Living guidelines are routinely updated guidelines that are developed for selected topic areas with rapidly evolving evidence that drives frequent change in clinical practice. These guidelines are updated on a regular schedule, based on the work of a standing panel that reviews the literature on a continuous basis.
Lyudmila Bazhenova, Nofisat Ismaila, Fawzi Abu Rous, Krishna Alluri, Janet Freeman-Daily, Balazs Halmos, Narinder Malhotra, Kristen A. Marrone, Sonam Puri, Angel Qin, and Natasha B. Leighl
Published online, November 12, 2024, DOI: 10.1200/JCO.24.02133
First-Line Treatment Options Update
Recommendation 1.1. Clinicians should offer osimertinib (Evidence quality: Moderate; Strength of recommendation: Strong).
Recommendation 1.1.1. Clinicians may offer osimertinib with platinum doublet chemotherapy or amivantamab plus lazertinib (Evidence quality: Moderate; Strength of recommendation: Weak).
Second-Line Treatment Options Update
Recommendation 2.2. For patients who have progressive disease on osimertinib or other EGFR tyrosine kinase inhibitors (TKIs) without emergent T790M or other targetable alterations, clinicians may offer platinum-based chemotherapy with or without amivantamab (Evidence quality: Moderate; Strength of recommendation: Strong).
Recommendation 2.2.2. For patients who have progressive disease on EGFR TKI, anti-PD-(L)1 agents with or without platinum chemotherapy are not recommended (Evidence quality: High; Strength of recommendation: Strong).
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