Optimizing SCLC Management: The Role of Genomics and New Therapies
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Ariel Lopez-Chavez, MD, discusses the role of comprehensive genomic profiling in small cell lung cancer management.
Ariel Lopez-Chavez, MD, medical oncologist, director of precision medicine and developmental therapeutics at Allegheny Health Network Cancer Institute, discusses comprehensive genomic profiling and how it impacts the treatment and clinical management of patients with small cell lung cancer.
He starts by stating that comprehensive genomic profiling in small cell lung cancer management is primarily used for patients who have never smoked, either at diagnosis or when the diagnosis of SCLC is uncertain (e.g., to differentiate it from large cell carcinoma). He also suggests its utility upon relapse to identify potential alternative therapies.
“Mainly it is reserved for patients that have never smoked because small cell lung cancer, being a disease mainly in people that have smoked heavily, whenever we have a patient that has never smoked, comprehensive molecular profiling is important right at diagnosis or when there are questions in regards to the diagnosis of small cell lung cancer. If there is a question of small cell vs large cell carcinoma or the diagnosis is not clear, then definitely it is recommended,” Lopez-Chavez explains.
“The other option would be, once patients relapse, they may be looking for other therapies. Then, comprehensive molecular profiling may offer something there,” he adds.
Lopez-Chavez continues by discussing how oncologists should integrate novel agents into the small cell lung cancer treatment paradigm. He emphasizes the importance of prioritizing participation in clinical trials for these new treatments.
“The first priority is the novel agents entering clinical trials, which I believe should continue to take precedence. Participating in these trials of novel agents should remain a top priority. It will then depend on the readouts from these trials to determine how we will integrate these therapies into practice,” he adds.
In addition, Lopez-Chavez discusses the importance of newer agents, especially in the second-line setting and beyond. He explains that they tend to be favorable compared with other treatments in this space as they tend to be more tolerable.
“These newer agents are a welcome addition to our treatment model for small cell lung cancer.”
