Treatment Decision Making by Stage for Resectable NSCLC

Opinion
Video

Patrick Forde, MBBCh, and Tina Cascone, MD, PhD, discuss their institution’s approaches to treatment decision making for patients with resectable non-small cell lung cancer.

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

Forde and Cascone discuss the decision-making process for choosing between neoadjuvant, perioperative, or adjuvant therapy in patients with early-stage NSCLC. For stage III disease, there is a strong consensus that patients should receive some form of preoperative treatment due to the significant benefits demonstrated in clinical trials. However, the decision for stage II patients is more challenging.

At The University of Texas MD Anderson Cancer Center, there is a strong inclination to administer a neoadjuvant approach even in stage II patients, as it allows for the assessment of tumor biology and response to treatment at baseline and after surgery, which can be aligned with long-term outcomes. Additionally, patients generally tolerate treatment better before surgery rather than after. However, if a patient undergoes upfront surgery, an adjuvant chemotherapy and immunotherapy paradigm is available for nondriver mutations.

Factors influencing the decision include the surgeon's referral, the patient's willingness to undergo chemotherapy, and the potential benefits of neoadjuvant therapy, such as increased likelihood of receiving and completing systemic therapy, better tolerability, and the ability to assess tumor responsiveness to therapy using pathologic response.

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

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