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: zhanglj@sysucc.org.cn; 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 c-ROS oncogene 1, receptor tyrosine kinase (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, MRD 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.

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