Dr. Bunn on the Treatment of Early-Stage Lung Cancer

Paul A. Bunn Jr, MD
Published: Wednesday, Sep 19, 2018



Paul A. Bunn Jr, MD, distinguished professor, Division of Medical Oncology, James Dudley Chair in Lung Cancer Research, University of Colorado Denver, 2014 Giant of Cancer Care® in Lung Cancer, discusses the treatment of patients with early-stage non–small cell lung cancer (NSCLC).

The goal of treating patients with early-stage disease is to cure them, Bunn says. Surgery can cure some patients. Data have shown that neoadjuvant chemotherapy has improved the 5-year survival rate by 5%. Bunn says this is clinically meaningful, but it essentially means that to benefit 1 patient, 20 patients would have to be treated. A number of recent clinical trials have looked at ways to prolong survival or even cure more patients with early-stage NSCLC.

One option is to give targeted therapy for patients with activating mutations. Unfortunately, Bunn says, data have not demonstrated a survival advantage in this approach. This likely has to do with the fact that targeted therapy doesn’t kill enough cancer cells. Neoadjuvant trials are being done with tyrosine kinase inhibitors to see why some cancer cells persist. This could lead to combination therapy, he concludes.
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Paul A. Bunn Jr, MD, distinguished professor, Division of Medical Oncology, James Dudley Chair in Lung Cancer Research, University of Colorado Denver, 2014 Giant of Cancer Care® in Lung Cancer, discusses the treatment of patients with early-stage non–small cell lung cancer (NSCLC).

The goal of treating patients with early-stage disease is to cure them, Bunn says. Surgery can cure some patients. Data have shown that neoadjuvant chemotherapy has improved the 5-year survival rate by 5%. Bunn says this is clinically meaningful, but it essentially means that to benefit 1 patient, 20 patients would have to be treated. A number of recent clinical trials have looked at ways to prolong survival or even cure more patients with early-stage NSCLC.

One option is to give targeted therapy for patients with activating mutations. Unfortunately, Bunn says, data have not demonstrated a survival advantage in this approach. This likely has to do with the fact that targeted therapy doesn’t kill enough cancer cells. Neoadjuvant trials are being done with tyrosine kinase inhibitors to see why some cancer cells persist. This could lead to combination therapy, he concludes.

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Community Practice Connections™: Working Group for Changing Standards in EGFR-Mutated Lung Cancers: Real-World Applications of the Evidence for NursesJun 29, 20191.5
Oncology Briefings™: Current Perspectives on Preventing and Managing Tumor Lysis SyndromeJun 30, 20191.0
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