Protocol for guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 Lung Cancer Medical Education Committee of Chinese Medical Education Association

Corresponding?author：

Lung Cancer Medical Education Committee of Chinese Medical Education Association, Email: zhanglj@sysucc.org.cn

Keywords：

Non-small cell lung cancer; perioperative treatment; targeted therapy; guideline; protocol

DOI：

10.7507/1007-4848.202603090

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Lung cancer is the most prevalent and lethal malignant tumor in China, with non-small cell lung cancer (NSCLC) accounting for approximately 85% of cases. Although surgery remains the primary treatment modality for early- to mid-stage patients, the risk of postoperative recurrence and metastasis remains high. Conventional adjuvant chemotherapy offers limited therapeutic benefits and is associated with significant adverse reactions. In recent years, targeted therapy has demonstrated remarkable advantages in the treatment of NSCLC with driver gene mutations. Accordingly, the guideline working group has drafted the "Protocol for guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026)", which provides a comprehensive overview of the guideline formulation process.

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4.	Jiang Y, Lin Y, Fu W, et al. The impact of adjuvant EGFR-TKIs and 14-gene molecular assay on stage I non-small cell lung cancer with sensitive EGFR mutations. EClinicalMedicine, 2023, 64: 102205.
5.	毛鋒, 潘雁, 李子明, 等.Ⅰb期肺癌術后輔助化療高風險因素分析. 中國肺癌雜志, 2014, 17(5): 411-416.Mao F, Pan Y, Li ZM, et al. High risk indication of postoperative chemotherapy in early stage non-small cell lung cancer. Chin J Lung Cancer, 2014, 17(5): 411-416.
6.	Pignon JP, Tribodet H, Scagliotti GV, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol, 2008, 26(21): 3552-3559.
7.	Chouaid C, Danson S, Andreas S, et al. Adjuvant treatment patterns and outcomes in patients with stage ⅠB-ⅢA non-small cell lung cancer in France, Germany, and the United Kingdom based on the LuCaBIS burden of illness study. Lung Cancer, 2018, 124: 310-316.
8.	Tan AC, Tan DSW. Targeted therapies for lung cancer patients with oncogenic driver molecular alterations. J Clin Oncol, 2022, 40(6): 611-625.
9.	中國臨床腫瘤學會指南工作委員會. 主編. 中國臨床腫瘤學會(CSCO)非小細胞肺癌診療指南. 北京: 人民衛生出版社, 2025.Chinese Society of Clinical Oncology Guidelines Working Committee. Chinese Society of Clinical Oncology (CSCO) guidelines for diagnosis and treatment of non-small cell lung cancer. Beijing: People's Health Publishing House, 2025.
10.	中華醫學會腫瘤學分會. 中華醫學會肺癌臨床診療指南(2025版). 中華腫瘤雜志, 2025, 47(9): 769-810.Oncology Society of Chinese Medical Association. Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition). Chin J Oncol, 2025, 47(9): 769-810.
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12.	Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
13.	梁昌昊, 尹冠翔, 王雅琪, 等. 中醫藥臨床實踐指南制定和修訂中德爾菲法應用的方法流程及建議. 協和醫學雜志, 2023, 14(5): 1084-1090.Liang CH, Yin GX, Wang YQ, et al. Application of Delphi method in the development and revision of clinical practice guidelines of traditional Chinese medicine: process and suggestions. Med J Peking Union Med Coll Hosp, 2023, 14(5): 1084-1090.
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16.	楊楠, 趙巍, 潘旸, 等. 針對臨床實踐指南科學性、透明性和適用性的評級工具研發. 中華醫學雜志, 2022, 102(30): 2329-2337.Yang N, Zhao W, Pan Y, et al. Development of a rating tool for scientific rigor, transparency, and applicability of clinical practice guidelines. Natl Med J China, 2022, 102(30): 2329-2337.
17.	李代萍, 梁瑞, 李霖龍, 等. 老年肺癌患者圍術期綜合管理指南(2025)計劃書. 中國循證醫學雜志, 2025, 25(12): 1379-1383.Li DP, Liang R, Li LL, et al. Protocol for the guideline on perioperative comprehensive management of elderly patients with lung cancer (2025). Chin J Evid Based Med, 2025, 25(12): 1379-1383.
18.	陳耀龍, 馬艷芳, 周奇, 等. 誰應該參與臨床實踐指南的制定? 協和醫學雜志, 2019, 10(5): 524-530.Chen YL, Ma YF, Zhou Q, et al. Who should participate in the development of clinical practice guidelines? Med J Peking Union Med Coll Hosp, 2019, 10(5): 524-530.
19.	靳英輝, 張林, 黃笛, 等. 臨床實踐指南制定方法—指南制定參與人員及組成分配. 中國循證心血管醫學雜志, 2018, 10(4): 385-391.Jin YH, Zhang L, Huang D, et al. Methodology for developing clinical practice guidelines: guideline development group members and composition. Chin J Evid Based Cardiovasc Med, 2018, 10(4): 385-391.
20.	National Institute for Health and Care Excellence. Developing NICE guidelines: the manual. London: National Institute for Health and Care Excellence, 2024. Available from: https://www.nice.org.uk/process/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869.
21.	Jordans IPM, de Leeuw RA, Stegwee SI, et al. Sonographic examination of uterine niche in non-pregnant women: a modified Delphi procedure. Ultrasound Obstet Gynecol, 2019, 53: 107-115.

1. 孫可欣, 李荔, 王少明, 等. 2024年中國分地區惡性腫瘤流行情況分析. 中華腫瘤雜志, 2026, 48(3): 400-412.Sun KX, Li L, Wang SM, et al. Cancer incidence and mortality across diverse geographical regions in China, 2024. Chin J Oncol, 2026, 48(3): 400-412.
2. Molina JR, Yang P, Cassivi SD, et al. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc, 2008, 83(5): 584-594.
3. Wozniak AJ, Gadgeel SM. Adjuvant therapy for resected non-small cell lung cancer. Ther Adv Med Oncol, 2009, 1(2): 109-118.
4. Jiang Y, Lin Y, Fu W, et al. The impact of adjuvant EGFR-TKIs and 14-gene molecular assay on stage I non-small cell lung cancer with sensitive EGFR mutations. EClinicalMedicine, 2023, 64: 102205.
5. 毛鋒, 潘雁, 李子明, 等.Ⅰb期肺癌術后輔助化療高風險因素分析. 中國肺癌雜志, 2014, 17(5): 411-416.Mao F, Pan Y, Li ZM, et al. High risk indication of postoperative chemotherapy in early stage non-small cell lung cancer. Chin J Lung Cancer, 2014, 17(5): 411-416.
6. Pignon JP, Tribodet H, Scagliotti GV, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol, 2008, 26(21): 3552-3559.
7. Chouaid C, Danson S, Andreas S, et al. Adjuvant treatment patterns and outcomes in patients with stage ⅠB-ⅢA non-small cell lung cancer in France, Germany, and the United Kingdom based on the LuCaBIS burden of illness study. Lung Cancer, 2018, 124: 310-316.
8. Tan AC, Tan DSW. Targeted therapies for lung cancer patients with oncogenic driver molecular alterations. J Clin Oncol, 2022, 40(6): 611-625.
9. 中國臨床腫瘤學會指南工作委員會. 主編. 中國臨床腫瘤學會(CSCO)非小細胞肺癌診療指南. 北京: 人民衛生出版社, 2025.Chinese Society of Clinical Oncology Guidelines Working Committee. Chinese Society of Clinical Oncology (CSCO) guidelines for diagnosis and treatment of non-small cell lung cancer. Beijing: People's Health Publishing House, 2025.
10. 中華醫學會腫瘤學分會. 中華醫學會肺癌臨床診療指南(2025版). 中華腫瘤雜志, 2025, 47(9): 769-810.Oncology Society of Chinese Medical Association. Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition). Chin J Oncol, 2025, 47(9): 769-810.
11. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
12. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
13. 梁昌昊, 尹冠翔, 王雅琪, 等. 中醫藥臨床實踐指南制定和修訂中德爾菲法應用的方法流程及建議. 協和醫學雜志, 2023, 14(5): 1084-1090.Liang CH, Yin GX, Wang YQ, et al. Application of Delphi method in the development and revision of clinical practice guidelines of traditional Chinese medicine: process and suggestions. Med J Peking Union Med Coll Hosp, 2023, 14(5): 1084-1090.
14. 陳耀龍, 楊克虎, 王小欽, 等. 中國制定/修訂臨床診療指南的指導原則(2022版). 中華醫學雜志, 2022, 102(10): 697-703.Chen YL, Yang KH, Wang XQ, et al. Guidelines for the development and revision of clinical practice guidelines in China (2022 edition). Natl Med J China, 2022, 102(10): 697-703.
15. 蘭平, 何曉生. 臨床實踐指南的制定流程與規范. 中華胃腸外科雜志, 2022, 25(1): 10-14.Lan P, He XS. Development process and standards of clinical practice guidelines. Chin J Gastrointest Surg, 2022, 25(1): 10-14.
16. 楊楠, 趙巍, 潘旸, 等. 針對臨床實踐指南科學性、透明性和適用性的評級工具研發. 中華醫學雜志, 2022, 102(30): 2329-2337.Yang N, Zhao W, Pan Y, et al. Development of a rating tool for scientific rigor, transparency, and applicability of clinical practice guidelines. Natl Med J China, 2022, 102(30): 2329-2337.
17. 李代萍, 梁瑞, 李霖龍, 等. 老年肺癌患者圍術期綜合管理指南(2025)計劃書. 中國循證醫學雜志, 2025, 25(12): 1379-1383.Li DP, Liang R, Li LL, et al. Protocol for the guideline on perioperative comprehensive management of elderly patients with lung cancer (2025). Chin J Evid Based Med, 2025, 25(12): 1379-1383.
18. 陳耀龍, 馬艷芳, 周奇, 等. 誰應該參與臨床實踐指南的制定? 協和醫學雜志, 2019, 10(5): 524-530.Chen YL, Ma YF, Zhou Q, et al. Who should participate in the development of clinical practice guidelines? Med J Peking Union Med Coll Hosp, 2019, 10(5): 524-530.
19. 靳英輝, 張林, 黃笛, 等. 臨床實踐指南制定方法—指南制定參與人員及組成分配. 中國循證心血管醫學雜志, 2018, 10(4): 385-391.Jin YH, Zhang L, Huang D, et al. Methodology for developing clinical practice guidelines: guideline development group members and composition. Chin J Evid Based Cardiovasc Med, 2018, 10(4): 385-391.
20. National Institute for Health and Care Excellence. Developing NICE guidelines: the manual. London: National Institute for Health and Care Excellence, 2024. Available from: https://www.nice.org.uk/process/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869.
21. Jordans IPM, de Leeuw RA, Stegwee SI, et al. Sonographic examination of uterine niche in non-pregnant women: a modified Delphi procedure. Ultrasound Obstet Gynecol, 2019, 53: 107-115.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesProtocol for guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026)

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