National Clinical Practice Guideline for the treatment of non-small cell lung cancer in early, locally advanced and metastatic stages

Abstract

Introduction: Lung cancer is one of the leading causes of mortality worldwide. Symptomatic manifestations of the disease generally occur in the advanced-stage setting, and therefore an important number of patients have advanced or metastatic disease by the time they are diagnosed. This situation contributes to a poor prognosis in the treatment of lung cancer. Evidence-based clinical recommendations are of great value to support decision-making for daily practice, and thus improving health care quality and patient outcomes. Objectives: This Clinical Practice Guideline (CPG) contains systematically developed recommendations to support clinicians, patients and patient-carers, policy makers and other stakeholders in the diagnosis and management of patients with early, advanced and metastatic stages of non-small cell lung cancer. Methodology: This document was an initiative of the Mexican Society of Oncology (SMEO) in collaboration with the Mexican Center of Clinical Excellence (CENETEC) according to international standards. Such standards included those described by the IOM (Institute of Medicine), NICE (National Institute for Clinical Excellence), SIGN (Scottish Intercollegiate Guidelines Network) and GIN (Guideline International Network). An interdisciplinary Guideline Development Group (GDG) was formed which included medical oncologists, surgical oncologists, radiation therapists, and methodologists with expertise in critical appraisal, systematic reviews and clinical practice guidelines development. Results: 62 clinical questions were agreed among members of the GDG. With the evidence identified from systematic reviews, the GDG developed clinical recommendations using a modified Delphi Panel technique. Patients' representatives validated them. Conclusions: This CPG aims to support the shared decision-making process for patients with different stages of non-small cell lung cancer. Our goal is to improve health-care quality on these patients.