Advocacy Experts Research Articles

Treatment of Pleural Mesothelioma: ASCO Guideline Update.

To provide evidence-based recommendations to practicing physicians and others on the management of pleural mesothelioma (PM). ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pathology, cancer genetics, and advocacy experts to conduct an updated literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2016 through 2024. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. The literature search identified 110 additional relevant studies to inform the evidence base for this guideline. Evidence-based recommendations were developed for surgical cytoreduction, immunotherapy, chemotherapy, pathology, and germline testing in patients with PM.Additional information is available at www.asco.org/thoracic-cancer-guidelines.

Challenges and opportunities in newly diagnosed glioblastoma in the United Kingdom: A Delphi panel.

Glioblastoma is the deadliest primary malignant brain tumor in adults with limited treatment options and an average survival time of 12-18 months in the United Kingdom. In addition, glioblastoma has a highly detrimental impact on physical, cognitive, and emotional well-being, leaving substantial unmet needs for patients and caregivers. This study aimed to identify unmet needs in people with newly diagnosed glioblastoma and opportunities to mitigate them. Utilizing Delphi methodology, an initial roundtable discussion with patient advocacy experts from 5 brain tumor organizations in the United Kingdom informed the development of 2 rounds of surveys across 9 domains (diagnosis, treatment, integrated care, support beyond treatment, quality of life, access to new treatments, access to trials, measures to ease the burden, and impact of COVID-19). Consensus was predefined as ≥70% agreement. A total of 17 Delphi panelists (glioblastoma patients, caregivers, and patient representatives) completed the first round of questionnaires and 26 completed the second. Consensus was reached on 16/21 questions (76.2%) and 7/9 domains. Panelists reached a consensus on key questions including the high frequency of diagnosis via emergency departments, the lack of effective personalized treatments and holistic care, the high caregiver burden, the lack of awareness and availability of access to clinical trials, and the negative impact of COVID-19 on glioblastoma care. Significant unmet needs exist for newly diagnosed glioblastoma patients in the United Kingdom, highlighting the demand for increased research funding, comprehensive patient care, caregiver support, enhanced awareness and access to clinical trials, and new treatments.

Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update.

To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer. A multidisciplinary panel of medical oncology, geriatric oncology, internal medicine, psychology, psychiatry, exercise oncology, integrative medicine, behavioral oncology, nursing, and advocacy experts was convened. Guideline development involved a systematic literature review of randomized controlled trials (RCTs) published in 2013-2023. The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits. Certainty and quality of evidence were low to moderate for CRF management interventions. Clinicians should recommend exercise, CBT, mindfulness-based programs, and tai chi or qigong to reduce the severity of fatigue during cancer treatment. Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment. For survivors after completion of treatment, clinicians should recommend exercise, CBT, and mindfulness-based programs; in particular, CBT and mindfulness-based programs have shown efficacy for managing moderate to severe fatigue after treatment. Yoga, acupressure, and moxibustion may also be recommended. Patients at the end of life may be offered CBT and corticosteroids. Clinicians should not recommend L-carnitine, antidepressants, wakefulness agents, or routinely recommend psychostimulants to manage symptoms of CRF. There is insufficient evidence to make recommendations for or against other psychosocial, integrative, or pharmacological interventions for the management of fatigue.Additional information is available at www.asco.org/survivorship-guidelines.

Accessible Metaverse: A Theoretical Framework for Accessibility and Inclusion in the Metaverse

The following article investigates the Metaverse and its potential to bolster digital accessibility for persons with disabilities. Through qualitative analysis, we examine responses from eleven experts in digital accessibility, Metaverse development, disability advocacy, and policy formulation. This exploration uncovers key insights into the Metaverse’s current state, its inherent principles, and the challenges and opportunities it presents in terms of accessibility. The findings reveal a mixed state of inclusivity within the Metaverse, highlighting significant advancements along with notable gaps, especially in integrating assistive technologies and ensuring interoperability across different virtual environments. This study emphasizes the Metaverse’s potential to revolutionize experiences for individuals with disabilities, provided that accessibility is embedded in its foundational design. Ethical and legal considerations, such as privacy, non-discrimination, and evolving legal frameworks, are identified as critical factors that shape an inclusive Metaverse. We propose a comprehensive framework that emphasizes technological adaptation and innovation, user-centric design, universal access, social and economic considerations, and global standards. This framework aims to guide future research and policy interventions to foster an inclusive digital environment in the Metaverse. This paper contributes to the emerging discourse on the Metaverse and digital accessibility, offering a nuanced understanding of its complexities and a roadmap for future exploration and development. This underscores the necessity of a multi-faceted approach that incorporates technological innovation, user-centered design, ethical considerations, legal compliance, and continuous research to create an inclusive and accessible Metaverse.

Therapy for Stage IV Non-Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2023.3.

To provide evidence-based recommendations for patients with stage IV non-small cell lung cancer (NSCLC) without driver alterations. This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized clinical trials (RCTs), with the latest time frame spanning February to October 2023. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened. The literature search included systematic reviews, meta-analyses, and randomized controlled trials. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Ten new RCTs were identified in the latest search of the literature to date. Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients without driver alterations.Additional information is available at www.asco.org/living-guidelines.

Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2023.3.

To provide evidence-based recommendations for patients with stage IV non-small cell lung cancer with driver alterations. This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized clinical trials (RCTs), with the latest time frame spanning February to October 2023. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened. The literature search included systematic reviews, meta-analyses, and randomized controlled trials. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Eight new RCTs were identified in the latest search of the literature to date. Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients based on targetable driver alterations.Additional information is available at www.asco.org/living-guidelines.

Community NGO intervention for Alzheimer’s patients rehabilitation

AbstractBackground Alzheimer’s patients Rehabilitation services aren’t well‐developed concept in resource‐Poor nations due to poor economics & lack of expertise. With limited resources we wanted to explore these rehabilitation services in rural villages. Rural/tribal areas of India lung Alzheimer’s patients [Ca] patients lack rehabilitation support available only in city hospitals. Our 12‐year CBO is training youth volunteers & traditional faith halers in marginalized communities to provide rehabilitation.MethodAround 1340 cases of Alzheimer’s will be in rural/tribal of India by 2025, but hospitals lack dedicated Rehabilitation program. patients returning to villages after onco‐therapy in cities urgently need Rehabilitation support to suit their economic, social, cultural background. Since August 2018 Our NGO clinic started free advise on Rehabilitation. [n = 91]. With 6 trained nurses, two physicians, we screened patients. Average age 62 years, M:F ratio 75:25. Our support services devised as‐per need of Patients in consultation with family & stretched over 21 months included conselling, physiotherapy, occupational therapy, rehabilitation. Responses assessed with Quality of life scale by Flanagan Quality of Life Scale (QOLS) & psychological evaluation by Likert psychometric scale. This presentation demonstrates project in developmental stages & basic operational facts. Initially started as practically oriented guidance center & later developed in well‐organized set‐up offering free rehabilitation services in villages. It comprises NGO staff and traditional faith healers.ResultOur program highlights variability of psychological & Socio‐medical aspects in rehabilitation. Patents needed medical interventions in 18%, psychological approaches in 84% while remaining 16% needed combination of both.ConclusionThis is pilot project running on community donation. We plan to document, evaluate this in large sample size, but resource restriction didn’t permit. To overcome this, we plan networking of European NGO’s, advocacy experts at AAIC‐2023 Venue for better study design, technical support & collaborative efforts. I do not claim “I transformed whole community of patients but we had certainly taken initiative by this cost‐effective approach”.

Developing consensus-based oncology financial advocacy services guidelines.

38 Background: Financial advocacy interventions help patients, and their families address financial hardship experienced through the cancer journey. However, how financial services are offered to patients varies greatly. Across the field of financial advocacy there is a lack of standardization of services, which is needed to accurately evaluate the impact of oncology financial advocacy. The Association of Community Cancer Centers (ACCC) Financial Advocacy Network (FAN) set out to revamp the Financial Advocacy Services Guidelines originally published in 2018, with the goal of providing cancer programs direction in implementing and improving financial advocacy services offered to patients with cancer. Methods: ACCC convened a task force of 7 multidisciplinary financial advocacy experts to guide the process of creating consensus-based financial advocacy services guidelines. The task force assembled a panel of 49 diverse oncology financial advocacy experts. A literature review and input from panelists was used to draft a list of guideline statements. Panelists went through 2 rounds of anonymous voting to inform revisions to the guideline statements. Consensus for the guideline statements was set at 75% agreement. The statements were rated as should not be a guideline, minimum guideline, or enhanced guideline. Cancer program staff completed a questionnaire upon downloading the guidelines. Results: After completion of the 2 rounds, the panel reached consensus that 43 statements should be guidelines. The guidelines are split into three main domains: financial advocacy services & functions; program management functions; and partner engagement functions. The updated Guidelines, which provide cancer organizations with the foundation to implement services to help reduce financial burdens of care, were published in March 2023 and are publicly available. From March 2023 until June 2023, it was downloaded by 93 cancer program staff members, of which 74% stated they will use it to assist in the development, implementation, and/or enhancement of a formal advocacy program at their organization and 58% responded that they have a financial advocacy program already implemented or have a financial advocate on staff. Conclusions: As financial advocacy grows more complex, interventions for patients with cancer are vital. The Guidelines provide expert-developed and consensus-based methods to assist cancer organizations with implementing financial intervention services. Importantly, the newly published guidelines will aid in closing existing gaps in delivery of oncology financial services as 48% of respondents stated they do not have a financial advocacy program or staff member. Further it will promote broader collaboration among partners to aid with assessment tools, creating valid measures and rigorous evaluation of the guidelines to improve cancer patients’ experience and reduce financial barriers to care.

Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer Care Ontario) Guideline.

To provide evidence-based recommendations to practicing clinicians on the management of patients with small-cell lung cancer. An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2022. Outcomes of interest included response rates, overall survival, disease-free survival or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. The literature search identified 95 relevant studies to inform the evidence base for this guideline. Evidence-based recommendations were developed to address systemic therapy options, timing of therapy, treatment in patients who are older or with poor performance status, role of biomarkers, and use of myeloid-supporting agents in patients with small-cell lung cancer.Additional information is available at www.asco.org/thoracic-cancer-guidelines.

Expert views on high fat, salt and sugar food marketing policies to tackle obesity and improve dietary behaviours in the UK: a qualitative study

BackgroundThere has been a lack of progress in reducing obesity in the United Kingdom (UK) despite Government strategies released over the last 30 years. These strategies, including the most recent publication from July 2020, have focused on childhood obesity and high fat, sugar and/or salt (HFSS) marketing restrictions, particularly broadcast advertising. In this study, we aimed to examine a range of expert views on the potential impact and the relative importance of such policies.MethodsSemi-structured interviews were conducted with 42 experts in policy (n = 19), industry (n = 10), and advocacy (n = 13) with an interest in obesity. The UK Government’s 2020 obesity strategy was used as a prompt to guide discussion on policy options. Qualitative thematic analysis was employed to answer the three research questions and themes were inductively coded within each research question. Data were also cross compared using matrix coding and a form of framework analysis to examine the views expressed by the different types of stakeholders.ResultsReactions to the July 2020 proposal were mixed among policy and advocacy stakeholders, while commercial stakeholders expressed disappointment. A main theme emerging in all groups was frustration with the policy process and wishing to see more clarity regarding restrictions and their implementation. There was an overall lack of trust that the government would carry out their proposed plan and agreement that a more comprehensive, multi-sector approach aimed at the underlying drivers of obesity would be most effective, with some stakeholders indicating that some of the proposed policies could make a difference if implemented robustly. On the theme of promoting healthier options, some stakeholders suggested lowering the prices of ‘healthy’ products and making them more accessible to combat regressivity. There was a potentially surprising level of agreement between policy/advocacy stakeholders and commercial stakeholders, although commercial stakeholders were more likely to advocate for collaboration between government and industry as well as voluntary industry measures.ConclusionWhile HFSS marketing restrictions have a role to play and send a strong signal – provided they are implemented comprehensively – investment in these policies needs to be part of wider efforts to tackle the underlying drivers of obesity.

Oncology financial advocacy services guidelines: Results of a Delphi study.

e18606 Background: At least half of people with cancer experience financial toxicity1 but financial advocacy has emerged as a promising intervention to mitigate it. How cancer programs and practices screen for financial toxicity among patients and the types of services they offer vary greatly. Standardization is needed to evaluate the outcomes and impacts of financial advocacy. Therefore, the Association of Community Cancer Centers (ACCC) Financial Advocacy Network set out to develop Oncology Financial Advocacy Services Guidelines (hereafter “the Guidelines”) to address this gap. Methods: To conduct this original, non-clinical trial research, ACCC convened a task force of seven multidisciplinary experts in financial advocacy to oversee a modified Delphi study. The task force assembled a panel of 49 experts, who represented oncology financial advocacy staff, multidisciplinary cancer care team members, financial advocacy subject matter experts, as well as patients and patient advocates. Based on a literature review and qualitative input from panelists, the task force drafted a list of 44 potential guidelines. In early 2022, panelists completed two rounds of anonymous voting, determining if each statement should not be a guideline, be a minimum guideline, or be an enhanced guideline. Consensus was set at 75% agreement. Results: The panel reached consensus that 43 statements should be guidelines. One guideline was rated minimum, while another 17 trended toward being considered minimum (60%-74% agreement among panelists). The panel rated one guideline as enhanced, with two others trending toward being enhanced. Twenty-two guidelines did not reach consensus one way or another on being minimal vs. enhanced. Conclusions: The Guidelines are publicly available in a report that includes implementation considerations extracted from Delphi panelists’ comments and task force input. Half of guidelines did not reach consensus on whether they are minimum or enhanced, reflecting the diversity of current financial advocacy practice and a need to develop greater standardization in the field. ACCC is taking several next steps to advance research and quality practice using the Guidelines, including collaborative policy development, assessment tools, and the creation of valid metrics and accountability measures.

Trial Advocacy and Nitojutsu

Miyamoto Musashi was a master Japanese swordsman. His text, the Book of Five Rings, sets out his philosophy on combat and the way of the warrior. This article takes his teachings and applies them to art of trial advocacy. The Five Scrolls of Musashi’s text allow for an engagement with the fundamental importance of preparation, the effective deployment of law and fact, awareness and professional ethics. The connections are made through the use of current experts in advocacy, including Glissan and Hampel. The use of techniques involving katana is, of course, only a metaphor – one aimed at getting law students to think of trials in a more life-or-death way. Advocacy is not the showiness of TV, but the hard grind of training and preparation that was the life of a ronin.

Quasi-experimental Controlled Study on the Effect of Autism Resource Clinic Guardian Attendance at a Military Treatment Facility.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that requires multidisciplinary care. Evidence-based practice indicates that early intervention may improve long-term ASD outcomes. The Autism Resource Clinic (ARC) provides an educational session for guardians empowering them to build a personalized ASD team for their child. We examined the impact of guardian attendance of an ARC at a Military Treatment Facility on time to initiation of patient services and guardian stress level. A quasi-experimental controlled study was conducted comparing a group of guardians attending the ARC with a group of guardians not attending the ARC following a child's initial ASD diagnosis. ARC speakers included medical, county/state, community/military, and advocacy experts. Surveys were completed at diagnosis, 1, 2, and 3 mo postdiagnosis. Initiation of patient services and Parental Stress Scale scores were compared between groups using independent samples t-test, chi-square tests, or nonparametric tests, as appropriate. Use of Applied Behavioral Analysis was significantly higher among ARC attendees vs. nonattendees (73.3% vs. 33.3%, P = 0.028). County early intervention was more frequent among ARC attendees versus nonattendees (40% vs. 13.3%, P = 0.09). Of borderline significance, median time to initiation of genetics services was greater in ARC attendees vs. nonattendees (106 vs. 65.5, P = 0.10). The two groups did not differ on changes in Parental Stress Scale score from baseline to follow-up months 1, 2, or 3. Although ARC did not influence time to initiation of patient services or guardian stress level, attendance of ARC was associated with more frequent use of Applied Behavioral Analysis services and county early intervention services. This pilot study is unique as it targets guardians of ASD patients within military treatment facilities. Study limitations include data collection during the coronavirus disease 2019 pandemic, sequential evaluation of experimental and control groups, sample size and generalizability. A large, multicenter, randomized controlled trial is required to better assess the impact of this educational opportunity among military populations.

A Message to Our 2022 Peer Reviewers: Thank You

Journal of Patient-Centered Research and Reviews utilizes a diverse group of scholars to evaluate original submissions. Through this published acknowledgment, the editors of JPCRR express our sincerest gratitude for the generous volunteer contributions made over the previous 12 months by the following clinical, health research, and patient advocacy experts.

Development of telehealth principles and guidelines for older adults: A modified Delphi approach.

The COVID-19 pandemic elevated telehealth as a prevalent care delivery modality for older adults. However, guidelines and best practices for the provision of healthcare via telehealth are lacking. Principles and guidelines are needed to ensure that telehealth is safe, effective, and equitable for older adults. The Collaborative for Telehealth and Aging (C4TA) composed of providers, experts in geriatrics, telehealth, and advocacy, developed principles and guidelines for delivering telehealth to older adults. Using a modified Delphi process, C4TA members identified three principles and 18 guidelines. First, care should be person-centered; telehealth programs should be designed to meet the needs and preferences of older adults by considering their goals, family and caregivers, linguistic characteristics, and readiness and ability to use technology. Second, care should be equitable and accessible; telehealth programs should address individual and systemic barriers to care for older adults by considering issues of equity and access. Third, care should be integrated and coordinated across systems and people; telehealth should limit fragmentation, improve data sharing, increase communication across stakeholders, and address both workforce and financial sustainability. C4TA members have diverse perspectives and expertise but a shared commitment to improving older adults' lives. C4TA's recommendations highlight older adults' needs and create a roadmap for providers and health systems to take actionable steps to reach them. The next steps include developing implementation strategies, documenting current telehealth practices with older adults, and creating a community to support the dissemination, implementation, and evaluation of the recommendations.

Proposed solutions by the American College of Allergy, Asthma, and Immunology and advocacy experts to address racial disparities in atopic dermatitis and food allergy

Atopic dermatitis (AD) and food allergies are more prevalent and more severe in people with skin of color than White individuals. The American College of Allergy, Asthma, and Immunology (ACAAI) sought to understand the effects of racial disparities among patients with skin of color with AD and food allergies. The ACAAI surveyed its members (N = 200 completed), conducted interviews with health care providers and advocacy leaders, and hosted a roundtable to explore the challenges of diagnosis and management of AD and food allergies in people with skin of color and to discuss potential solutions. Most of the survey respondents (68%) agreed that racial disparities make it difficult for people with skin of color to receive adequate treatment for AD and food allergies. The interviews and roundtable identified access to care, burden of costs, policies and infrastructure that limit access to safe foods and patient education, and inadequate research involving people with skin of color as obstacles to care. Proposed solutions included identifying ways to recruit more people with skin of color into clinical trials and medical school, educating health care providers about diagnosis and treating AD and food allergy in people with skin of color, improving access to safe foods, creating and disseminating culturally appropriate materials for patients, and working toward longer appointment times for patients who need them. Challenges in AD and food allergy in persons with skin of color were identified by the ACAAI members. Solutions to these challenges were proposed to inspire actions to mitigate racial disparities in AD and food allergy.

SY02-2 Japan's Cancer Survivorship Guidelines: Exercise edition

A committee was formed to implement the Japanese Cancer Survivorship Guidelines in 2018. The panel members consisted of experts in oncology clinical practice, nursing, health science, epidemiology, and patient advocacy. The panel reached consensus on the definition of cancer survivorship, the aim of the guidelines, and target users (Matsuoka et al, 2019).

Maternal health expert feedback on the attributes of a predictive analytics tool to improve pregnancy-related cardiovascular and mental health outcomes in the United States

ABSTRACT Identify pregnancy-related challenges and opportunities to improve maternal health care in the United States and understand the potential role of predictive analytics tool(s) in bridging the existing gaps, specifically, in CVD (cardiovascular disease) and depression. Experts in maternal health care, research, patient advocacy, CVD, psychiatry, and technology were interviewed during February and March of 2020. Additionally, published literature was reviewed to assess existing data, insights, and best practices that might help develop effective predictive analytics tool(s). The majority (78%) of the 18 experts interviewed were women. The feedback revealed several insights, including multiple barriers to diagnosis and treatment of pregnancy-related CVD and depression. In experts’ collective opinion, predictive analytics could play an important role in maternal health care and in limiting pregnancy-related CVD and depression, but it must be grounded in quality data and integrate with existing health management systems. A holistic approach to maternal health that factors in racial-ethnic, regional, and socioeconomic disparities is needed that starts with preconception counseling and continues through 1 year postpartum. Predictive analytics tool(s) that are based on diverse and high-quality data could bridge some of the existing gaps in maternal health care and potentially help limit pregnancy-related CVD and depression.

Students of Change: Health Policy in Action.

Health policy is more impactful for public health than many other strategies as it can improve health outcomes for an entire population. Yet in the "see one, do one, teach one" environment of medical school, most students never get past the "see one" stage in learning about the powerful tools of health policy and advocacy. The University of New Mexico School of Medicine mandates health policy and advocacy education for all medical students during their family medicine clerkship rotation. The aim of this project is to describe a unique health policy and advocacy course within a family medicine clerkship. We analyzed policy briefs from 265 third-year medical students from April 2016 through April 2019. Each brief is categorized by the level of change targeted for policy reform: national, state, city, or university/school. Implemented policies are described. Slightly less than one-third of the policies (30%) relate to education, 36% advocate for health system change by addressing cost, access, or quality issues, and 34% focus on public health issues. Fourteen policies have been initiated or successfully enacted. This curriculum gives each medical student a health policy tool kit with immediate opportunities to test their skills, learn from health policy and advocacy experts, and in some cases, implement health policies while still in medical school. A 1-week family medicine policy course can have impact beyond the classroom even during medical school, and other schools should consider this as a tool to increase the impact of their graduates.

Management of Stage III Non-Small-Cell Lung Cancer: ASCO Guideline.

To provide evidence-based recommendations to practicing clinicians on management of patients with stage III non-small-cell lung cancer (NSCLC). An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary oncology, community oncology, research methodology, and advocacy experts was convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. The literature search identified 127 relevant studies to inform the evidence base for this guideline. Evidence-based recommendations were developed to address evaluation and staging workup of patients with suspected stage III NSCLC, surgical management, neoadjuvant and adjuvant approaches, and management of patients with unresectable stage III NSCLC.Additional information is available at www.asco.org/thoracic-cancer-guidelines.