ONCAlert | 2018 SGO Annual Meeting on Women’s Cancer
Lung Cancer Case Studies

Mark Kris, MD: Evaluating Therapeutic Options

Mark Kris, MD
Published Online:Apr 27, 2016
RP is a 72 year old whose past medical history is notable for hypertension (well-controlled), hyperuricemia, and gout. He presents to his PCP with fatigue, progressive dyspnea, and a persistent, nonproductive cough of approximately 1 month's duration. He is a former smoker and quit approximately 30 years ago.

mNSCLC with Mark Kris, MD and Mark Socinski, MD: Case 1



Which, in your view, is more important when evaluating therapeutic options for this patient – age or performance status?

The single most important determinant for prognosis and choice of therapy and to some extent also, prediction of the success of therapy is the performance status, the functional status of the patient. Age is something to consider. However, it is totally trumped by performance status. A young person that is not fit at age 47 will do much less well than a 75-year-old who is fit at that point.

mNSCLC: Case 1

RP is a 72 year old whose past medical history is notable for hypertension (well-controlled), hyperuricemia, and gout. He presents to his PCP with fatigue, progressive dyspnea, and a persistent, nonproductive cough of approximately 1 month’s duration. He is a former smoker and quit approximately 30 years ago.

  • Chest X-ray in October 2015 showed a large mass in the upper left lobe and CT scan showed a left pleural effusion and enlargement of the left mediastinal and hilar lymph node.
  • MRI of the brain was negative for intracranial metastases.
  • The patient underwent resection of the primary mass which showed large cell carcinoma. Pleural fluid was tapped and also positive.
  • His lung cancer was staged as 4. His biopsy was sent for molecular testing and showed no actionable mutations in EGFR or ALK.
  • His current performance status is 1.
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