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    Alur Penatalaksanaan Pasien Ca Paru (NCCN 2021)

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    Yulia Devina
    1. The document outlines treatment pathways for patients with lung cancer based on the type of cancer and presence of mutations. 2. For EGFR mutation-positive cancers, first-line treatment includes EGFR TKIs like osimertinib, erlotinib, afatinib or gefitinib. If the cancer progresses, it is checked for the T790M mutation. 3. For T790M-positive cancers, second-line treatment is with osimertinib. For T790M-negative cancers, chemotherapy is given according to protocols for adenocarcinoma or squamous cell carcinoma.

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    Alur Penatalaksanaan Pasien Ca Paru (NCCN 2021)

    Uploaded by

    Yulia Devina
    17 views1 page
    1. The document outlines treatment pathways for patients with lung cancer based on the type of cancer and presence of mutations. 2. For EGFR mutation-positive cancers, first-line treatment includes EGFR TKIs like osimertinib, erlotinib, afatinib or gefitinib. If the cancer progresses, it is checked for the T790M mutation. 3. For T790M-positive cancers, second-line treatment is with osimertinib. For T790M-negative cancers, chemotherapy is given according to protocols for adenocarcinoma or squamous cell carcinoma.

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    ALUR PENATALAKSANAAN PASIEN CA PARU (NCCN 2021)

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    1. The document outlines treatment pathways for patients with lung cancer based on the type of cancer and presence of mutations. 2. For EGFR mutation-positive cancers, first-line treatment includes EGFR TKIs like osimertinib, erlotinib, afatinib or gefitinib. If the cancer progresses, it is checked for the T790M mutation. 3. For T790M-positive cancers, second-line treatment is with osimertinib. For T790M-negative cancers, chemotherapy is given according to protocols for adenocarcinoma or squamous cell carcinoma.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    17 views1 page

    Alur Penatalaksanaan Pasien Ca Paru (NCCN 2021)

    Uploaded by

    Yulia Devina
    1. The document outlines treatment pathways for patients with lung cancer based on the type of cancer and presence of mutations. 2. For EGFR mutation-positive cancers, first-line treatment includes EGFR TKIs like osimertinib, erlotinib, afatinib or gefitinib. If the cancer progresses, it is checked for the T790M mutation. 3. For T790M-positive cancers, second-line treatment is with osimertinib. For T790M-negative cancers, chemotherapy is given according to protocols for adenocarcinoma or squamous cell carcinoma.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    ALUR PENATALAKSANAAN PASIEN CA PARU (NCCN 2021)

    Progressive disease: asimtomatik diteruskan TKI atau simptomatik


    (brain/sistemik)
    EGFR-TKI Osimertinib  Brain: terapi definitive/surgery, osimertinib diteruskan
    (preferred)  Sistemik: limited disease/lesi multiple Jika limited
    disease: terapi definitive/surgery, osimertinib diteruskan.
    Jika Lesi multiple (sesuai tatalaksana
    adenocarsinoma/squamous)
    Exon 18,19,21 Erlotinib (recomedation)/Afatinib/Gefitinib
    Jika Progressive disease: Periksa Mutasi T790M )

    Mutasi EGFR (+)


    Mutasi T790M (+) Mutasi T790M (-)

    Jika Progresive on Erlotinib +/- Bevacizumab atau Afatinib/Gefitinib


     Asimptomatik : Osimertinib atau Erlotinib diteruskan + Kemoterapi sesuai tatalaksana
    ramucirumab/bevarizumab atau Afatinib/Gefinitib. Adenicarsinoma/Squamous
     Simptomatik: Sistemik : limited metastasis Erlotinib diteruskan +
    ramucirumab/bevarizumab atau Afatinib/Gefinitib. Multipel lesi:
    Adenocarsinoma Osimertinib (jika belum diberikan)

    Exon 20 Terapi sesuai tatalaksanana Adenocarsinoma atau Squamous Ca

    Non
    Squamous Kemoterapi Cisplatin - Paclitaxel + Imunoterapi Pembrolizumab
    Mutasi EGFR (-)
    atau
    Kemoterapi Carboplatin/Cisplatin – Pemetrexed + Imunoterapi Bevalizumab
    Large cell, NOS Jika PDL1 >50%: mono-imunoterapi: Pembrolizumab
    NSCLC
    KPKBSK

    Jika PDL1>50%: Carboplatin-Paclitacel + Imunoterapi Pembrolizumab


    Squamous Non Pemetrexed, imunoterapi non bevalizumab
    Atau
    Doublet kemoterapi atau Doublet kemoterapi + Imunoterapi
    Carboplatin – Paclitaxel + Imunoterapi Nivolumab

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