^aSee Principles of Pathologic Review (NSCL-A).
^cTemel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastaticnon-small-cell lung cancer. N Engl J Med 2010;363:733-742.
^ggIf repeat biopsy is not feasible, plasma testing should be considered.
^hhSee Principles of Molecular and Biomarker Analysis (NSCL-G).
ⁱⁱThe NCCN NSCLC Guidelines Panel strongly advises broader molecular profiling with thegoal of identifying rare driver mutations for which effective drugs may already be available, or to appropriately counsel patients regardingthe availability of clinical trials. Broad molecular profiling is a key component of theimprovement of care of patients with NSCLC.
See Emerging Biomarkers to Identify Patients for Therapies (NSCL-H).

^jjTesting should include the neurotrophic receptor tyrosine kinase (NTRK) gene fusion; if positive,see NSCL-26.
^kkIn patients with squamous cell carcinoma, the observed incidence of EGFR mutations is 2.7% with a confidence that the true incidenceof mutations is less than 3.6%. This frequency of EGFR mutations does not justify routine testing of all tumor specimens. Forbes SA,Bharma G, Bamford S, et al. The catalogue of somatic mutations in cancer (COSMIC). Curr Protoc Hum Genet 2008;chapter 10:unit 10.11.
^lllPaik PK, Varghese AM, Sima CS, et al. Response to erlotinib in patients with EGFR mutantadvanced non-small cell lung cancers with a squamous or squamous-like component. Mol Cancer Ther 2012;11:2535-2540.

來源：NCCN guideline (http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf)

^hhSee Principles of Molecular and Biomarker Analysis (NSCL-G).
^mmSee Targeted Therapy for Advanced or Metastatic Disease (NSCL-I).
ⁿⁿFor performance status 0-4.

來源：NCCN guideline (http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf)

^hhSee Principles of Molecular and Biomarker Analysis (NSCL-G).
^mmSee Targeted Therapy for Advanced or Metastatic Disease (NSCL-I).
^tt The data in the second-line setting suggest that PD-1/PD-L1 inhibitor monotherapy is less effective, irrespective of PD-L1 expression, in EGFR+/ALK+ NSCLC.
^uu Beware of flare phenomenon in subset of patients who discontinue ALK inhibitor. If disease flare occurs, restart ALK inhibitor
^ww If not previously given.
^xx Ceritinib, alectinib, or brigatinib are treatment options for patients with ALK-positive metastatic NSCLC that has progressed on crizotinib.
^yy Lorlatinib is a treatment option after progression on crizotinib and alectinib,

來源：NCCN guideline (http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf)

^hhSee Principles of Molecular and Biomarker Analysis (NSCL-G).
^mmSee Targeted Therapy for Advanced or Metastatic Disease (NSCL-I).
^ttThe data in the second-line setting suggest that PD-1/PD-L1 inhibitor monotherapy bris less effective, irrespective of PD-L1 expression, in EGFR+/ALK+ NSCLC.
^uuBeware of flare phenomenon in subset of patients who discontinue ALK inhibitor. If disease flare occurs, restart ALK inhibitor.

來源：NCCN guideline (http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf)