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Considering the Role of Clinical Trials for Patients With Molecularly Altered Lung Cancers

Sarah B. Goldberg, MD, MPH
Published Online:4:04 PM, Tue September 3, 2019

Sarah B. Goldberg, MD, MPH, associate professor of internal medicine, Yale School of Medicine and Yale Cancer Center, discusses the role of clinical trials in patients with lung cancer who have molecularly altered tumors, such as EGFRALKBRAFROS1, or other alterations. These patients typically consider either targeted therapy or immunotherapy treatment options.

At any stage of disease, whether it is at initial diagnosis or progression of disease, physicians and patients should consider clinical trials as an option. Even when there is a great standard of care available, clinical trials aim to improve upon the standard therapies, Goldberg says, to provide patients with the best outcomes.

Physicians often think about immunotherapy, targeted therapy, chemotherapy, or combination regimens when faced with newly diagnosed patients harboring a molecularly altered tumor. However, Goldberg says these patients are less likely to benefit from immunotherapy; targeted therapy may be the most beneficial frontline option.

After a patient progresses on any therapy, obtaining a biopsy can lead to a better understanding of what happened at that time, and the biopsy can help in determining the next treatment option. There are a number of clinical trials investigating an optimal sequence of treatment in these subsets of patients. Goldberg concludes that at any stage of disease, these clinical trials can improve the treatment of patients.
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