COMPREHENSIVE BIOMARKER TESTING
WHAT IMPACT COULD
A HIDDEN BIOMARKER
HAVE ON YOUR NSCLC PATIENTS?

Biomarker testing may be what’s missing from an optimized treatment plan for non-small cell lung cancer (NSCLC).

BIOMARKER TESTING IS AN IMPORTANT FIRST STEP IN THE DIAGNOSIS OF NSCLC

Early detection of lung cancer—including testing for biomarkers—is critical.1 Despite receiving standard of care, a majority of patients develop recurrent disease, and >50% of patients with stages II-III NSCLC receive surgery without neoadjuvant or adjuvant therapy.2-4

a Based on a retrospective review of complete surgical resection for early-stage (N=1294) and stage IIIA (N=346) NSCLC (7th edition AJCC cancer staging).2

bIn patients with recurrent disease.5

Before choosing a treatment plan for a patient with NSCLC, it’s important to order and wait for all biomarker test results—in addition to PD-L1—to make an informed decision.

BIOMARKERS ARE COMMON IN NSCLC

METASTATIC NSCLC (mNSCLC)
NONSQUAMOUS

MORE THAN 60%

of patients have oncogenic drivers—and of these patients, about 2 in 3 have an actionable biomarker6-10c

cRegardless of PD-L1 expression.

STAGES I-III NSCLC

Evolving biomarkers include:

  • BRAF18
  • MET19
  • NTRK18
  • ROS118
  • KRAS18

Emerging = currently being studied in clinical trials; evolving = either in proof-of-concept studies or in early clinical stage.

A DEEPER UNDERSTANDING OF BIOMARKERS HAS REDEFINED THE THERAPEUTIC LANDSCAPE IN NSCLC20,21

Studies are currently evaluating the utility of targeting additional biomarkers
in earlier stages of NSCLC.22-25

TARGETED THERAPIES MAY LEAD TO BETTER OUTCOMES IN PATIENTS WITH ACTIONABLE BIOMARKERS21,26-29

When considering NSCLC treatment options for patients with an oncogenic driver, NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer recommend prioritizing treatment with a targeted therapy over an immune checkpoint inhibitor.21d

  • Based on studies of advanced or metastatic NSCLC, starting patients on immunotherapy and switching to a targeted therapy may lead to increased risk for immune-related adverse events30,31
  • Contraindications for treatment with PD-1/PD-L1 inhibitors in patients with advanced or metastatic NSCLC may include the presence of oncogenes (such as EGFR and ALK), which would predict a lack of benefit21
d Regardless of PD-L1 expression, which can be elevated in patients with an oncogenic driver.

Optimize testing practices to inform appropriate treatment plans

NCCN GUIDELINES® RECOMMENDATIONS FOR BIOMARKER TESTING

In mNSCLC, the NCCN Guidelines recommend21:

Molecular testing be performed (when feasible) via a broad panel-based approach, typically by next-generation sequencing (NGS)

  • to identify actionable alterations for which FDA-approved drugs may be available
  • to appropriately counsel patients regarding the availability of clinical trials

Upfront PD-L1 expression testing to ensure that patients, across all PD-L1 expression levels, are negative for actionable molecular biomarkers before utilizing IO as a first-line treatment optione

In stages IB-IIIA, IIIB (T3, N2) NSCLC, NCCN Guidelines recommend biomarker testing of resected surgical tissue or biopsy for21e:

  • PD-L1 expression
  • EGFR mutations
  • ALK rearrangements

Some oncogenic drivers (eg, EGFR exon 19 deletion or exon 21 L858R, ALK rearrangements) have been shown to be associated with less benefit from PD-1/PD-L1 inhibitors.21

e The NCCN Guidelines for NSCLC provide recommendations for certain individual biomarkers that should be tested and recommend testing techniques, but do not endorse any specific commercially available biomarker assays or commercial laboratories.
  NCCN makes no warranties of any kind whatsoever regarding their content, use, or application, and disclaims any responsibility for their application or use in any way.
  Please see the latest version of the NCCN Guidelines for the most up-to-date and detailed recommendations.

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INSUFFICIENT TISSUE (OR QNS) IS NOT A CONCLUSIVE RESULT AND MAY LEAD TO AN UNINFORMED TREATMENT DECISION21

  • To minimize tissue usage and potential wastage, as well as make the most informed treatment decision, biomarker testing should be done using validated tests that assess all recommended actionable biomarkers
  • Use tissue-based testing as the primary method for biomarker analysis
    • Testing using peripheral blood (most commonly plasma-based testing of circulating tumor DNA (ctDNA)) can be utilized in conjunction with tissue-based testing to achieve complete genotyping for recommended biomarkers

LIQUID BIOPSY (PLASMA ctDNA TESTING) IS RECOMMENDED UNDER CERTAIN CIRCUMSTANCES BY BOTH NCCN GUIDELINES AND IASLC GUIDELINES21,32

IASLC Guidelines32
Liquid biopsy is considered an accurate, reliable, and complementary approach for genotyping of newly diagnosed patients with mNSCLC, and it should be performed using a clinically validated NGS platformf

NCCN Guidelines21
Liquid biopsy (plasma ctDNA testing) can be considered for eligible patients with NSCLC when there is limited tissue availability or the patient is unfit for invasive tissue sampling

Liquid biopsy may overcome some of the limitations of tumor tissue genotyping due to a faster turnaround time and a less invasive procedure32

f Liquid biopsy can be considered a preferred method of molecular testing in some clinical settings and complementary to tumor tissue testing in others.32

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UNDERSTANDING THE BENEFIT OF COMPREHENSIVE BIOMARKER TESTING

Not only can identifying gene alterations inform which targeted therapies might be right for each patient, it also can help determine which therapies to avoid due to a potential lack of clinical benefit.16 NGS can assess most actionable biomarkers with one test—so you can identify if a biomarker is responsible for driving disease.33

By using a broad panel-based approach, like NGS, you could improve the overall patient experience and make biomarker testing more efficient compared with sequential single-gene testing.34

Account for multiple
biomarkers with one test

Fewer rebiopsies and
complications

Shorter time-to-test
results

Lower costs to
healthcare system

TIME-TO-TEST RESULTS WITH NGS VS SEQUENTIAL TESTING34

This was based on a study that used a decision tree analytic modeling approach and budget impact analysis assuming a hypothetical health plan covering 1 million members. Model inputs and assumptions may contain uncertainty or have limited generalizability. The time-to-results shown below are variable and subject to the type of tests ordered and the laboratories used.34

gFor Medical-insured or commercially insured patients.

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HEALTHCARE SYSTEM COST SAVINGS AND COVERAGE OF NGS IN mNSCLC

HEALTHCARE SYSTEM COST SAVINGS PER PATIENT BY ORDERING NGS INSTEAD OF SINGLE-GENE SEQUENTIAL TESTINGh-m

This analysis consisted of a hypothetical 1-million-member health plan with 2,066 Medicare-insured patients and 156 commercially insured patients estimated to have mNSCLC and be eligible for testing. Biomarker testing costs were included, but the costs and benefits of therapy were excluded.34

~$700

cost savings per
Medicare-insured patient

~$800

cost savings per
commercially insured patient

Cost savings for testing in eNSCLC are not yet available.

h This study consists of a modeling approach using a decision tree and budget impact framework. The model inputs and assumptions—some of which were based on opinions—may have limited generalizability or contain uncertainty. A robust analysis of accurate real-life numbers would be required before making any definitive conclusions. However, model results stayed robust in sensitivity analyses.
i The reimbursement amount for testing was estimated based off of publicly available CMS information or commercial claims. Consequently, the results may not be generalizable beyond the studied payers.
j The per-patient cost of sequential testing was considered to be the total cost of each individual test for PD-L1 and alterations with or without FDA-approved therapies—EGFR, ALK, ROS1, BRAF, MET, HER2, RET, NTRK1, and KRAS—multiplied by the amount of patients who received each test, which was determined by the results for the preceding testing and rebiopsy rate.
k The cost of the NGS testing strategy was the total cost of the PD-L1 test and NGS.
l Plan–total testing costs were estimated assuming all patients with mNSCLC were tested using only one strategy.
m Costs were reported in 2017 US dollars.

NGS IS GENERALLY COVERED FOR PATIENTS WITH mNSCLC ACROSS LARGE PAYER NETWORKS35,36n

The Centers for Medicare & Medicaid Services has determined that NGS as a diagnostic laboratory test is reasonable and necessary, and is covered nationally when performed in a CLIA-certified laboratory and all of the following requirements are met37:

  • Ordered by a treating physician
  • Patient has:
    • either recurrent, relapsed, refractory, metastatic, or advanced stage III or IV cancer; and,
    • either not been previously tested using the same NGS test for the same primary diagnosis of cancer, or repeat testing using the same NGS test only when a new primary cancer diagnosis is made by the treating physician; and,
    • decided to seek further cancer treatment (eg, therapeutic chemotherapy)
  • The diagnostic laboratory test using NGS must have FDA approval or clearance as a companion in vitro diagnostic; and an FDA-approved or FDA-cleared indication for use in that patient’s cancer; and results provided to the treating physician for management of the patient using a report template to specify treatment options

nDiagnostic coverage may vary across payers.

GENENTECH IS COMMITTED TO FIGHTING LUNG CANCER

AJCC=American Joint Committee on Cancer; ALK=anaplastic lymphoma kinase; BRAF=B-Raf proto-oncogene; CLIA=Clinical Laboratory Improvement Amendments; CMS=Centers for Medicare & Medicaid Services; ctDNA=circulating tumor DNA; EGFR=epidermal growth factor receptor; FISH=fluorescence in situ hybridization; HER2=human epidermal growth factor receptor 2; IASLC=International Association for the Study of Lung Cancer; IHC=immunohistochemistry; KRAS=Kirsten rat sarcoma; MET=MET proto-oncogene; NCCN=National Comprehensive Cancer Network® (NCCN®); NTRK=neurotrophic tyrosine receptor kinase; PCR=polymerase chain reaction; PD-1=programmed cell-death protein 1; PD-L1=programmed death-ligand 1; QNS=quantity not sufficient; RET=rearranged during transfection; ROS1=ROS proto-oncogene 1.

References: 1. American Lung Association. State of Lung Cancer: 2022 Report. https://www.lung.org/getmedia/647c433b-4cbc-4be6-9312-2fa9a449d489/SOLC-2022-Print-Report.pdf. Accessed February 14, 2024. 2. Lou F, Sima CS, Rusch VW, Jones DR, Huang J. Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer. Ann Thorac Surg. 2014;98(5):1755-1761. 3. Aggarwal C, Bubendorf L, Cooper WA, et al. Molecular testing in stage I–III non-small cell lung cancer: approaches and challenges. Lung Cancer. 2021;162:42-53. 4. MacLean M, Luo X, Wang S, Kernstine K, Gerber DE, Xie Y. Outcomes of neoadjuvant and adjuvant chemotherapy in stage 2 and 3 non-small cell lung cancer: an analysis of the National Cancer Database. Oncotarget. 2018;9(36):24470-24479. 5. West H, Hu X, Zhang S, et al. Treatment patterns and outcomes in resected early-stage non-small cell lung cancer: an analysis of the SEER-Medicare data. Clin Lung Cancer. 2023;24(3):260-268. 6. Hirsch FR, Scagliotti GV, Mulshine JL, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017;389(10066):299-311. 7. VanderLaan PA, Rangachari D, Costa DB. The rapidly evolving landscape of biomarker testing in non-small cell lung cancer. Cancer Cytopathol. 2021;129(3):179-181. 8. US Food and Drug Administration. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-sotorasib-kras-g12c-mutated-nsclc. Accessed January 30, 2024. 9. König D, Prince SS, Rothschild SI. Targeted therapy in advanced and metastatic non-small cell lung cancer. An update on treatment of the most important actionable oncogenic driver alterations. Cancers (Basel). 2021;13(4):804. 10. Peters S, Reck M, Smit EF, Mok T, Hellmann MD. How to make the best use of immunotherapy as first-line treatment of advanced/metastatic non-small-cell lung cancer. Ann Oncol. 2019;30:884-896. 11. Terrenato I, Ercolani C, Di Benedetto A, et al. A real-world systematic analysis of driver mutations’ prevalence in early- and advanced-stage NSCLC: implications for targeted therapies in the adjuvant setting. Cancers. 2022;14:2971. 12. Pennell NA, Zhang L, Lofgren KT, et al. A real-world (rw) evidence study quantifying the clinical value of multi-gene testing in early-stage lung adenocarcinoma (LUAD). J Clin Oncol. 2022;40:16(suppl)8525. 13. American Cancer Society. Targeted drug therapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/targeted-therapies.html. Accessed January 30, 2024. 14. ClinicalTrials.gov. A Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT03456076. Accessed January 30, 2024. 15. ClinicalTrials.gov. A Study of Selpercatinib After Surgery or Radiation in Participants With Non-Small Cell Lung Cancer (NSCLC). https://clinicaltrials.gov/ct2/show/NCT04819100. Accessed January 30, 2024. 16. Kerr KM, Thunnissen E, Dafni U, et al. A retrospective cohort study of PD-L1 prevalence, molecular associations and clinical outcomes in patients with NSCLC: Results from the European Thoracic Oncology Platform (ETOP) Lungscape Project. Lung Cancer. 2019;131:95-103. 17. American Cancer Society. Immunotherapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/immunotherapy.html. Accessed January 30, 2024. 18. ClinicalTrials.gov. A Study of Multiple Therapies in Biomarker-Selected Patients With Resectable Stages IB-III Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024. 19. ClinicalTrials.gov. Phase II of Neoadjuvant and Adjuvant Capmatinib in NSCLC (Geometry-N). https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024. 20. Russo A, Lopes AR, McCusker MG, et al. New targets in lung cancer (excluding EGFR, ALK, ROS1). Curr Oncol Rep. 2020;22(5):48. 21. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed May 10, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org. 22. Chen MF, Chaft JE. Early-stage anaplastic lymphoma kinase (ALK)-positive lung cancer: a narrative review. Transl Lung Cancer Res. 2023;12(2):337-345. 23. Malhotra J, Jabbour SK, Aisner J. Current state of immunotherapy for non-small cell lung cancer. Transl Lung Cancer Res. 2017;6(2):196-211. 24. Sandler JE, D’Aiello A, Halmos B. Changes in store for early-stage non-small cell lung cancer. J Thorac Dis. 2019;11(5):2117-2125. 25. Yi C, He Y, Xia H, Zhang P. Review and perspective on adjuvant and neoadjuvant immunotherapies in NSCLC. Onco Targets Ther. 2019;12:7329-7336. 26. Kris MG, Johnson BE, Berry LD, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs. JAMA. 2014;311(19):1998-2006. 27. Barlesi F, Mazières J, Merlio JP, et al. Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup (IFCT). Lancet. 2016;387(10026):1415-1426. 28. Solomon BJ, Kim DW, Wu YL, et al. J Clin Oncol. 2018;36(22):2251-2258. 29. Gutierrez ME, Choi K, Lanman RB, et al. Genomic profiling of advanced non-small cell lung cancer in community settings: gaps and opportunities. Clin Lung Cancer. 2017;18(6):651-659. 30. Lin JJ, Chin E, Yeap BY, et al. J Thorac Oncol. 2018;14(1):135-140. 31. Schoenfeld AJ, Arbour KC, Rizvi H, et al. Ann Oncol. 2019;30(5):839-844. 32. Rolfo C, Mack P, Scagliotti GV, et al. Liquid biopsy for advanced NSCLC: a consensus statement from the International Association for the Study of Lung Cancer. J Thorac Oncol. 2021;16(10):1647-1662. 33. Lindeman NI, Cagle PT, Aisner DL, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: guideline from the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. Arch Pathol Lab Med. 2018;142(3):321-346. 34. Pennell NA, Mutebi A, Zhou ZY, et al. Economic impact of next-generation sequencing versus single-gene testing to detect genomic alterations in metastatic non–small-cell lung cancer using a decision analytic model. JCO Precis Oncol. 2019;3:1-9. 35. Data on file. Genentech, Inc. 36. American Cancer Society Cancer Action Network. Payer Coverage Policies of Tumor Biomarker and Pharmacogenomic Testing. March 2023. https://www.fightcancer.org/sites/default/files/acs_can_payer_coverage_policies_of_tumor_biomarker_and_pharmacogenomic_testing_-_advi_final.pdf. Accessed January 19, 2024. 37. Centers for Medicare & Medicaid Services. Decision Memo for Next Generation Sequencing (NGS) for Medicare Beneficiaries with Advanced Cancer (CAG-00450I). https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&NCAId=296. Accessed January 19, 2024.

    • American Lung Association. State of Lung Cancer: 2022 Report. https://www.lung.org/getmedia/647c433b-4cbc-4be6-9312-2fa9a449d489/SOLC-2022-Print-Report.pdf. Accessed February 14, 2024.

      American Lung Association. State of Lung Cancer: 2022 Report. https://www.lung.org/getmedia/647c433b-4cbc-4be6-9312-2fa9a449d489/SOLC-2022-Print-Report.pdf. Accessed February 14, 2024.

    • Lou F, Sima CS, Rusch VW, Jones DR, Huang J. Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer. Ann Thorac Surg. 2014;98(5):1755-1761.

      Lou F, Sima CS, Rusch VW, Jones DR, Huang J. Differences in patterns of recurrence in early-stage versus locally advanced non-small cell lung cancer. Ann Thorac Surg. 2014;98(5):1755-1761.

    • Aggarwal C, Bubendorf L, Cooper WA, et al. Molecular testing in stage I–III non-small cell lung cancer: approaches and challenges. Lung Cancer. 2021;162:42-53.

      Aggarwal C, Bubendorf L, Cooper WA, et al. Molecular testing in stage I–III non-small cell lung cancer: approaches and challenges. Lung Cancer. 2021;162:42-53.

    • MacLean M, Luo X, Wang S, Kernstine K, Gerber DE, Xie Y. Outcomes of neoadjuvant and adjuvant chemotherapy in stage 2 and 3 non-small cell lung cancer: an analysis of the National Cancer Database. Oncotarget. 2018;9(36):24470-24479.

      MacLean M, Luo X, Wang S, Kernstine K, Gerber DE, Xie Y. Outcomes of neoadjuvant and adjuvant chemotherapy in stage 2 and 3 non-small cell lung cancer: an analysis of the National Cancer Database. Oncotarget. 2018;9(36):24470-24479.

    • West H, Hu X, Zhang S, et al. Treatment patterns and outcomes in resected early-stage non-small cell lung cancer: an analysis of the SEER-Medicare data. Clin Lung Cancer. 2023;24(3):260-268.

      West H, Hu X, Zhang S, et al. Treatment patterns and outcomes in resected early-stage non-small cell lung cancer: an analysis of the SEER-Medicare data. Clin Lung Cancer. 2023;24(3):260-268.

    • Hirsch FR, Scagliotti GV, Mulshine JL, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017;389(10066):299-311.

      Hirsch FR, Scagliotti GV, Mulshine JL, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017;389(10066):299-311.

    • VanderLaan PA, Rangachari D, Costa DB. The rapidly evolving landscape of biomarker testing in non-small cell lung cancer. Cancer Cytopathol. 2021;129(3):179-181.

      VanderLaan PA, Rangachari D, Costa DB. The rapidly evolving landscape of biomarker testing in non-small cell lung cancer. Cancer Cytopathol. 2021;129(3):179-181.

    • US Food and Drug Administration. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-sotorasib-kras-g12c-mutated-nsclc. Accessed January 30, 2024.

      US Food and Drug Administration. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-sotorasib-kras-g12c-mutated-nsclc. Accessed January 30, 2024.

    • König D, Prince SS, Rothschild SI. Targeted therapy in advanced and metastatic non-small cell lung cancer. An update on treatment of the most important actionable oncogenic driver alterations. Cancers (Basel). 2021;13(4):804.

      König D, Prince SS, Rothschild SI. Targeted therapy in advanced and metastatic non-small cell lung cancer. An update on treatment of the most important actionable oncogenic driver alterations. Cancers (Basel). 2021;13(4):804.

    • Peters S, Reck M, Smit EF, Mok T, Hellmann MD. How to make the best use of immunotherapy as first-line treatment of advanced/metastatic non-small-cell lung cancer. Ann Oncol. 2019;30:884-896.

      Peters S, Reck M, Smit EF, Mok T, Hellmann MD. How to make the best use of immunotherapy as first-line treatment of advanced/metastatic non-small-cell lung cancer. Ann Oncol. 2019;30:884-896.

    • Terrenato I, Ercolani C, Di Benedetto A, et al. A real-world systematic analysis of driver mutations’ prevalence in early- and advanced-stage NSCLC: implications for targeted therapies in the adjuvant setting. Cancers. 2022;14:2971.

      Terrenato I, Ercolani C, Di Benedetto A, et al. A real-world systematic analysis of driver mutations’ prevalence in early- and advanced-stage NSCLC: implications for targeted therapies in the adjuvant setting. Cancers. 2022;14:2971.

    • Pennell NA, Zhang L, Lofgren KT, et al. A real-world (rw) evidence study quantifying the clinical value of multi-gene testing in early-stage lung adenocarcinoma (LUAD). J Clin Oncol. 2022;40:16(suppl)8525.

      Pennell NA, Zhang L, Lofgren KT, et al. A real-world (rw) evidence study quantifying the clinical value of multi-gene testing in early-stage lung adenocarcinoma (LUAD). J Clin Oncol. 2022;40:16(suppl)8525.

    • American Cancer Society. Targeted drug therapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/targeted-therapies.html. Accessed January 30, 2024.

      American Cancer Society. Targeted drug therapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/targeted-therapies.html. Accessed January 30, 2024.

    • ClinicalTrials.gov. A Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT03456076. Accessed January 30, 2024.

      ClinicalTrials.gov. A Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT03456076. Accessed January 30, 2024.

    • ClinicalTrials.gov. A Study of Selpercatinib After Surgery or Radiation in Participants With Non-Small Cell Lung Cancer (NSCLC). https://clinicaltrials.gov/ct2/show/NCT04819100. Accessed January 30, 2024.

      ClinicalTrials.gov. A Study of Selpercatinib After Surgery or Radiation in Participants With Non-Small Cell Lung Cancer (NSCLC). https://clinicaltrials.gov/ct2/show/NCT04819100. Accessed January 30, 2024.

    • Kerr KM, Thunnissen E, Dafni U, et al. A retrospective cohort study of PD-L1 prevalence, molecular associations and clinical outcomes in patients with NSCLC: Results from the European Thoracic Oncology Platform (ETOP) Lungscape Project. Lung Cancer. 2019;131:95-103.

      Kerr KM, Thunnissen E, Dafni U, et al. A retrospective cohort study of PD-L1 prevalence, molecular associations and clinical outcomes in patients with NSCLC: Results from the European Thoracic Oncology Platform (ETOP) Lungscape Project. Lung Cancer. 2019;131:95-103.

    • American Cancer Society. Immunotherapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/immunotherapy.html. Accessed January 30, 2024.

      American Cancer Society. Immunotherapy for non-small cell lung cancer. https://www.cancer.org/cancer/types/lung-cancer/treating-non-small-cell/immunotherapy.html. Accessed January 30, 2024.

    • ClinicalTrials.gov. A Study of Multiple Therapies in Biomarker-Selected Patients With Resectable Stages IB-III Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024.

      ClinicalTrials.gov. A Study of Multiple Therapies in Biomarker-Selected Patients With Resectable Stages IB-III Non-Small Cell Lung Cancer. https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024.

    • ClinicalTrials.gov. Phase II of Neoadjuvant and Adjuvant Capmatinib in NSCLC (Geometry-N). https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024.

      ClinicalTrials.gov. Phase II of Neoadjuvant and Adjuvant Capmatinib in NSCLC (Geometry-N). https://clinicaltrials.gov/ct2/show/NCT04926831. Accessed January 30, 2024.

    • Russo A, Lopes AR, McCusker MG, et al. New targets in lung cancer (excluding EGFR, ALK, ROS1). Curr Oncol Rep. 2020;22(5):48.

      Russo A, Lopes AR, McCusker MG, et al. New targets in lung cancer (excluding EGFR, ALK, ROS1). Curr Oncol Rep. 2020;22(5):48.

    • Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed May 10, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org.

      Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed May 10, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org.

    • Chen MF, Chaft JE. Early-stage anaplastic lymphoma kinase (ALK)-positive lung cancer: a narrative review. Transl Lung Cancer Res. 2023;12(2):337-345.

      Chen MF, Chaft JE. Early-stage anaplastic lymphoma kinase (ALK)-positive lung cancer: a narrative review. Transl Lung Cancer Res. 2023;12(2):337-345.

    • Malhotra J, Jabbour SK, Aisner J. Current state of immunotherapy for non-small cell lung cancer. Transl Lung Cancer Res. 2017;6(2):196-211.

      Malhotra J, Jabbour SK, Aisner J. Current state of immunotherapy for non-small cell lung cancer. Transl Lung Cancer Res. 2017;6(2):196-211.

    • Sandler JE, D’Aiello A, Halmos B. Changes in store for early-stage non-small cell lung cancer. J Thorac Dis. 2019;11(5):2117-2125.

      Sandler JE, D’Aiello A, Halmos B. Changes in store for early-stage non-small cell lung cancer. J Thorac Dis. 2019;11(5):2117-2125.

    • Yi C, He Y, Xia H, Zhang P. Review and perspective on adjuvant and neoadjuvant immunotherapies in NSCLC. Onco Targets Ther. 2019;12:7329-7336.

      Yi C, He Y, Xia H, Zhang P. Review and perspective on adjuvant and neoadjuvant immunotherapies in NSCLC. Onco Targets Ther. 2019;12:7329-7336.

    • Kris MG, Johnson BE, Berry LD, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs. JAMA. 2014;311(19):1998-2006.

      Kris MG, Johnson BE, Berry LD, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs. JAMA. 2014;311(19):1998-2006.

    • Barlesi F, Mazières J, Merlio JP, et al. Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup (IFCT). Lancet. 2016;387(10026):1415-1426.

      Barlesi F, Mazières J, Merlio JP, et al. Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup (IFCT). Lancet. 2016;387(10026):1415-1426.

    • Solomon BJ, Kim DW, Wu YL, et al. J Clin Oncol. 2018;36(22):2251-2258.

      Solomon BJ, Kim DW, Wu YL, et al. J Clin Oncol. 2018;36(22):2251-2258.

    • Gutierrez ME, Choi K, Lanman RB, et al. Genomic profiling of advanced non-small cell lung cancer in community settings: gaps and opportunities. Clin Lung Cancer. 2017;18(6):651-659.

      Gutierrez ME, Choi K, Lanman RB, et al. Genomic profiling of advanced non-small cell lung cancer in community settings: gaps and opportunities. Clin Lung Cancer. 2017;18(6):651-659.

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      Lin JJ, Chin E, Yeap BY, et al. J Thorac Oncol. 2018;14(1):135-140.

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