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10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Non-small-cell lung cancer is the proving ground for precision medicine: a dozen targetable mutations each with a matched pill, immunotherapy for the rest, and ADCs and bispecifics arriving now. Because most cases are still found late, low-dose CT screening is the other half of the story.
Biomarker testing (EGFR, ALK, ROS1, BRAF, MET, RET, NTRK, KRAS G12C, HER2, PD-L1) is mandatory at diagnosis. Oncogene-addicted disease gets targeted therapy first (osimertinib, amivantamab-lazertinib, lorlatinib, selpercatinib, zongertinib, sotorasib/adagrasib); the rest get PD-(L)1 blockade ± chemotherapy. Perioperative immunotherapy (CheckMate 816, KEYNOTE-671) and adjuvant targeted therapy (ADAURA, ALINA) are standard. ADCs (Dato-DXd, T-DXd, telisotuzumab vedotin, iza-bren, HER3-DXd) and bispecifics (ivonescimab PD-1×VEGF) are the next layer. Low-dose CT screening cuts mortality by 20-24%.
How common it is. Non-small-cell disease is about 85 percent of lung cancer, so the world figures for the site are very close to the figures for this disease: 2,637,005 new lung cancers and 1,861,839 deaths a year, first in the world on both counts (GLOBOCAN 2024). GLOBOCAN does not split lung cancer by histology, so the split has to be read from registry series: of 1,572,045 lung cancers in men in 2022, 45.6 percent were adenocarcinoma, 29.4 percent squamous cell carcinoma and 6.5 percent large-cell carcinoma, and of 908,630 in women, 59.7, 17.1 and 6.5 percent, which is 81.5 percent of men's and 83.3 percent of women's lung cancers in the three non-small-cell types (Lancet Respiratory Medicine 2025). In the UK the site total is around 50,200 cases and 32,800 deaths a year (Cancer Research UK); in the United States 229,410 cases and 124,990 deaths are projected for 2026, with a five-year relative survival of 29.5 percent for the site (SEER).
| Setting | Approach | Guideline |
|---|---|---|
| Screening (age 50-80, ≥20 pack-years) | Annual low-dose CT with Lung-RADS reporting; AI nodule scoring emerging; robotic bronchoscopy for peripheral nodule biopsy. | not mapped |
| Stage I-II resectable | Lobectomy or segmentectomy (small peripheral) with nodal staging; SBRT if inoperable. Stage IB-IIIA: neoadjuvant chemo-IO (CheckMate 816) or perioperative chemo-IO (KEYNOTE-671); adjuvant osimertinib if EGFR-mutant (ADAURA), alectinib if ALK-positive (ALINA); adjuvant chemotherapy otherwise for stage II+. | not mapped |
| Stage III unresectable | Concurrent platinum chemoradiation → durvalumab 1 year (PACIFIC), or osimertinib until progression if EGFR-mutant (LAURA). Proton therapy in selected cases. | not mapped |
| Metastatic, EGFR exon 19 del / L858R | First line: osimertinib ± platinum-pemetrexed (FLAURA2) or amivantamab + lazertinib (MARIPOSA, OS benefit). Progression: re-biopsy/ctDNA; amivantamab + chemotherapy (MARIPOSA-2), Dato-DXd (TROPION-Lung05), platinum doublet; MET TKI add-on if MET-amplified; platinum-etoposide if small-cell transformation. | not mapped |
| Metastatic, EGFR exon 20 insertion | Amivantamab + platinum-pemetrexed (PAPILLON); sunvozertinib later line. | not mapped |
| Metastatic, ALK-rearranged | Lorlatinib (CROWN; 5-year PFS 60%) or alectinib first line; on progression, neladalkib (under review) or lorlatinib if not used; local therapy for oligoprogression; chemotherapy. | not mapped |
| Metastatic, ROS1-rearranged | Repotrectinib or zidesamtinib (2026) first line; entrectinib/crizotinib alternatives. | not mapped |
| Metastatic, KRAS G12C | First line: PD-(L)1 ± chemotherapy by PD-L1 (G12C inhibitor + IO combinations in phase 3: olomorasib SUNRAY-01, divarasib Krascendo 2). Second line: sotorasib or adagrasib (CodeBreaK 200, KRYSTAL-12); divarasib superior head-to-head (Krascendo 1, 2026). | not mapped |