Communicating Durability and Hope to Patients

Ana I. Velázquez Mañana, MD, MSc, describes how she discusses durability of benefit with patients who have ROS1-positive non-small cell lung cancer (NSCLC) while many trials remain ongoing. She explains the limitations of the available data, balancing hope with realistic expectations. Dr. Velázquez Mañana tells patients she cannot quote a median overall survival; however, most patients remain on therapy and responding for up to 4 years, with some subsets doing worse and others doing better. Julia K. Rotow, MD, and Matthew A. Gubens, MD, MS, note that many patients are young, have never smoked, and arrive expecting months to live, so they emphasize that medians now stretch into years as the field keeps advancing. Dr. Gubens contrasts this with the nihilism of his early training. Estelamari Rodriguez, MD, MPH, and the panel call for outreach to pulmonologists, surgeons, primary care physicians, and pathologists, citing institutional efforts to add RNA sequencing backup and continued use of single-gene tests that waste tissue.