Abstract
This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.
In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.
These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Torsten Gerriet Blum reports an unrestricted grant of less than €1000 from Stiftung Oskar Helene Heim (Berlin, Germany), through which staff support for the work of the current Task Force was provided.
Conflict of interest: Rebecca L. Morgan has nothing to disclose.
Conflict of interest: Valérie Durieux has nothing to disclose.
Conflict of interest: Joanna Chorostowska-Wynimko declares grants to the National Institute of Tuberculosis and Lung Diseases from Pfizer and to the Polish Respiratory Society from AstraZeneca; consulting fees from AstraZeneca, Pfizer, Amgen, Takeda, Merck Sharp & Dohme, Roche and Roche Diagnostica; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Pfizer, CelonPharma, Amgen, Takeda, Novartis, Bristol Myers Squibb, Merck Sharp & Dohme, Roche, Roche Diagnostica and Amoy; support for attending meetings and/or travel from Bristol Myers Squibb, AstraZeneca, Merck Sharp & Dohme, Pfizer and Amgen; participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, Pfizer, Takeda, Merck Sharp & Dohme, Roche and Roche Diagnostica, all in the 36 months prior to manuscript submission; and that they are Secretary General of the European Respiratory Society and a member of the Executive Committees of the Polish Respiratory Society and the Polish Coalition for Personalized Medicine.
Conflict of interest: David R Baldwin declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Bristol Myers Squibb, AstraZeneca, Roche and Merck Sharp & Dohme, in the 36 months prior to manuiscript submission.
Conflict of interest: Jeanette Boyd is an employee of the European Lung Foundation
Conflict of interest: Corinne Faivre-Finn reports research grants from AstraZeneca and Elekta; payment or honoraria for presentations from AstraZeneca; support for attending meetings and/or travel from Elekta and AstraZeneca; and participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca and Merck Sharp & Dohme, all in the 36 months prior to manuscript submission.
Conflict of interest: Françoise Galateau-Salle has nothing to disclose.
Conflict of interest: Fernando Gamarra has nothing to disclose.
Conflict of interest: Bogdan Grigoriu declares support for attending meetings and/or travel from Roche and AstraZeneca; and participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, all in the 36 months prior to manuscript submission.
Conflict of interest: Georgia Hardavella has nothing to disclose.
Conflict of interest: Michael Hauptmann has nothing to disclose.
Conflict of interest: Erik Jakobsen has nothing to disclose.
Conflict of interest: Dragana Jovanovic declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Merck Sharp & Dohme, Roche, Boehringer Ingelheim, WCBIP 2020 and AstraZeneca; payment for expert testimony relating to the health effects of air pollution from SO2 released by Serbia Zijin Copper mining and smelting complex and the two biggest Serbian power plants, all in the 36 months prior to manuscript submission; and that they are a member of the editorial boards of the Journal of Thoracic Disease and the AME Surgical Journal, and a Committee member of The National Ecological Association (NEA), Serbia.
Conflict of interest: Paul Knaut has nothing to disclose.
Conflict of interest: Gilbert Massard declares a speaker's fee from Pneumo Update Europe, in the 36 months prior to manuscript submission.
Conflict of interest: John McPhelim declares advisory board payments from AstraZeneca, Janssen-Cilag and Bristol Myers Squibb, in the 36 months prior to manuscript submission.
Conflict of interest: Anne-Pascale Meert has nothing to disclose.
Conflict of interest: Robert Milroy has nothing to disclose.
Conflict of interest: Riccardo Muhr has nothing to disclose.
Conflict of interest: Luciano Mutti has nothing to disclose.
Conflict of interest: Marianne Paesmans has nothing to disclose.
Conflict of interest: Pippa Powell is an employee of the European Lung Foundation.
Conflict of interest: Paul Martin Putora declares research grants to their institution from AstraZeneca, Takeda and Bayer; and a speaker's fee from Janssen-Cilag, all in the 36 months prior to manuscript submission.
Conflict of interest: Janette Rawlinson declares travel/accommodation support from BTOG to attend annual meeting in Dublin as patient advocate/steering committee member Jan 2019; travel/accommodation support from ERS to attend screening meeting in Barcelona Dec 2018 (patient representative) and ELF patient event at ERS Congress Madrid 2019; travel/accommodation support from NCRI to attend conference in Glasgow 2019 (consumer member); Travel/accommodation support from EORTC to attend Patient Days event as a speaker and patient panel member Feb 2020; and that they have been a Non Executive Director (lay member) at Sandwell and West Birmingham Clinical Commissioning Group, UK (until April 2021).
Conflict of interest: Anna L Rich has nothing to disclose.
Conflict of interest: David Rigau is a methodologist of the European Respiratory Society.
Conflict of interest: Dirk de Ruysscher declares grants to their institution from AstraZeneca and BeiGene; payment to their institution for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; and payment to their institution for participation on an Advisory Board from AstraZeneca, all in the 36 months prior to manuscript submission.
Conflict of interest: Jean-Paul Sculier has nothing to disclose.
Conflict of interest: Arnaud Schepereel declares a research grant to their institution from Bristol Myers Squibb; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Bristol Myers Squibb and Leo Pharma; support for attending meetings and/or travel from AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme and Roche; and payment for Participation on a Data Safety Monitoring Board or Advisory Board from AstraZeneca, Bristol Myers Squibb and Merck Sharp & Dohme, all in the 36 months prior to manuscript submission.
Conflict of interest: Dragan Subotic has nothing to disclose.
Conflict of interest: Paul Van Schil declares consulting fees paid to their institution by AstraZeneca and Merck Sharp & Dohme; payment to their institution for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; and travel expenses related to participation in Data Safety Monitoring or Advisory Boards for the LungART Trial and the Pearls Trial, all in the 36 months prior to manuscript submission; and that they are the President-elect of the International Association for the Study of Lung Cancer and the Treasurer of the Belgian Association for Cardio-Thoracic Surgery.
Conflict of interest: Clare Williams is an employee of the European Lung Foundation
Conflict of interest: Thomy Tonia is a methodologist of the European Respiratory Society.
Conflict of interest: Thierry Berghmans declares consulting fees from InhaTarget; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Janssen; and participation on a Data Safety Monitoring Board or Advisory Board for Janssen and Roche, all in the 36 months prior to manuscript submission.
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- Received December 20, 2021.
- Accepted September 23, 2022.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
