NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 74

74
NCCN Guidelines for Patients
®
: Non-Small Cell Lung Cancer
Version 1.2014
Part 7: Treatment by cancer stage
EGFR or ALK status: Positive
Histology
Performance status score First-line treatment
ALK gene rearrangement
Any
Crizotinib
Overactive EGFR mutation Any
Erlotinib or afatinib
This chart lists first-line treatments for if the EGFR
mutation or ALK gene rearrangement is present. First-
line treatments for cancers with known gene changes
aren’t based on performance status. Instead, any cancer
with ALK gene rearrangements should be treated with
crizotinib. Any cancer with a gene mutation that causes
overactive EGFRs should be treated with erlotinib or
afatinib.
Abnormal EGFR or ALK genes may be found while you
are on first-line chemotherapy. In this case, you may
be switched to targeted therapy without completing
chemotherapy or after completing chemotherapy. For an
EFGR mutation, another option is that erlotinib may be
added to the first-line chemotherapy. If the cancer keeps
growing while on targeted therapy, read
Treatments after
first line
on page 76.
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