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Guideline registry — lung squamous cell carcinoma

Last verified: 2026-08-30. This registry records the exact source checked, not a timeless recommendation. Drug authorization, reimbursement, and living-guideline versions must be rechecked at the point of care. LUSC is covered inside NSCLC guidance; histology-specific constraints are extracted in the wiki guidelines page.

Current cross-setting sources

Issuer Document and jurisdiction Version/date checked LUSC use Access and update rule
ASCO Therapy for stage IV NSCLC without driver alterations; international/US-centered Living version 2026.3.3, updated 2026-07-24 First and subsequent systemic therapy by histology and PD-L1 Living source; recheck before each treatment decision
ASCO Management of stage III NSCLC 2022 full guideline Resectability, chemoradiation, consolidation, selected surgery [PMID 34936470](https://pubmed.ncbi.nlm.nih.gov/34936470/){target="_blank" rel="noopener"}; ASCO lists an update as a 2025–2026 priority
NICE Lung cancer: diagnosis and management, NG122; England Published 2019; updated 2024-03-08; reviewed 2026-02-10 Open diagnosis-to-palliative-care pathway and links to technology appraisals NG122; drug links change independently
ESMO Early and locally advanced NSCLC living guideline; Europe Living web source checked 2026-08-30 Staging, surgery, perioperative therapy, unresectable stage III, follow-up ESMO living guideline; membership/access may vary
NCCN Non-Small Cell Lung Cancer; United States Current professional guideline requires authenticated access Full pathway, including drugs and sequencing Verify version in NCCN account on decision date; do not infer current version from a secondary summary

Version hazard

The indexed ASCO article is version 2026.3.1 ([PMID 42190141](https://pubmed.ncbi.nlm.nih.gov/42190141/){target="_blank" rel="noopener"}), while the official living page was already version 2026.3.3 at this review. Cite the web version for current recommendations and the PMID for the archived publication; never silently combine them.

Screening and referral

Issuer Recommendation checked Eligibility frame Important difference
USPSTF Lung Cancer Screening, 2021 Annual LDCT, age 50–80, ≥20 pack-years, current or quit within 15 years US preventive recommendation; symptoms leave screening pathway. Official source, [PMID 33687470](https://pubmed.ncbi.nlm.nih.gov/33687470/){target="_blank" rel="noopener"}
American Cancer Society 2023 guideline update Annual LDCT, age 50–80, ≥20 pack-years, current or former smoking Does not stop eligibility solely at 15 quit-years. Official source, [PMID 37909877](https://pubmed.ncbi.nlm.nih.gov/37909877/){target="_blank" rel="noopener"}
CHEST Screening for Lung Cancer guideline/expert panel report, 2021 Programmatic LDCT with risk/benefit and implementation guidance Adds program quality, comorbidity, and nodule-management detail. Official source
NICE Suspected cancer: recognition and referral, NG12 Symptom- and imaging-triggered urgent referral Updated 2026-04-15; not a screening rule. Official source

Pathology and biomarkers

Issuer Document Status checked Core LUSC implication
CAP/IASLC/AMP Molecular testing for targeted tyrosine-kinase inhibitors 2018 update; CAP page notes further update work Do not exclude all squamous samples reflexively; preserve tissue, use validated assays, integrate clinical/morphologic context. Official CAP, [PMID 29398453](https://pubmed.ncbi.nlm.nih.gov/29398453/){target="_blank" rel="noopener"}
CAP/AMP/IASLC/PPS/LUNGevity PD-L1 and TMB testing for checkpoint-therapy selection Active; published 2024 Validated PD-L1 assay and percent expression; do not use TMB alone to select advanced NSCLC for ICI. Official CAP, [PMID 38625026](https://pubmed.ncbi.nlm.nih.gov/38625026/){target="_blank" rel="noopener"}
CAP Lung resection protocol Version 5.1.0.0, September 2025 Synoptic specimen and TNM reporting
CAP Lung biomarker reporting protocol Version 2.2.0.0, September 2025 Structured PD-L1 and genomic reporting

Assay guardrails

  • Report PD-L1 clone/platform, score type, percentage, specimen, date, and adequacy.
  • Use companion/clinically validated assays as intended where feasible; validate any laboratory-developed test.
  • 22C3, 28-8, and SP263 tumour-cell staining may be analytically similar in many samples, but predictive interchangeability outside linked indications is not fully established.
  • SP142 tumour-cell staining is not numerically interchangeable with the other common assays.
  • TMB should not independently select checkpoint therapy in routine advanced NSCLC under the 2024 CAP guideline.
  • A negative plasma panel is not a negative tumour panel when shedding is low.

Staging, surgery, and radiation

Issuer Document Date Use and caveat
IASLC/UICC/AJCC Ninth-edition lung TNM proposals Effective staging era from 2025 Record T/N/M descriptors and edition; stage-group proposal [PMID 38447919](https://pubmed.ncbi.nlm.nih.gov/38447919/){target="_blank" rel="noopener"}, M descriptors [PMID 38320664](https://pubmed.ncbi.nlm.nih.gov/38320664/){target="_blank" rel="noopener"}
ERS/ESTS Fitness for radical treatment 2009 Structured spirometry, diffusing capacity, predicted postoperative function, exercise/cardiac assessment; update needed for contemporary perioperative therapy. [PMID 19477657](https://pubmed.ncbi.nlm.nih.gov/19477657/){target="_blank" rel="noopener"}
ASTRO SBRT for early-stage NSCLC 2017 Curative radiation for medically inoperable disease and selected high-risk contexts; predates modern sublobar and immunotherapy trials. [PMID 28596092](https://pubmed.ncbi.nlm.nih.gov/28596092/){target="_blank" rel="noopener"}
ASTRO/ESTRO Oligometastatic NSCLC 2023 Conditional local therapy integration when all disease can be treated safely; not a mandate for widespread disease. [PMID 37294262](https://pubmed.ncbi.nlm.nih.gov/37294262/){target="_blank" rel="noopener"}
ASCO/SNO/ASTRO Treatment for brain metastases 2022 Symptomatic CNS disease generally receives local therapy regardless of systemic regimen. [PMID 34932393](https://pubmed.ncbi.nlm.nih.gov/34932393/){target="_blank" rel="noopener"}

Safety and supportive care

Issuer Document Date Trigger/use
CHEST Central-airway obstruction 2025 Symptomatic obstruction; multidisciplinary therapeutic bronchoscopy plus oncologic therapy. [PMID 39029785](https://pubmed.ncbi.nlm.nih.gov/39029785/){target="_blank" rel="noopener"}
ATS/STS/STR Malignant pleural effusion 2018 Symptom-directed drainage, indwelling catheter, or pleurodesis according to expansion and preference. [PMID 30272503](https://pubmed.ncbi.nlm.nih.gov/30272503/){target="_blank" rel="noopener"}
ASCO Immune-related adverse events 2021 update Organ-specific grading, hold/discontinue, steroids/additional immunosuppression, rechallenge. [PMID 34724392](https://pubmed.ncbi.nlm.nih.gov/34724392/){target="_blank" rel="noopener"}
ASCO/IDSA Fever and neutropenia outpatient management 2018 Formal low-risk assessment; initial treatment/observation and reliable follow-up required. [PMID 29461916](https://pubmed.ncbi.nlm.nih.gov/29461916/){target="_blank" rel="noopener"}
ASCO Cancer-associated venous thromboembolism 2023 update Prophylaxis and treatment; individualize for haemoptysis, thrombocytopenia, renal function, brain disease, and procedures. [PMID 37075273](https://pubmed.ncbi.nlm.nih.gov/37075273/){target="_blank" rel="noopener"}
Endocrine Society Hypercalcaemia of malignancy 2023 Hydration, antiresorptive therapy, and selected calcitonin use according to severity and renal/cardiac context. [PMID 36545746](https://pubmed.ncbi.nlm.nih.gov/36545746/){target="_blank" rel="noopener"}

Explicit cross-guideline disagreements or mismatches

Topic Mismatch Safe handling
Screening quit-years USPSTF uses ≤15 quit-years; ACS 2023 does not Apply governing program; record which rule and why
TNM NICE NG122 states recommendations were developed with AJCC seventh edition Map actual T/N/M descriptors before applying a stage label
Perioperative regimen Neoadjuvant-only and perioperative options coexist Do not compare hazard ratios across trials or assume adjuvant contribution
Molecular scope 2018 molecular guideline predates many targets Use it for methods/tissue principles plus current therapy guidance
TMB Research associations versus CAP “do not use alone” recommendation Keep TMB investigational/context-specific
Access NICE appraisals can recommend or reject drugs differently from US guidance Separate evidence from jurisdictional reimbursement

Update triggers

Recheck this registry when any of the following occurs:

  • ASCO living guideline version changes;
  • a perioperative or metastatic phase III trial reports OS or a regulatory decision;
  • NCCN/ESMO/NICE updates the relevant NSCLC pathway;
  • CAP issues its post-2024 molecular-testing update;
  • tenth-edition TNM proposals begin;
  • a biomarker receives companion-diagnostic status;
  • a squamous ADC or KEAP1/NFE2L2-directed therapy changes standard care;
  • national screening eligibility changes.

Registry quality checks

  • [x] Official source preferred where available.
  • [x] PMID used only after live PubMed verification in the 2026-08-30 audit session.
  • [x] Version/date and jurisdiction recorded.
  • [x] Living web version separated from archived journal version.
  • [x] TNM-edition mismatch explicitly flagged.
  • [x] Drug evidence separated from local authorization/reimbursement.
  • [ ] NCCN professional version must be verified in an authenticated account at point of use.