Referral of Early-Stage NSCLC to Multidisciplinary Teams


Panelists examine multidisciplinary teams and coordination of care for patients with non-small cell lung cancer, including when to involve surgeons, oncologists, and radiation oncologists.

This is a video synopsis/summary of a Precision Medicine featuring Patrick Forde, MBBCh, and Tina Cascone, MD, PhD.

Forde and Cascone discuss how patients with early-stage lung cancer are referred to multidisciplinary teams at their respective institutions. At MD Anderson Cancer Center, patients can be referred directly from primary care physicians/community physicians to a multidisciplinary clinic where they see thoracic medical oncology, surgery, and radiation specialists on the same day. Invasive mediastinal staging is often set up in advance by interventional pulmonologists. Another path is through general oncology, where staging and molecular profiling are completed before referral to the multidisciplinary team.

The determination of resectability is crucial, especially with the availability of preoperative therapies. Patients typically undergo a CT scan, biopsy, mediastinal staging, PET scan, brain MRI, and chest CT with intravenous contrast to assess technical and medical resectability. In phase 3 trials of neoadjuvant and perioperative strategies, patients were evaluated by thoracic surgeons to ensure medically and technically resectable tumors prior to enrollment. These trials did not aim to convert unresectable tumors to resectable. The definition of resectability is evolving, with some trials including stage IIIA, IIIB, and multistation N2 disease, but ultimately depends on the surgeon’s assessment and the patient’s fitness for surgery.

Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.

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