Video

Personalizing the Treatment of Lung Cancer

For High-Definition, Click

Anne S. Tsao, MD, Mark A. Socinski, MD, Corey J. Langer, MD, Alan B. Sandler, MD, and David Gandara, MD, discuss molecular testing and the treatment decision-making process.

Tsao begins the conversation by mentioning that histologically subtyping is still important because of the available treatments. In addition, it's crucial for pathologists to get adequate tissue samples and make the distinction between adenocarcinoma, squamous cell carcinoma, and neuroendocrine cancer.

Socinski notes that clinical behavior and therapeutic direction varies greatly between squamous and non-squamous patients. Bevacizumab and pemetrexed are options for non-squamous patients but are not for those with squamous histology. Socinski agrees with Tsao though oncologists will need to rely on pathologists to make the squamous/non-squamous distinction.

The need for testing has largely been governed by the evolution of therapies. Previously, Langer says, oncologists and pathologists adhered to a one-size-fits-all strategy.

Sandler says that he, and the rest of the oncology community, is curious as to how much a patient can get out of one targeted agent. As effective as a targeted agent is, it does have limitations.

Socinski adds that his practice has been studying and analyzing several targeted agents that show activity but a lot remains unknown.

Langer stresses the idea to manage patient expectations. Patients often read about new agents and expect to be cured, but Langer says it's important to file data and make decisions along the way.

Gandara explains the process to his patients by using the bus analogy: An oncologist has to look for the bus driver among 30 passengers when conducting molecular testing.

Related Videos
Leah Backhus, MD, MPH, FACS, professor, University Medical Line, Cardiothoracic Surgery, co-director, Thoracic Surgery Clinical Research Program, associate program director, Thoracic Track, CT Surgery Residency Training Program, Thelma and Henry Doelger Professor of Cardiovascular Surgery, Stanford Medicine; chief, Thoracic Surgery, VA Palo Alto
Roy S. Herbst, MD, PhD, Ensign Professor of Medicine (Medical Oncology), professor, pharmacology, deputy director, Yale Cancer Center; chief, Medical Oncology, director, Center for Thoracic Cancers, Yale Cancer Center and Smilow Cancer Hospital; assistant dean, Translational Research, Yale School of Medicine
A panel of 4 experts on lung cancer
A panel of 4 experts on lung cancer
5 KOLs are featured in this peer exchange
5 KOLs are featured in this peer exchange
Sam Brondfield, MD, MA
4 KOLs are featured in this series
4 KOLs are featured in this series
5 KOLs are featured in this peer exchange