1

顺铂为基础的辅助化疗和/或阿替唑单抗,不建议用于这类患者的常规治疗。

建议进行术后多模式评估,包括咨询肿瘤内科医生,以评估每个患者辅助治疗的益处和风险。

2017年指南关于辅助全身治疗的部分,概述了在推荐辅助治疗方案时,所要考虑的除肿瘤分期外的其他因素。(类型:循证和专家小组共识,利大于弊,特别是在肿瘤较大的患者中;证据质量:中等;推荐力度:中等)

建议1.3

IIA期、IIB期和IIIA期:推荐所有患者接受以顺铂为基础的辅助化疗。

具有致敏性EGFR突变的肿瘤患者,无论PD-L1状态如何,化疗后建议用奥希替尼辅助治疗。

除了具有致敏性EGFR突变的患者,所有在顺铂为基础的化疗后PD-L1 ≥ 1%的患者,都推荐用阿替唑单抗辅助治疗。(类型:循证和专家小组共识;证据质量:高;推荐力度:强)

注:该指南所使用的分期标准,是用于研究的第7版分期标准,不是目前的第8 版肺癌分期标准。

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    2022-10-29 juliusluan78
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    2022-05-06 quxin068
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    2022-04-01 ms1000001091551956

    重生物治疗

    0

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