ASCO生存指南：无驱动突变改变的IV期非小细胞肺癌治疗

S 0-1, clinicians may offer nivolumab and ipilimumab alone or nivolumab and ipilimumab plus chemotherapy. With high PD-L1 expression, SCC, and PS 0-1, clinicians may offer single-agent atezolizumab. With high PD-L1 expression, squamous cell carcinoma (SCC), and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With negative and low positive PD-L1 expression, SCC, and PS 0-1, clinicians may offer nivolumab and ipilimumab alone or in combination with two cycles of platinum-based chemotherapy. With non-SCC who received an immune checkpoint inhibitor and chemotherapy as first-line therapy, clinicians may offer second-line paclitaxel plus bevacizumab. With non-SCC, who received chemotherapy with or without bevacizumab and immune checkpoint inhibitor therapy, clinicians should offer the options of third-line single-agent pemetrexed, docetaxel, or paclitaxel plus bevacizumab.

除2020年低解读程序性死亡阴离子-1（PD-L1）症状的并不需要部份（肿瘤分之一评分[TPS]≥50%），非粒状细胞核恶性肿瘤（non-SCC），并且功用精神状态评分（PS）为0-1，外科内科医生可以缺少单药阿替酚珠霉素。PD-L1低解读（TPS≥50%），非粒状细胞核恶性肿瘤，PS 0-1，外科内科医生可以另行可用阿替利珠霉素和伊匹木霉素，或阿替利珠霉素和伊匹木霉素加在化学疗法。PD-L1解读阴性（0%）和低阳性（TPS 1%-49%）、非粒状细胞核恶性肿瘤和PS 0-1，外科内科医生可以另行可用纳武利堪霉素和伊匹木霉素或纳武利堪霉素和伊匹木霉素加在化学疗法。由于PD-L1低解读、粒状细胞核恶性肿瘤和PS 0-1，外科内科医生可以缺少单药阿替利珠霉素。由于PD-L1低解读、粒状细胞核恶性肿瘤（SCC）和PS 0-1，外科内科医生可以另行可用纳武利堪霉素和伊匹木霉素，或分拆两个时间段的基于铂的化学疗法共同可用。对于PD-L1解读阴性和低阳性、粒状细胞核恶性肿瘤和PS 0-1，外科内科医生可以另行可用纳武利堪霉素和伊匹木霉素或与两个基于铂的化学疗法时间段共同可用。对于不能接受免疫管理系统检查点抑制剂和化学疗法作为一线放射治疗的非粒状细胞核恶性肿瘤症状，外科内科医生可能会缺少主干线紫杉醇加在贝伐珠霉素。对于非粒状细胞核恶性肿瘤症状，无论有否不能接受化学疗法共同或部共同贝伐珠霉素和免疫管理系统检查点抑制剂放射治疗，外科内科医生应缺少黄线单药培美曲塞、柏加在他赛或紫杉醇加在贝伐珠霉素的并不需要。

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