Oncology PulsePoint: ASCO Updates Targeted Therapy for Stage IV NSCLC
Andrew Li, PharmD, BCOP, discusses key targeted therapy updates in the 2026 ASCO living guideline for stage IV non–small cell lung cancer and how pharmacists can help manage treatment-related toxicities and access barriers.
The American Society of Clinical Oncology (ASCO) Living Guideline, version 2026.3.0, expands targeted treatment options for patients with stage IV non–small cell lung cancer (NSCLC) harboring EGFR, HER2, ROS1, NRG1, and other driver alterations. Andrew Li, PharmD, BCOP, an oncology pharmacist at Providence Regional Cancer Partnership in Everett, Washington, highlights major changes for patients with classical EGFR mutations, including combination regimens that improve survival but carry greater toxicity and a higher treatment burden. He also examines barriers to real-world implementation, including access to oral therapy, financial approval, infusion requirements, and uncertainty about treating older or medically frail patients.