Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with early and locally advanced non-small-cell lung cancer

The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with early and locally advanced non-small-cell lung cancer (NSCLC) were published in August 2025 and were adapted in November 2025 according to previously established standard methodology to produce the Pan-Asian adapted ESMO consensus guidelines for the management of Asian patients with early and locally advanced NSCLC. The adapted guidelines presented in this article represent the consensus opinions reached by a panel of Asian experts on the treatment of patients with early and locally advanced NSCLC representing the oncological societies of China (Chinese Society of Clinical Oncology), Indonesia (Indonesian Society of Hematology and Medical Oncology), India (Indian Society of Medical and Paediatric Oncology), Japan [Japanese Society of Medical Oncology (JSMO)], South Korea (Korean Society of Medical Oncology), Malaysia (Malaysian Oncological Society), the Philippines (Philippine Society of Medical Oncology), Singapore (Singapore Society of Oncology), Taiwan (Taiwan Oncology Society) and Thailand (Thai Society of Clinical Oncology), coordinated by ESMO and JSMO. The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different regions of Asia. The latter are discussed separately in the article. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with early and locally advanced NSCLC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials. Attention is drawn to the disparity in the drug approvals and reimbursement strategies among the different regions.