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Treatment Paradigm Evolving in Early-Stage Lung Cancer

Gina Columbus @ginacolumbusonc
Published: Wednesday, Jan 03, 2018

Dan J. Raz, MD

Dan J. Raz, MD
While systemic therapies have steadily moved through the pipeline for patients with non–small cell lung cancer that is more advanced or metastatic, the same cannot be said for those with early-stage disease—even though approximately 50% of this patient population will relapse following surgery and standard chemotherapy. However, the ongoing Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials (ALCHEMIST) are looking to change this.

on Advanced Non–Small Cell Lung Cancer.

OncLive: You spoke on surgical resection in an era of biomarker-driven therapy in lung cancer. What has changed here?

Raz: A lot has changed in lung cancer in general, in terms of personalized medicine and using a patient's own tumor to come up with more specific treatments. I spoke about how it relates to patients with earlier-stage disease who are having surgery. Currently, there is not a whole lot of personalized medicine we do for patients who are undergoing surgery, but there are a lot of advances we are making. There are new clinical trials and some research ideas that I spoke about to try to introduce the topic. 

You mentioned the ALCHEMIST trial in your lecture. Can you discuss that a little bit and the potential impact of this trial’s findings?

That is a very important trial for patients with lung cancer, but especially for those who have earlier-stage disease. What this trial does is it looks at the mutational profile of patients with lung cancer who have undergone surgical resection and earlier stage disease—so stage Ib to IIIa. It allows them to receive standard therapy, but then based on their mutational profile, they get additional therapies if they have certain changes.
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