In Treatment

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Transcript

There are many open questions in managing lung cancer, but one of our historical areas that has been especially challenging has been locally advanced/stage III NSCLC, which we most commonly treat with at least two different forms of therapy, such as chemotherapy followed by surgery, chemo and radiation followed by surgery, or (most commonly) chemotherapy and radiation without surgery. Why is it such a controversial area?

Liquid biopsies (also called serum testing) is a practice already approved in Europe for EGFR lung cancer patients. Drawing blood to test for acquired resistance is easier and quicker than needle biopsies. How long until it is standard practice in the US?

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A study released at ASCO 2015 showed that the BRAF V600E mutation had a high response rate to combination therapy Tafinlar (dabrafenib) plus Mekinist (trametinib), which led the doctors to agree that BRAF testing in lung cancer should become commonplace.

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Transcript

A French study presented at ASCO 2015 showed a survival benefit with Avastin (bevacizumab) added to standard chemo, unlike a prior US study. The doctors discuss the influence of this trial and future potential benefits from immunotherapy in mesothelioma.

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Managing brain metastases is a big concern for lung cancer patients. The doctors discuss the drawbacks of whole brain radiotherapy and the fact that there are still unknowns regarding more targeted stereotactic radiosurgery.

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Surgery, specifically a lobectomy or possibly pneumonectomy, has been the longtime historical standard of care for fit patients with early-stage, operable non-small cell lung cancer (NSCLC).

A Japanese study of squamous cell carcinoma showed value in nedaplatin vs cisplatin/Taxotere (docetaxel). But with differences in how Asian versus Caucasian patients metabolize chemotherapy, can we presume this benefit would exist for everyone?

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A trial studying Cometriq (cabozantinib) for RET rearrangements showed a promising response rate, which led the doctors to discuss if they think RET is going to be the next actionable target in lung cancer.

Please feel free to offer comments and raise questions in our Discussion Forums.