Sorry this is a 2-parter, but I’m concerned about how surgery affects scan frequency and clinical trial inclusion.
In cases of sarcomatoid carcinoma, or any other aggressive and poorly differentiated cancer, should patients be getting scans more frequently to test for recurrence after surgery?
My dad, 72, had a right upper lobe lobectomy/lymphadenectomy on Jan. 16, having previously been treated with chemoradiotherapy (cis-etoposide/46 Gy) for stage IIIa adenocarcinoma. The pathology report indicates sarcomatoid carcinoma—tumor has 50% viable tumor cells, a lymph node has 90%. He does not test positive for an EGFR or ALK mutation. Currently, his pain is manageable but his side effects include persistent fatigue and a worsening cough. He also has some difficulty using his right hand.
With an eye on having a safety net, looking at nivolumab trials online, the inclusion criteria varies. Does surgery disqualify a patient if the criteria simply states, patient has a metastatic tumor or NSCLC with PD-L1 gene expression? The fine print doesn’t mention being chemo-naïve.