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

86 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 ROS1 gene rearrangement Guide 23 lists treatment options for ROS1 gene rearrangements. These options may help you no matter your performance status. First-line treatment You may have two options. The preferred option of NCCN experts is crizotinib. The other option is ceritinib. These treatments are targeted therapies. Next-in-line treatment The cancer may worsen while on first-line treatment. If the cancer doesn’t worsen much, one option may be to stay on first-line treatment. Local treatment may be added. It is sometimes used when the metastasis is within a confined area. Examples of these areas are the brain or adrenal gland. Platinum-based chemotherapy may be an option. It is often used if there are multiple metastatic tumors causing symptoms. Read Guide 26 to learn more options for Adenocarcinoma, large cell, and unknown types . Read Guide 27 to learn more options for Squamous cell carcinoma . 7 Metastatic cancer ROS1 gene rearrangement Guide 23. Treatment for ROS1 gene rearrangement First-line treatment What are the options? • Crizotinib (preferred) • Ceritinib Next-in-line treatment What are the options? • Start treatment for histologic type ◦◦ Adenocarcinomas, large cell, unknown types (see Guide 26 ) ◦◦ Squamous cell carcinoma (see Guide 27 ) The people that are truly there for you are your angels! – Jon Lung cancer survivor “