Updates to the 2024 CSCO advanced non-small cell lung cancer guidelines

Jiale Wang; Tianyu Qiu; Shengxiang Ren

doi:10.20892/j.issn.2095-3941.2024.0497

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Table 1

Summary of updated drugs in the 2024 CSCO guidelines and relevant clinical issues

Drugs	Trials	Mutation	Administration	Indication	Objective response rate (%)	Progression free survival (months)	Overall survival (months)	Treatment-related adverse events (%)	NMPA/FDA approval	Medical insurance
Osimertinib with chemotherapy	FLAURA2	EGFR	Osimertinib with chemotherapy vs. osimertinib monotherapy	First line	92 vs. 83***	29.4 vs. 19.9***	Immature	Anemia (46.4); diarrhea (43.4); nausea (43.1)	FDA/NMPA	Yes
Befotertinib	IBIO-103	EGFR	Befotertinib or icotinib	First line	67 vs. 64	22.1 vs. 13.8***	Immature	Thrombocytopenia (57.7); headache (34.1); elevated ALT (33.3)	NMPA	Yes
	IBIO-102		Befotertinib 50 mg or 75 to 100 mg once daily	Post line	54 (50 mg); 68 (75–100 mg)	16.5 (50 mg); 16.6 (75–100 mg)	23.9 (50 mg); 31.5 (75–100 mg)	Thrombocytopenia (52.8; 63.1); leukopenia (19.3; 25.5); anemia (18.8; 24.1)^#	NMPA	Yes
Amivantamab	PAPILLON	EGFR 20ins	Amivantamab–chemotherapy or chemotherapy alone	First line	73 vs. 47***	11.4 vs. 6.7***	Immature	Neutropenia (59.0); paronychia (56.0); rash (54.0)	FDA	No
Sunvozertinib	WU-KONG6	EGFR 20ins	Sunvozertinib 300 mg once daily	Post line	61	Immature	Immature	CPK increased (17.0); diarrhea (8.0); anemia (6.0) (grade ≥ 3)	NMPA	Yes
Iruplinalkib	INSPIRE	ALK	Iruplinalkib 180 mg once daily or crizotinib 250 mg twice daily	First line	93 vs. 89	27.7 vs. 14.6***	Immature	AST increased (60.1); CPK increased (58.0); ALT increased (50.3)	NMPA	Yes
	INTELLECT		Iruplinalkib 180 mg orally once daily for a 21-day cycle	Post line	70	19.8		AST increased (43.2); ALT increased (37.0); CPK increased (34.9)	NMPA	Yes
Vebreltinib	KUNPENG	METex14	Vebreltinib at 200 mg twice daily in 28-day cycles	First line	77	14.5	20.3	Peripheral edema (82.7); Qt prolongation (30.8); elevated serum creatinine (28.8)	NMPA	Yes
				Post line	71	7.7	20.7		NMPA	Yes
Repotrectinib	TRIDENT-1	ROS1	160 mg daily for 14 days, followed by 160 mg twice daily	First line	79	35.7	Immature	Dizziness (58.0); dysgeusia (50.0); paresthesia (30.0)	FDA/NMPA	Yes
				Post line	38	9	25.1		FDA/NMPA	Yes
Encorafenib + Binimetinib	PHAROS	BRAF V600	Encorafenib 450 mg once daily plus binimetinib 45 mg twice daily	First line	75	Immature	Immature	Nausea (50.0); diarrhea (43.0); fatigue (32.0)	FDA	No
				Post line	46	9.3	Immature		FDA	No

***P < 0.001; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CPK, creatine phosphokinase; NMPA, National Medical Products Administration; FDA, Food and Drug Administration. ^#The two values in parentheses represent the proportion of adverse events for 50 mg and 75–100 mg, respectively.