Dr. Rafael Santana-Davila, Assistant Professor of Medicine at the University of Washington, Seattle Cancer Care Alliance joins GRACE to discuss treatment of early stage non-small cell lung cancer.

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.

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.

Dr. Karen Kelly of University of California, Davis, presents her current view on using molecular markers in early stage non-small cell lung cancer and explains the RADIANT study that she leads.

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Dr. Heather Wakelee from Stanford University discusses the open question of whether patients with resectable or locally advanced NSCLC should have testing for molecular markers, as well as how we might use this information in clinical practice.

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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.

The next live webinar to be done through the partnership of GRACE and LUNGevity Foundation will be on the timely subject of using molecular features of a resected non-small cell lung cancer in order to better understand the probability of the cancer recurring. This will be on November 14th, 7 PM Eastern/4 PM Pacific, and will hope to answer the question, "Could these molecular features improve upon current staging efforts to help us refine our recommendations of which patients should receive post-operative chemotherapy in order to reduce the chance of recurrence?"

We've covered the potential value of systemic therapy for early stage NSCLC in a wide range of posts and podcasts, and to summarize what we've learned in a sentence, it's basically that chemotherapy can significantly increase progression-free survival (PFS) and overall survival (OS) in patients who have undergone curative surgery for stage I-III NSCLC, but the benefit is far more convincing in patients with a high enough risk to justify the potential adverse effects of chemotherapy.

The answer is, "Usually pretty early". I tell my patients that the risk is "front-loaded", meaning that we typically see recurrences occur in the first couple of years after curative therapy for lung cancer, if they're going to happen at all. That said, I haven't seen a lot of data that actually illustrates the point, but there was a presentation at ASCO this past year that addressed how well recurrences/disease-free survival predict overall survival after surgery for resectable NSCLC.