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：

WANG Weidong ¹ , LIN Yongbin ¹ , TIAN Hui ² , LI Gaofeng ³ , XU Shun ⁴ , LIAO Yongde ⁵ , MA Haitao ⁶ , LIU Junfeng ⁷ , GU Chundong ⁸ , YAN Xiaolong ⁹ , WANG Shumin ¹⁰ , SUN Daqiang ¹¹ , LIU Jianyang ¹² , XUE Tao ¹³ , MA Shaohua ¹⁴ , LI Zhigang ¹⁵ , YUAN Shuanghu ¹⁶ , LIN Gen ¹⁷ , CAI Ling ¹ , ZHOU Jianping ¹⁸ , ZHONG Wenzhao ¹⁹ , LIANG Naixin ²⁰ , HAN Yi ²¹ , WANG Junfeng ²² , ZHANG Weidong ²³ , WANG Xin ²⁴ , CHEN Lianjuan ¹ ,  LIU Lunxu ²⁵ ,  ZHI Xiuyi ²⁶ ,  ZHANG Lanjun ¹ , Lung Cancer Medical Education Committee of Chinese Medical Education Association

1. Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China;
2. Department of Thoracic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250011, P. R. China;
3. Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, 650000, P. R. China;
4. Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110000, P. R. China;
5. Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China;
6. Department of Thoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, 215000, P. R. China;
7. Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China;
8. Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, P. R. China;
9. Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, P. R. China;
10. Department of Thoracic and Cardiovascular Surgery, General Hospital of Northern Theater Command of the Chinese PLA, Shenyang, 110016, P. R. China;
11. Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300051, P. R. China;
12. Department of Thoracic Surgery, Jilin Cancer Hospital, Changchun, 130103, P. R. China;
13. Department of Thoracic Surgery, Zhongda Hospital, Southeast University, Nanjing, 210009, P. R. China;
14. Department of Thoracic Oncology Surgery, Peking University Cancer Hospital, Beijing, 100142, P. R. China;
15. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai, 200030, P. R. China;
16. Department of Radiation Oncology, Anhui Cancer Hospital, Hefei, 230088, P. R. China;
17. Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, P. R. China;
18. Department of Thoracic Surgery, Dongguan People’s Hospital, Dongguan, 523059, Guangdong, P. R. China;
19. Department of Pulmonary Surgery, Guangdong Provincial People’s Hospital, Guangzhou, 510080, P. R. China;
20. Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, P. R. China;
21. Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, P. R. China;
22. Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150081, P. R. China;
23. Department of Thoracic Surgery, Tianjin First Central Hospital, Tianjin, 300192, P. R. China;
24. Clinical Trial Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100031, P. R. China;
25. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
26. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;

Corresponding?author：

LIU Lunxu, Email: lunxu_liu@aliyun.com; ZHI Xiuyi, Email: xiuyizhi2015@163.com; ZHANG Lanjun, Email: zhanglj@sysucc.org.cn

Keywords：

Oncogene-driven non-small cell lung cancer; molecular testing; perioperative treatment; targeted therapy; guidelines

DOI：

10.7507/1007-4848.202607074

Video：

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Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Citation： WANG Weidong, LIN Yongbin, TIAN Hui, LI Gaofeng, XU Shun, LIAO Yongde, MA Haitao, LIU Junfeng, GU Chundong, YAN Xiaolong, WANG Shumin, SUN Daqiang, LIU Jianyang, XUE Tao, MA Shaohua, LI Zhigang, YUAN Shuanghu, LIN Gen, CAI Ling, ZHOU Jianping, ZHONG Wenzhao, LIANG Naixin, HAN Yi, WANG Junfeng, ZHANG Weidong, WANG Xin, CHEN Lianjuan, LIU Lunxu, ZHI Xiuyi, ZHANG Lanjun, Lung Cancer Medical Education Committee of Chinese Medical Education Association. Guidelines for the perioperative diagnosis and treatment of oncogene-driven non-small cell lung cancer (2026). Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(9): 1337-1353. doi: 10.7507/1007-4848.202607074 Copy

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