The Oncology Society of the Chinese Medical Association convened multidisciplinary experts in respiratory medicine, medical oncology, thoracic surgery, radiation oncology, radiology, and pathology to produce the "Guideline for clinical diagnosis and treatment of lung cancer (2026 edition)." The guideline was formulated through a consensus conference with the stated aims of standardizing lung cancer prevention and management across China, improving diagnostic and therapeutic quality, enhancing patient prognosis, and providing evidence-based recommendations for clinicians at all levels.
The 2026 edition updates the prior (2025) guideline across multiple domains and synthesizes recent evidence, newly approved indications by the National Medical Products Administration (NMPA), and current clinical practice in China. The document is intended for clinicians and allied professionals involved in imaging, laboratory medicine, and multidisciplinary lung cancer care.
The guideline refines quality control requirements for low-dose computed tomography (LDCT) screening, emphasizing standardized processes for screening implementation. In addition to organized screening programs, the 2026 edition introduces guidance on opportunistic screening—defined as screening performed outside formal population-screening programs—as well as the appropriate scope and application of artificial intelligence technologies to support lung cancer screening workflows.
These additions reflect an effort to clarify operational standards for image acquisition and interpretation, to broaden practical screening strategies that may be used in real-world Chinese clinical settings, and to recognize the emerging role of AI tools in image analysis and risk stratification.
Based on recent clinical research and newly approved NMPA indications, the guideline supplements recommendations for molecular pathological testing. Several new gene-testing–related recommendations were added to reflect advances in actionable biomarkers and targeted therapy options.
The pathology section integrates up-to-date guidance on specimen handling, histologic classification, and the indications for molecular profiling to inform systemic therapy selection. The guideline emphasizes tests that are relevant to available treatments in China and aligns recommended testing with regulatory approvals and clinical evidence.
Perioperative systemic therapy recommendations for non–small cell lung cancer (NSCLC) have been revised in light of recently approved drugs and indications. The 2026 edition updates both neoadjuvant and adjuvant regimens applicable to surgical management of NSCLC, providing clinicians with contemporary, evidence-informed options that reflect agents currently accessible in China.
These updates are presented to help surgical and medical oncology teams select perioperative strategies that align with national approvals and evolving trial evidence.
For patients with unresectable stage III NSCLC who receive concurrent or sequential chemoradiotherapy, the guideline adds additional options for consolidation immunotherapy. These recommendations expand the post–chemoradiotherapy treatment choices available for this patient population and are incorporated according to approved indications and clinical practice considerations.
The guideline further refines first-line and subsequent-line treatment strategies for patients with advanced NSCLC harboring EGFR mutations. Updates reflect recently available evidence and approvals that influence sequencing and selection of targeted and systemic therapies for EGFR-mutant disease.
Clinicians are advised to interpret these recommendations in the context of NMPA-approved indications and the availability of agents within Chinese practice settings.
In recognition of expanding targeted therapy options, the 2026 edition updates treatment recommendations for NSCLC with specific molecular subtypes, including anaplastic lymphoma kinase (ALK) fusion, KRAS G12C mutation, human epidermal growth factor receptor 2 (HER-2) mutations, and MET amplification. These updates reflect the approval of novel agents for these molecularly defined groups and provide guidance on integrating subtype-directed therapies into clinical care.
A core principle of the guideline is alignment with NMPA-approved indications. Recommendations prioritize drugs and regimens that are practically available in China. Where relevant, the guideline integrates recommendations from international guidelines while considering the current status of Chinese clinical practice and available evidence.
This approach is intended to ensure that guidance is both evidence-based and operationally feasible for clinicians working within the national regulatory and pharmaceutical context.
The guideline covers a comprehensive range of topics including lung cancer screening, diagnosis, imaging, pathology, molecular and immunologic biomarker testing, multimodality treatment options (surgery, radiotherapy, systemic therapy), and follow-up. It is aimed at clinicians at all levels—pulmonologists, medical oncologists, thoracic surgeons, radiation oncologists—as well as radiology and laboratory medicine professionals. The stated outcomes are improved standardization of care, better diagnostic and treatment quality, and ultimately improved patient prognosis.
The guideline is published in Zhonghua Yi Xue Za Zhi (2026 Sep 22;106(35):3687–3723). DOI: 10.3760/cma.j.cn112137-20260511-01255. PubMed PMID: 42763208. The authors reported no conflicts of interest.
Note: This summary is restricted to the content reported in the PubMed entry and English abstract; detailed algorithmic recommendations, dosing specifics, and full evidence tables are reported in the full-text guideline (article in Chinese) and are not reproduced here.