Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition): An interpretation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHONG Runbo ¹ , WANG Yiyang ² , HAN Baohui ¹ ,  FANG Wentao ²

1. Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai, 200030, P. R. China;
2. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200030, P. R. China;

Corresponding author：

FANG Wentao, Email: vwtfang@hotmail.com

Keywords：

Lung cancer; diagnosis; treatment; guideline; interpretation

DOI：

10.7507/1007-4848.202208073

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition) has been published this year. The 2022 edition has been updated in the aspects of lung cancer screening, pathology, standards of thoracic surgery, treatment of metastatic lung cancer. In this study, we tried to introduce those updated aspects in the guideline of 2022 edition.

Citation： ZHONG Runbo, WANG Yiyang, HAN Baohui, FANG Wentao. Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition): An interpretation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(11): 1402-1406. doi: 10.7507/1007-4848.202208073 Copy

1.	中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版). 中华肿瘤杂志, 2018, 40(12): 935-964.
2.	中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2022版). 中华医学杂志, 2022, 102(23): 1706-1740.
3.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
4.	Wender R, Fontham ET, Barrera E, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin, 2013, 63(2): 107-117.
5.	Wood DE, Kazerooni EA, Baum SL, et al. Lung cancer screening, version 3. 2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2018, 16(4): 412-441.
6.	Koo LC, Ho JH. Worldwide epidemiological patterns of lung cancer in nonsmokers. Int J Epidemiol, 1990, 19 Suppl 1: S14-S23.
7.	Travis WD, Dacic S, Wistuba I, et al. IASLC multidisciplinary recommendations for pathologic assessment of lung cancer resection specimens after neoadjuvant therapy. J Thorac Oncol, 2020, 15(5): 709-740.
8.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
9.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
10.	Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
11.	Kozower BD, Larner JM, Detterbeck FC, et al. Special treatment issues in non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e369S-e399S.
12.	He J, Su C, Liang W, et al. Icotinib versus chemotherapy as adjuvant treatment for stage Ⅱ-ⅢA EGFR-mutant non-small-cell lung cancer (EVIDENCE): A randomised, open-label, phase 3 trial. Lancet Respir Med, 2021, 9(9): 1021-1029.
13.	Wu YL, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med, 2020, 383(18): 1711-1723.
14.	Le Pechoux C, Pourel N, Barlesi F, et al. Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): An open-label, randomised, phase 3 trial. Lancet Oncol, 2022, 23(1): 104-114.
15.	Hui Z, Men Y, Hu C, et al. Effect of postoperative radiotherapy for patients with pⅢA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy: The phase 3 PORT-C randomized clinical trial. JAMA Oncol, 2021, 7(8): 1178-1185.
16.	Lu S, Dong XR, Jian H, et al. Randomized phase Ⅲ trial of aumolertinib (HS-10296, Au) versus gefitinib (G) as first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and EGFR exon 19 del or L858R mutations (EGFRm). J Clin Oncol, 2021, 39(15 Suppl): 463s.
17.	Horn L, Wang Z, Wu G, et al. Ensartinib vs. crizotinib for patients with anaplastic lymphoma kinase-positive non-small cell lung cancer: A randomized clinical trial. JAMA Oncol, 2021, 7(11): 1617-1625.
18.	Camidge DR, Kim HR, Ahn MJ, et al. Brigatinib versus crizotinib in ALK inhibitor-naive advanced ALK-positive NSCLC: Final results of phase 3 ALTA-1L trial. J Thorac Oncol, 2021, 16(12): 2091-2108.
19.	Huber RM, Hansen KH, Paz-Ares Rodríguez L, et al. Brigatinib in crizotinib-refractory ALK+ NSCLC: 2-year follow-up on systemic and intracranial outcomes in the Phase 2 ALTA trial. J Thorac Oncol, 2020, 15(3): 404-415.
20.	Lu S, Fang J, Li X, et al. Once-daily savolitinib in Chinese patients with pulmonary sarcomatoid carcinomas and other non-small-cell lung cancers harbouring MET exon 14 skipping alterations: A multicentre, single-arm, open-label, phase 2 study. Lancet Respir Med, 2021, 9(10): 1154-1164.
21.	Planchard D, Smit EF, Groen HJM, et al. Dabrafenib plus trametinib in patients with previously untreated BRAF V600E-mutant metastatic non-small-cell lung cancer: An open-label, phase 2 trial. Lancet Oncol, 2017, 18(10): 1307-1316.
22.	Zhou C, Wang Z, Sun Y, et al. Sugemalimab versus placebo, in combination with platinum-based chemotherapy, as first-line treatment of metastatic non-small-cell lung cancer (GEMSTONE-302): Interim and final analyses of a double-blind, randomised, phase 3 clinical trial. Lancet Oncol, 2022, 23(2): 220-233.
23.	Yang Y, Wang Z, Fang J, et al. Efficacy and safety of sintilimab plus pemetrexed and platinum as first-line treatment for locally advanced or metastatic nonsquamous NSCLC: A randomized, double-blind, phase 3 study (Oncology pRogram by InnovENT anti-PD-1-11). J Thorac Oncol, 2020, 15(10): 1636-1646.
24.	Zhou C, Wu L, Fan Y, et al. Sintilimab plus platinum and gemcitabine as first-line treatment for advanced or metastatic squamous NSCLC: Results from a randomized, double-blind, phase 3 trial (ORIENT-12). J Thorac Oncol, 2021, 16(9): 1501-1511.
25.	Lu S, Wang J, Yu Y, et al. Tislelizumab plus chemotherapy as first-line treatment for locally advanced or metastatic nonsquamous NSCLC (RATIONALE 304): A randomized phase 3 trial. J Thorac Oncol, 2021, 16(9): 1512-1522.
26.	Wang J, Lu S, Yu X, et al. Tislelizumab plus chemotherapy vs. chemotherapy alone as first-line treatment for advanced squamous non-small-cell lung cancer: A phase 3 randomized clinical trial. JAMA Oncol, 2021, 7(5): 709-717.
27.	Zhou C, Chen G, Huang Y, et al. Camrelizumab plus carboplatin and pemetrexed versus chemotherapy alone in chemotherapy-naive patients with advanced non-squamous non-small-cell lung cancer (CameL): A randomised, open-label, multicentre, phase 3 trial. Lancet Respir Med, 2021, 9(3): 305-314.
28.	Ren S, Chen J, Xu X, et al. Camrelizumab plus carboplatin and paclitaxel as first-line treatment for advanced squamous NSCLC (CameL-Sq): A phase 3 trial. J Thorac Oncol, 2022, 17(4): 544-557.
29.	Herbst RS, Giaccone G, de Marinis F, et al. Atezolizumab for first-line treatment of PD-L1-selected patients with NSCLC. N Engl J Med, 2020, 383(14): 1328-1339.
30.	Nishio M, Barlesi F, West H, et al. Atezolizumab plus chemotherapy for first-line treatment of nonsquamous NSCLC: Results from the randomized phase 3 IMpower132 trial. J Thorac Oncol, 2021, 16(4): 653-664.
31.	Goldman JW, Dvorkin M, Chen Y, et al. Durvalumab, with or without tremelimumab, plus platinum-etoposide versus platinum-etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): Updated results from a randomised, controlled, open-label, phase 3 trial. Lancet Oncol, 2021, 22(1): 51-65.

1. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版). 中华肿瘤杂志, 2018, 40(12): 935-964.
2. 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2022版). 中华医学杂志, 2022, 102(23): 1706-1740.
3. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
4. Wender R, Fontham ET, Barrera E, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin, 2013, 63(2): 107-117.
5. Wood DE, Kazerooni EA, Baum SL, et al. Lung cancer screening, version 3. 2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2018, 16(4): 412-441.
6. Koo LC, Ho JH. Worldwide epidemiological patterns of lung cancer in nonsmokers. Int J Epidemiol, 1990, 19 Suppl 1: S14-S23.
7. Travis WD, Dacic S, Wistuba I, et al. IASLC multidisciplinary recommendations for pathologic assessment of lung cancer resection specimens after neoadjuvant therapy. J Thorac Oncol, 2020, 15(5): 709-740.
8. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
9. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
10. Suzuki K, Watanabe SI, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
11. Kozower BD, Larner JM, Detterbeck FC, et al. Special treatment issues in non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e369S-e399S.
12. He J, Su C, Liang W, et al. Icotinib versus chemotherapy as adjuvant treatment for stage Ⅱ-ⅢA EGFR-mutant non-small-cell lung cancer (EVIDENCE): A randomised, open-label, phase 3 trial. Lancet Respir Med, 2021, 9(9): 1021-1029.
13. Wu YL, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med, 2020, 383(18): 1711-1723.
14. Le Pechoux C, Pourel N, Barlesi F, et al. Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): An open-label, randomised, phase 3 trial. Lancet Oncol, 2022, 23(1): 104-114.
15. Hui Z, Men Y, Hu C, et al. Effect of postoperative radiotherapy for patients with pⅢA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy: The phase 3 PORT-C randomized clinical trial. JAMA Oncol, 2021, 7(8): 1178-1185.
16. Lu S, Dong XR, Jian H, et al. Randomized phase Ⅲ trial of aumolertinib (HS-10296, Au) versus gefitinib (G) as first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and EGFR exon 19 del or L858R mutations (EGFRm). J Clin Oncol, 2021, 39(15 Suppl): 463s.
17. Horn L, Wang Z, Wu G, et al. Ensartinib vs. crizotinib for patients with anaplastic lymphoma kinase-positive non-small cell lung cancer: A randomized clinical trial. JAMA Oncol, 2021, 7(11): 1617-1625.
18. Camidge DR, Kim HR, Ahn MJ, et al. Brigatinib versus crizotinib in ALK inhibitor-naive advanced ALK-positive NSCLC: Final results of phase 3 ALTA-1L trial. J Thorac Oncol, 2021, 16(12): 2091-2108.
19. Huber RM, Hansen KH, Paz-Ares Rodríguez L, et al. Brigatinib in crizotinib-refractory ALK+ NSCLC: 2-year follow-up on systemic and intracranial outcomes in the Phase 2 ALTA trial. J Thorac Oncol, 2020, 15(3): 404-415.
20. Lu S, Fang J, Li X, et al. Once-daily savolitinib in Chinese patients with pulmonary sarcomatoid carcinomas and other non-small-cell lung cancers harbouring MET exon 14 skipping alterations: A multicentre, single-arm, open-label, phase 2 study. Lancet Respir Med, 2021, 9(10): 1154-1164.
21. Planchard D, Smit EF, Groen HJM, et al. Dabrafenib plus trametinib in patients with previously untreated BRAF V600E-mutant metastatic non-small-cell lung cancer: An open-label, phase 2 trial. Lancet Oncol, 2017, 18(10): 1307-1316.
22. Zhou C, Wang Z, Sun Y, et al. Sugemalimab versus placebo, in combination with platinum-based chemotherapy, as first-line treatment of metastatic non-small-cell lung cancer (GEMSTONE-302): Interim and final analyses of a double-blind, randomised, phase 3 clinical trial. Lancet Oncol, 2022, 23(2): 220-233.
23. Yang Y, Wang Z, Fang J, et al. Efficacy and safety of sintilimab plus pemetrexed and platinum as first-line treatment for locally advanced or metastatic nonsquamous NSCLC: A randomized, double-blind, phase 3 study (Oncology pRogram by InnovENT anti-PD-1-11). J Thorac Oncol, 2020, 15(10): 1636-1646.
24. Zhou C, Wu L, Fan Y, et al. Sintilimab plus platinum and gemcitabine as first-line treatment for advanced or metastatic squamous NSCLC: Results from a randomized, double-blind, phase 3 trial (ORIENT-12). J Thorac Oncol, 2021, 16(9): 1501-1511.
25. Lu S, Wang J, Yu Y, et al. Tislelizumab plus chemotherapy as first-line treatment for locally advanced or metastatic nonsquamous NSCLC (RATIONALE 304): A randomized phase 3 trial. J Thorac Oncol, 2021, 16(9): 1512-1522.
26. Wang J, Lu S, Yu X, et al. Tislelizumab plus chemotherapy vs. chemotherapy alone as first-line treatment for advanced squamous non-small-cell lung cancer: A phase 3 randomized clinical trial. JAMA Oncol, 2021, 7(5): 709-717.
27. Zhou C, Chen G, Huang Y, et al. Camrelizumab plus carboplatin and pemetrexed versus chemotherapy alone in chemotherapy-naive patients with advanced non-squamous non-small-cell lung cancer (CameL): A randomised, open-label, multicentre, phase 3 trial. Lancet Respir Med, 2021, 9(3): 305-314.
28. Ren S, Chen J, Xu X, et al. Camrelizumab plus carboplatin and paclitaxel as first-line treatment for advanced squamous NSCLC (CameL-Sq): A phase 3 trial. J Thorac Oncol, 2022, 17(4): 544-557.
29. Herbst RS, Giaccone G, de Marinis F, et al. Atezolizumab for first-line treatment of PD-L1-selected patients with NSCLC. N Engl J Med, 2020, 383(14): 1328-1339.
30. Nishio M, Barlesi F, West H, et al. Atezolizumab plus chemotherapy for first-line treatment of nonsquamous NSCLC: Results from the randomized phase 3 IMpower132 trial. J Thorac Oncol, 2021, 16(4): 653-664.
31. Goldman JW, Dvorkin M, Chen Y, et al. Durvalumab, with or without tremelimumab, plus platinum-etoposide versus platinum-etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): Updated results from a randomised, controlled, open-label, phase 3 trial. Lancet Oncol, 2021, 22(1): 51-65.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition): An interpretation

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content