Targeted Therapy for Patients With Metastatic Non–Small Cell Lung Cancer

Molecular testing is recommended for initial diagnosis in patients with non-small cell lung cancer (NSCLC), according to the updated NCCN Guidelines, because targeted therapies are available that can improve patient outcomes. Targeted therapies are currently approved for <i>EGFR</i> mutations, <i>ALK</i> and <i>ROS1</i> gene rearrangements, and <i>BRAF</i> mutations, with the list of emerging "actionable" targets growing. The 2018 NCCN Guidelines for NSCLC incorporate new therapies, including the EGFR tyrosine kinase inhibitor osimertinib and the ALK inhibitor alectinib, as first-line preferences.