My Treatment Approach: Lung Cancer Practice Patterns

Communication and education of a patient with lung cancer and their family is only part of a nurse practitioner’s responsibility. Moreover, they often represent the primary point of contact for a patient when it comes to their diagnostic workup, treatment follow-up, and symptom management.

David R. Gandara, highlights key data regarding the earlier integration of targeted therapy in NSCLC, the growing role of molecular testing with tissue and liquid biopsy, and the importance of incorporating a multidisciplinary approach to patient care in the paradigm.

Pivotal trials, such as the phase 3 FLAURA trial with osimertinib in patients with EGFR-mutant non–small cell lung cancer NSCLC, have demonstrated the significant benefit yielded with targeted therapies.

Sandip P. Patel, MD, discussed the real-world application of the phase 3 PACIFIC trial in unresectable stage III non–small cell lung cancer.

Although adjuvant targeted therapy options are reserved for patients with EGFR-mutated non–small cell lung cancer, molecular testing is a critical step in the treatment of all patients with metastatic disease, where multiple driver mutations are associated with FDA-approved therapeutics.

David J. Feller-Kopman, MD, discusses the imperative role of the pulmonologist in the screening and management of lung cancer.

Jay M. Lee, MD, discusses the implications of the ADAURA trial in early-stage resectable NSCLC, the importance of molecular testing, and the need for a multidisciplinary approach in this population.

Jonathan W. Goldman, MD, discusses the significance of the phase 3 CASPIAN and IMpower133 trials in small cell lung cancer and efforts made to optimize molecular testing.

Benjamin H. Kann, MD, discusses the significance of the PACIFIC trial in patients with stage III NSCLC, existing barriers to treatment, and shared strategies to overcome common challenges faced in clinical practice.

Syed M. Quadri, MD, discusses the role of surgery in early-stage and locally advanced lung cancer, as well future directions with robotic and minimally invasive surgery.

Roy Decker, MD, PhD, discusses the utility of interventional radiology and SBRT in patients with oligometastatic disease and detailed ongoing clinical trials for NSCLC as they relate to radiation therapy.

Marianne Davies, NP, DNP, MSN, BSN, discussed the potential severity of immune-related adverse effects and detailed recommended management strategies for patients receiving checkpoint inhibitors, especially in lung cancer.

Julia K. Rotow, MD, discusses how she approaches molecularly testing in patients with liquid- and tissue-based biopsies, the importance of waiting to initiate immunotherapy until a patient’s molecular testing results are confirmed, and other nuances that she considers when treating patients with advanced non–small cell lung cancer.

Christopher G. Azzoli, MD, discusses the importance of identifying molecular aberrations prior to starting a patient with advanced non–small cell lung cancer on immunotherapy, ongoing research aimed at furthering the immunotherapy paradigm, and explained why novel biomarkers of response to immunotherapy are needed.