Non-Squamous NSCLC
Scottish Cancer Network: Clinical Management Pathways
Treatment of EGFR/ALK/ROS1 mutations should take priority over any other mutations e.g. MET. Immunotherapy (alone or in combination with chemotherapy) is not an appropriate first line treatment choice in the presence of these mutations, regardless of PDL1 status. Please refer to the appropriate pathway for preferred treatment choices.
In the presence of concurrent mutations (EGFR/ALK/ROS1) further consideration should be given to wider patient and diagnostic picture. Consider additional support from literature, peers etc.
Throughout the patient pathway, consideration should be given to patient preference, performance status and other relevant patient factors.
Patient eligibility and suitability for available clinical trials should be considered and discussed with individual patients as appropriate.
| Author | Nicola Steele (on behalf of SACT subgroup) | Reviewer | John Maclay |
|
Date of creation Updated |
20/09/2023 23/07/2025 |
Version number | 1.3 |
| Description of last update |
Section: EGFR Sensitising NSCLC Stage III/IV non-squamous
Osimertinib in combination with pemetrexed and platinum-based chemotherapy added following SMC2736 advice.
Addition of new treatment arm for EGFR exon 19 deletions or exon 21 (L858R) substitution mutations. Minor updates made to pathway for clarity around this change.
|
||
| Review Date | 20/09/2026 | Contact | nss.scottishcancernetwork@nhs.scot |