The Grey Areas of Lung Cancer

Silvia Novello, MD, PhD, assistant professor, Thoracic Oncology Unit, University of Turin, San Luigi Hospital, Orbassano, Italy, discusses some of the grey areas in lung cancer care.

While repeated chemotherapy is good for patients with stage 2 or 3A lung cancer, little is known about how to treat the early stages of lung cancer, Novello says.

Novello says that the best chemotherapy for patients with lung cancer is unknown. If the lung cancer indication is for chemotherapy, physicians add a platinum compound but do not know which other drug to add to achieve the best results. Until trials are completed, physicians should use the chemotherapy combination they are the most comfortable with.

It is also unknown as to where targeted therapies fall into place in an adjuvant setting, Novello says.At this time, nothing is known about molecules such as EGFR tyrosine kinase inhibitors or anaplastic lymphoma kinase (ALK) inhibitors, so if a tumor tests positive forEGFRor ALK, there is not enough data to treat that patient.

Clinical Pearls

• Little is known about the early stages of lung cancer
• Doctors do not know the best chemotherapy compound to use for patients with lung cancer
• The role of targeted therapies in lung cancer is still unknown