Abstract:

In 2022, there were approximately 2.5 million newly-diagnosed cases of lung cancer and 1.8 million deaths worldwide. In China, there were about 1.060 6 million newly-diagnosed cases and 733 300 deaths from lung cancer. The incidence and mortality of lung cancer ranked first among malignant tumors in China and globally. Non-small cell lung cancer (NSCLC) accounts for about 85% of lung cancer cases. Biomarker testing is crucial for its treatment selection. From December 2024 to January 2025, the National Comprehensive Cancer Network (NCCN) successively released the 2025 first (V1), second (V2) and third (V3) versions of clinical practice guidelines for NSCLC. Some of the updates are of great significance in the field of lung cancer diagnosis and treatment. The main updates in V1 include initial treatment evaluation, biomarker tes-ting, optimization of treatment pathways for specific gene mutations, and the addition of emerging targeted therapeutic drugs. Major newly added drugs include erdafitinib for the fibroblast growth factor receptor (FGFR) gene, zenocutuzumab for neuroregulatory protein 1 (NRG1) gene fusions, and trastuzumab deruxtecan for human epidermal growth factor receptor 2 (HER2) overexpression, providing patients with more treatment options. V2 adds ensartinib as the first-line preferred regimen for anaplastic lymphoma kinase (ALK) - rearranged NSCLC. V3 recommends nivolumab subcutaneous injection as an alternative to intravenous infusion for neoadjuvant system treatment. Despite the continuous emergence of new targets and therapies, how to achieve precise, accessible, and standardized testing and treatment remains the core challenge and optimization direction in future clinical practice.

Key words: Non-small cell lung cancer, Guideline interpretation, Biomarkers, Targeted therapy