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Role of Surgery Could Change Following Durvalumab Approval for Stage III NSCLC

Caroline Seymour
Published: Wednesday, Apr 11, 2018

Benny Weksler, MD, FACS

Benny Weksler, MD, FACS
The use of surgery remains pivotal for patients with stage I and II non–small cell lung cancer (NSCLC); however, surgeons are now less likely to resect tumors patients with stage III disease following the release of the results from the PACIFIC trial and other studies, says Benny Weksler, MD, FACS.

State of the Science Summit™ on Advanced Non–Small Cell Lung Cancer, Weksler, chief, Division of Thoracic Surgery, professor of surgery, University of Tennessee Health Science Center, Eastridge- Cole Endowed Professor of Thoracic Surgery, West Cancer Center, tracked the use of surgery in a biomarker-driven and drug-dependent era and highlighted other cases in which surgery can benefit patients with NSCLC.

OncLive: How is surgery impacted in the biomarker-driven era of NSCLC?

Weksler: For most operable patients with lung cancer, biomarkers are not part of the decision-making process in taking patients to surgery.

How is the role of surgery changing as more systemic regimens are being explored in clinical trials?

We are becoming more minimally invasive and working through small incisions. Up to this point, targeted therapy has not been shown to improve patient outcomes with stage I and II disease. The biggest thing that happened in the last year was the PACIFIC trial, which examined the monoclonal antibody durvalumab to the PD-L1 protein. The trial showed that patients with stage IIIA and IIIB disease had a very significant benefit from 1 year of administration of the antibody. In this group of patients, surgery is not going to be part of their treatment anymore.
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