2.

目前各指南推荐的Pan-negative型晚期NSCLC治疗选择

Current guidelines recommended for the treatment of advanced Pan-negative NSCLC

Guideline	Pathology	First line	Maintenance	Second line	Third line
A: nivolumab, pembrolizumab（PD-L1≥1%）and atezolizumab; B: nivolumab, pembrolizumab (PD-L1≥1%); C: vinorelbine, gemcitabineand docetaxel; D: vinorelbine, gemcitabine, docetaxel, and taxol.
NCCN 2018 v2[55]	Squamous carcinoma	PD-L1≥50%: PS 0-2: Pembrolizumab. If progress, treatment according to NSCLC of PD-L1 < 50%; PS 3-4: Best supportive care	-	PS 0-1: Platinum-based two drugs chemotherapy; PS 2: Two drugs combined or single drug chemotherapy PS 3-4: Best supportive care	PS 0-2: Docetaxel+ramucirumab/gemcitabine; PS 3-4: Best supportive care
		PD-L1 < 50%: PS 0-1: Platinum-based chemotherapy；PS 2: Two drugs combined or single drug chemotherapy PS 3-4: Best supportive care	Gemcitabine or docetaxel	PS 0-2: Systemic immune checkpointinhibitorsA; docetaxel+ramucirumab; gemcitabine; PS 3-4: Best supportive care	PS 0-2: Therapyneverused before PS 3-4: Best supportive care
	Non-squamous carcinoma	PD-L1≥50%: Same as above	-	PS 0-1: Platinum-based two drugs chemotherapy+bevacizumab; Pemetrexed+carboplatin+pembrolizumab PS 2: Platinum-based two drugs or single drug chemotherapy	PS 0-2: Docetaxel+ramucirumab/gemcitabine; pemetrexed PS 3-4: Best supportive care
		PD-L1 < 50%: PS 0-1: Platinum-based two drugs chemotherapy+bevacizumab; Pemetrexed+carboplatin+ pembrolizumab PS 2: Platinum-based two drugs or single drug chemotherapy PS 3-4: Best supportive care	Bevacizumab; pemetrexed; pemetrexed + bevacizumab; gemcitabine	PS 0-2: Systemic immune checkpointinhibitorsA; docetaxel+ ramucirumab; gemcitabine; pemetrexed PS 3-4: Best supportive care	PS 0-2: Therapy neverused before PS 3-4: Best supportive care
ESMO Guideline 2016[56]	Squamous carcinoma	Age < 70 and PS 0-1: Platinum-based two drugs (4-6 cycles) orcisplatin+gemcitabine+necitumumab (EGFR IHC+)	-	PS 0-2: Systemic immune checkpoint inhibitorsB/ docetaxel + ramucirumab; erlotinib/afatinib	-
		Age≥70 and PS 2 or age < 70 and PS 0-2: Carboplatin-based two drugs or single drug chemotherapyC		PS 3-4: Best supportive care；
		PS 3-4: Best supportive care
	Non-squamous carcinoma	Age < 70 and PS 1: Platinum-based two drugs (4-6 cycles) orcisplatin+albumin taxol+ bevacizumab	Pemetrexed+ bevacizumab	PS 0-2: Systemic immune checkpoint inhibitorsB/pemetrexed /docetaxel+ramucirumab/nintedanib/ erlotinib	-
		Age≥70 and PS 2 or age < 70 and PS 0-2: Carboplatin-based two drugs or single drug chemotherapyC
		PS 3-4: Best supportive care		PS 3-4: Best supportive care
CSCO Guideline 2017 v1[57]	Squamous carcinoma	PS 0-1: Platinum-based two drugs/ gemcitabine+docetaxel/vinorelbine	-	PS 0-2: Docetaxel/vinorelbine/gemcitabine/ afatinib	-
		PS 2: Single drug chemotherapyD		PS 3-4: Clinical trial or best supportive care
		PS 3-4: Clinical trial or best supportive care
	Non-squamous carcinoma	PS 0-1: Platinum-based two drugs chemotherapy+bevacizumab	Pemetrexed；bevacizumab	PS 0-2: Docetaxel/pemetrexed	Clinical trial or best supportive care
		PS 2: Single drug chemotherapyD; pemetrexed+ carboplatin ortaxol+carboplatin (every week)
		PS 3-4: Clinical trial or best supportive care		PS 3-4: Best supportive care