2024 CSCO晚期非小细胞肺癌指南更新（英）

Cancer Biol Med 2025. doi: 10.20892/j.issn.2095-3941.2024.0497EDITORIALUpdates to the 2024 CSCO advanced non-small cell lung cancer guidelinesJiale Wang1,2, Tianyu Qiu1,2, Shengxiang Ren1,21School of Medicine, Tongji University, Shanghai 200331, China; 2Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, ChinaIn the past year, several advancements have been achieved in the treatment of advanced non-small cell lung cancer (NSCLC), particularly in the areas of immunotherapy and tar-geted therapy. These achievements have provided additional options for improving patient outcomes. The 2024 Chinese Society of Clinical Oncology Guidelines for NSCLC (CSCO NSCLC), a key reference for clinical oncologists in China, have incorporated current global research and adapted recommen-dations for applicability in real-world scenarios in China. This update covers not only patient selection, efficacy, and safety, but also considers economics, and accessibility, with an aim to provide more precise and comprehensive treatment guidance for Chinese oncologists.The targeted therapy guidelines have been revised for EGFR, ALK, RET, and MET mutations, to provide practical, future-oriented recommendations for oncogenic driver muta-tions. For patients with NSCLC without oncogenic driver mutations and with a performance status of 2, atezolizumab has been included as a grade II front-line recommendation, thereby highlighting the importance of immunotherapy in this cohort. Furthermore, novel treatment approaches such as anti-body-drug conjugates (ADCs) are being actively investigated and have shown promising potential. This article describes key updates offering enhanced guidance for clinical practice and contributing to the advancement of lung cancer care quality.Advanced NSCLC with driver gene mutationsCommon driver gene mutationsNumerous clinical studies and targeted therapies concern-ing EGFR mutations, the most prevalent driver mutations in NSCLC in China, have emerged in recent years. Third-generation EGFR inhibitors such as osimertinib, furmoner-tinib, and almonertinib have been successfully introduced. On the basis of the results from the IBIO-103 and IBIO-102 studies, the fourth third-generation EGFR-targeted ther-apy befotertinib has become available. Compared with ico-tinib, befotertinib significantly prolongs progression-free survival (PFS) as a first-line treatment [22.1 months vs. 13.8 months, Hazard Ratio (HR) = 0.49, P < 0.0001]1. For patients with T790M mutations, befotertinib has also demonstrated a promising objective response rate (ORR) of 66.2%, with a median overall survival (OS) of 31.5 months2. On the basis of these data, the National Medical Products Administration (NMPA) approved befotertinib for both first- and second-line treatment of patients with EGFR mutations, and has included this grade I recommendation in the 2024 CSCO, thus further solidifying the role of third-generation EGFR in