Several weeks ago I had the opportunity to discuss several difficult cases with experts Drs. Paul Hesketh from the Lahey Clinic outside of Boston and Karen Kelly from Kansas University Medical Center in Kansas City, KS. These scenarios raise questions about how best to manage lung cancer issues in elderly and/or frail patients, starting with a 78 year-old woman who presented to me for discussion of the pros and cons of post-operative therapy, which also touch on other factors of administering chemotherapy to more marginal patients in general, regardless of the setting.

Here's a podcast from the webinar presentation earlier this month by our beloved Dr. Weiss, covering the open question of whether we should consider giving an EGFR inhibitor like Tarceva (erlotinib) as an adjuvant (post-operative) therapy following potentially curative surgery for early stage NSCLC. It's a setting in which there is a good rationale if we extrapolate from the setting of metastatic NSCLC, at least for patients with an EGFR mutation, but we've made incorrect presumptions before when we extrapolate.