In this Insights, we characterize recent advances in the field and describe our framework for the treatment of advanced non–small cell lung cancer (NSCLC). Initial assessment of a new patient with NSCLC is organized by histologic findings, which in most cases indicate a nonsquamous or squamous cell subtype.
Because targeted agents are primarily relevant in nonsquamous cancers, we subject these tumors to testing for driver mutations and rearrangements, which should at minimum include EGFR, ALK, ROS1, MET, and BRAF. Many centers perform a more extensive panel for such patients, a practice that is quickly becoming the norm because it can identify less frequent but potentially targetable mutations.