Metastatic Non-Small Cell Lung Cancer (NSCLC) Biomarker-Guided Treatment

Authored by Chinmay Jani, published on 2026-08-31 21:13:45.0

  1. Stage IV NSCLC
    • Molecular Testing (NGS)
      • EGFR exon 20 insertion
        • Ami + Chemo
      • Non-Actionable
        • Squamous
          • Carbo + Taxol + Pembro / Cemiplimab
            • Nivo + Ipi (STK11 / KEAP1)
              • Progression? Reassess NGS.
                • None
                  • Docetaxel ± ramucirumab / other subsequent therapy
                • HER2 protein overexpression
                  • ADC
                    • Fam-Trastuzumab Deruxtecan
                      (written as 'Aderg...'/ADC note; interpreted as HER2 ADC option)
                • KRAS G12C
                  • Sotorasib
                • CMS1
                  • Teliso-V
            • Single-agent immunotherapy
              • Progression? Reassess NGS.
                • None
                  • Docetaxel ± ramucirumab / other subsequent therapy
                • HER2 protein overexpression
                  • ADC
                    • Fam-Trastuzumab Deruxtecan
                      (written as 'Aderg...'/ADC note; interpreted as HER2 ADC option)
                • KRAS G12C
                  • Sotorasib
                • CMS1
                  • Teliso-V
        • Non-Squamous
          • Carbo + Pemetrexed + Pembro / Cemiplimab
            • Nivo + Ipi (STK11 / KEAP1)
              • Progression? Reassess NGS.
                • None
                  • Docetaxel ± ramucirumab / other subsequent therapy
                • HER2 protein overexpression
                  • ADC
                    • Fam-Trastuzumab Deruxtecan
                      (written as 'Aderg...'/ADC note; interpreted as HER2 ADC option)
                • KRAS G12C
                  • Sotorasib
                • CMS1
                  • Teliso-V
            • Single-agent immunotherapy
              • Progression? Reassess NGS.
                • None
                  • Docetaxel ± ramucirumab / other subsequent therapy
                • HER2 protein overexpression
                  • ADC
                    • Fam-Trastuzumab Deruxtecan
                      (written as 'Aderg...'/ADC note; interpreted as HER2 ADC option)
                • KRAS G12C
                  • Sotorasib
                • CMS1
                  • Teliso-V
      • EGFR (Mutated)
        • Osimertinib
          ± Chemo (board notes: 'osi + chemo')
          • Amit + Laz
            Amivantamab + lazertinib
            • Chemo → Amivantamab
              Sequence note: 'chemo' then 'Ami combo'
      • ALK
        • Lorlatinib (Crown)
          • Alectinib / Brigatinib
      • ROS1
        • Repotrectinib / Taletrectinib
          • Crizotinib
      • BRAF
        • Dabrafenib + Trametinib
          • Encorafenib + Binimetinib
      • HER2 (Alterations)
        • Zongertinib
      • RET+
        • Selpercatinib
      • MET (Exon 14)
        Bubble note: 'MET exon14'
        • Capmatinib
        • Tepotinib
      • NTRK
        • Entrectinib
      • VRG1 Fusion
        (written 'VRG1 fusion'—kept as on board)
        • Zenocotuzumab
tosprivacyMolecular Profiling Across 80,000 Patients With Lung Cancer