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Guideline registry — lung squamous cell carcinoma¶
Last checked: 2026-10-24 (targeted version/source check; older guideline recommendations were not re-audited). 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 | PubMed-indexed without-driver version 2026.3.1; web version unconfirmed, checked 2026-10-24 | First and subsequent systemic therapy by histology and PD-L1 | Archived publication, [PMID 42190141](https://pubmed.ncbi.nlm.nih.gov/42190141/){target="_blank" rel="noopener"}; living source returned HTTP 403 on 2026-10-24; do not label an inaccessible web version as verified |
| 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 version v1.3, August 2026; official page metadata retrieved 2026-10-17 | Staging, surgery, perioperative therapy, unresectable stage III, follow-up | ESMO living guideline; membership/access may vary |
| Oncology Society of Chinese Medical Association | Guideline for clinical diagnosis and treatment of lung cancer, 2026 edition; China | Published 2026 (Zhonghua Zhong Liu Za Zhi 48(9)); added 2026-10-10 | Compared with 2025, it updates LDCT quality control, opportunistic and AI screening, molecular testing aligned to NMPA approvals, perioperative regimens, and consolidation immunotherapy after chemoradiation for stage III | [PMID 42764215](https://pubmed.ncbi.nlm.nih.gov/42764215/){target="_blank" rel="noopener"}; Chinese full text, English abstract only read; drug options track NMPA approvals and do not transfer to other jurisdictions |
| 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 live 2026 PubMed ASCO living-guideline search on 2026-10-24 still returned without-driver version 2026.3.1 ([PMID 42190141](https://pubmed.ncbi.nlm.nih.gov/42190141/){target="_blank" rel="noopener"}). The official living page returned HTTP 403 on 2026-10-24, so its current version remains unconfirmed. Version 2026.3.3 is verified for the separate with-driver publication ([PMID 42607282](https://pubmed.ncbi.nlm.nih.gov/42607282/){target="_blank" rel="noopener"}); it cannot establish the without-driver web version. Before recording a living version, match both driver scope and version to a retrieved official document; a blocked page never validates a version.
ESMO source recheck (2026-10-24). The official early/locally advanced NSCLC page still identifies v1.3, August 2026 in its embedded citation metadata. The September Pan-Asian adaptation announcement remains catalogued; its full recommendations were not retrieved. (ESMO — “ESMO Living Guideline: Early and Locally Advanced NSCLC”, https://www.esmo.org/guidelines/living-guidelines/esmo-living-guideline-early-and-locally-advanced-nsclc, accessed 2026-10-24.)
NICE NG122 still states updated 2024-03-08, last reviewed 10 February 2026, on its directly retrieved page. This check does not establish that each linked technology appraisal is unchanged. (NICE — “Lung cancer: diagnosis and management”, https://www.nice.org.uk/guidance/ng122, accessed 2026-10-24.)
2026-10-24 catalogue additions (abstracts only). ESTRO published a high-dose thoracic reirradiation guideline for NSCLC (42 consensus statements; [PMID 42468604](https://pubmed.ncbi.nlm.nih.gov/42468604/){target="_blank" rel="noopener"}). STS published a 2026 expert consensus on sublobar-resection definition and practice (21 statements; [PMID 42320552](https://pubmed.ncbi.nlm.nih.gov/42320552/){target="_blank" rel="noopener"}). Neither full-text recommendation set was retrieved; no treatment default is inferred.
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"} |
| China National Pathology Quality Control Center | Clinical practice guideline for NSCLC molecular testing, 2026 update | 2026 | Makes MET amplification, HER2 mutation and KRAS mutation mandatory tests. Adds HER2 amplification/overexpression, MTAP deletion and SMARCA4 deletion as extended tests; Only the Chinese-language abstract was read. [PMID 42851192](https://pubmed.ncbi.nlm.nih.gov/42851192/){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"} |
| AATS | 2026 revised recommendations of the 2023 expert consensus: staging and multidisciplinary management of early-stage NSCLC | 2026 | Updates the 2023 document for further randomized pre- and perioperative chemo-immunotherapy evidence, adjuvant targeted therapy, and changing adjuvant-immunotherapy practice. It continues to require accurate invasive staging, molecular diagnostics and multidisciplinary review before multimodality therapy. Only the abstract was read. [PMID 42790620](https://pubmed.ncbi.nlm.nih.gov/42790620/){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"} |
| ESTRO | High-dose thoracic reirradiation for NSCLC | 2026 | 42 consensus statements on selection, target definition, dose, cumulative organ-at-risk assessment, and follow-up. Combination with systemic therapy remains conditional. Abstract only. [PMID 42468604](https://pubmed.ncbi.nlm.nih.gov/42468604/){target="_blank" rel="noopener"} |
| STS | Expert consensus on definition and practices of sublobar resection in NSCLC | 2026 | 21 Delphi statements after JCOG0802 and CALGB 140503; full statements not retrieved. [PMID 42320552](https://pubmed.ncbi.nlm.nih.gov/42320552/){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; current web labels require retrieved official evidence matching driver scope (2026-10-17).
- [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.