ROS1-rearranged lung cancers respond to crizotinib (ALK, cMET, and ROS1 tyrosine kinase inhibitor) and entrectinib (multikinase inhibitor, including ROS-1) with response rates over 70%.
For patients whose NSCLC reveals NTRK 1/2/3 gene fusion, treatment with larotrectinib (TRKA/B/C inhibitor) or entrectinib (multikinase inhibitor, including TRKA/B/C) is recommended.
Selpercatinib and pralsetinib (RET inhibitors) are recommended first-line treatments for RET fusion-positive NSCLC.
The combination of atezolizumab, an immune checkpoint inhibitor, and bevacizumab, an antibody to the VEGF receptor, has been shown to be superior to sorafenib and is now standard first-line therapy.
The combination of nivolumab and ipilimumab has been recommended as second-line therapy after failure of sorafenib.
In a meta-analysis of randomized controlled trials comparing indwelling pleural catheter with pleurodesis for malignant pleural effusions, indwelling pleural catheters resulted in shorter hospital stays and fewer repeat pleural interventions but increased rates of cellulitis.
Hyperuricemia & Tumor Lysis Syndrome
It is recommended to maintain a urinary output of at least 100 mL/hour, and a daily urine volume of at least 3 L/day.
If evidence of volume overload or inadequate urinary output develop, loop diuretics can be used.
Thiazide diuretics are contraindicated because they increase uric acid levels and can interact with allopurinol.