The International Association for the Study of Lung Cancer (IASLC) recently introduced the ninth edition of the TNM classification for lung cancer. This milestone is supported by a comprehensive database comprising 124 581 lung cancer patients from 75 centers across 25 nations between 2011 and 2019. Following the exclusion of incomplete data, the analysis focused on 87 043 patients. These insights guided the modifications in the ninth edition of the TNM classification for lung cancer. The updated classification now includes a higher representation of Asian patients, particularly showing significant growth among Chinese patients. This revised classification will offer more pertinent benchmarks for the diagnosis and prognostic assessment of lung cancer. This article delves into the database updates, stage adjustments, and rationale behind the IASLC ninth edition of the TNM classification for lung cancer.
The management of non-small cell lung cancer is rapidly advancing toward precision and individualized care. The National Comprehensive Cancer Network (NCCN) has recently released the 2026 version 1, 2, and 3 updates of the NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. These updated guidelines introduce significant revisions in several core areas, including the adoption of the AJCC 9th Edition TNM Staging System, optimization of recommendations for lung cancer screening and mediastinal staging, updates on perioperative immunotherapy and targeted therapy strategies, and the inclusion of emerging biomarkers such as neuregulin 1 (NRG1) fusions and mesenchymal-epithelial transition factor (MET) protein overexpression. This article provides a systematic interpretation of these key updates and focuses on integrating international guidelines with clinical practice in China. Specifically, considering the high prevalence of epidermal growth factor receptor (EGFR) mutations in the Chinese population, it analyzes the first-line positioning of osimertinib- and lazertinib-based combination regimens and evaluates the clinical value of domestic third-generation tyrosine kinase inhibitors. In response to the NCCN's cautious stance on “conversion therapy” for initially unresectable disease, the article elaborates on China’s exploratory efforts and the evolving evidence base for conversion strategies utilizing programmed death receptor 1 (PD-1) inhibitors (e.g., tislelizumab, toripalimab). Furthermore, it clarifies the “dual-track” diagnostic approach distinguishing MET pathway mutations from protein overexpression. Aimed at aligning with China’s clinical context, this review seeks to offer clinicians a practical reference that synthesizes cutting-edge international perspectives with local applicability.