All of us at the Global Resource for Advancing Cancer Education are very excited to introduce our newest project - the GRACE Spanish Lung Cancer Library. This collection of videos with our Spanish speaking faculty will discuss the basics of lung cancer for Spanish speaking patients and caregivers. For our first video, Antonio Calles, MD, Medical Oncologist, Thoracic Oncology Program, Hospital General Universitario, Gregorio Marraron, Madrid, Spain joined GRACE to discuss what is adjuvant chemotherapy for early stage NSCLC and why it would be recommended.

Dr. Heather Wakelee, Stanford University Medical Center, lists standard adjuvant chemotherapy regimens, comparing their administration and uses.

Dr. Heather Wakelee, Stanford University Medical Center, discusses the purpose of adjuvant chemotherapy, and which patients benefit most from it.

Transcript

Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the primary treatment options for stage IIIA NSCLC, including chemoradiation and surgery, and discusses trial evidence for each approach.

Dr. Edward S. Kim from the Levine Cancer Institute in Charlotte, NC discusses the feasibility of molecular marker testing and targeted therapy in the adjuvant or post-operative setting.

Drs. Ben Solomon, Leora Horn, & Jack West review trial result and implications of ECOG 1505 trial that showed no benefit to addition of Avastin (bevacizumab) to adjuvant chemotherapy for early stage NSCLC.

This is the first in a series of "uncut" videos that I'm starting that will focus on illustrative cases from my clinic that highlight some broader teaching points.  This particular video is on the decision-making process that led me to recommend adjuvant chemotherapy for a patient who underwent surgery for a 3.5 cm lung adenocarcinoma without lymph node involvement.

While post-operative chemotherapy for early stage NSCLC is a well-established standard for relatively healthy patients with stage II or higher resected cancers, the question of whether adjuvant chemotherapy is more likely to help or hurt a patient remains more a matter of debate.

There's a problem in our discussions of standard treatment for patients with higher risk resected early stage NSCLC, and that is that there is a pretty clearly defined standard of care of giving typically around 4 cycles of cisplatin-based chemotherapy to reduce the risk of recurrence, but in truth, the majority of people in the real world don't get it. Still, I wouldn't want to imply that the problem is definitely that doctors aren't giving the right treatment to people who should definitely be getting it.