Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non–Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update

Guideline Objective

This clinical practice guideline was produced jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO). It updates earlier CCO and ASCO guidelines on adjuvant chemotherapy and radiation therapy for patients with non-small-cell lung cancers (NSCLCs). This clinical practice guidelines addresses two principal questions in the treatment of patients with completely resected NSCLCs: the overall survival benefit and role of adjuvant systemic therapy, including chemotherapy and newer targeted therapy and immunotherapy options, and adjuvant radiation therapy. The joint guideline is published in the Journal of Clinical Oncology (JCO) and can be accessed directly from the link "Full Report" below.

ASCO updated selected recommendations in 2022 in their Amended recommendations (Rapid update). This document is meant to be used together with the original guideline (Full Report).

An assessment conducted in November 2024 by the OH-CCO Lung Cancer Disease Site Group ARCHIVED Guideline 7-A-2016-3 due to the rapidly changing treatment landscape. It is no longer considered current, pending future work.

Patient Population

Patients with completely resected stage I to IIIA NSCLCs (completely resected, defined as no macroscopic disease and uninvolved resection margins pathologically after surgery).

Intended Guideline Users

Surgical oncologists, medical oncologists, radiation oncologists, and other clinicians who treat patients in the target population.

Research Questions

This clinical practice guideline addresses two overarching clinical questions:

1. What is the benefit of adjuvant systemic therapy in patients with completely resected stage I to IIIA NSCLCs?
2. What is the benefit of adjuvant radiation therapy in patients with completely resected stage I to IIIA NSCLCs?