85IN - Implications for clinical practice

Date 01 October 2012
Event ESMO Congress 2012
Session Latest innovations in NSCLC management
Topics Non-Small-Cell Lung Cancer, Metastatic
Presenter Martin Reck
Authors M. Reck
  • Thoracic Oncology, Hospital Grosshansdorf, DE-22927 - Grosshansdorf/DE

Abstract

Treatment of advanced non-small cell lung cancer (NSCLC) has become quite complex and differentiated according to a variety of clinical, histological and molecular markers. This development does have several implications on diagnosis and treatment of patients in clinical practice: • Molecular screening for activating EGFR mutations should be routinely performed in patients with advanced non squamous NSCLC. In clinical practice intensification of cooperation between oncologist and pathologist will be crucial in order to optimize the exchange of information and in order to minimize the time to the receipt of the test results. For the future sequential biopsies for the identification of resistance mediating mechanisms will be of increasing importance and should be integrated in the diagnostic algorithm. • In the future a variety of highly specific drugs will be available or investigated in patients with molecular oncogenic alterations which do occur in NSCLC with frequency of less than 5%. In clinical practice it will be essential to create interregional diagnostic and therapeutic networks to be able to identify and to treat most of these patients adequately. • By introducing new targeted therapies in treatment of Lung Cancer also a variety of specific side effects has been established. In clinical practice awareness as well as sufficient management strategies will be crucial to facilitate these therapies. • Maintenance therapies either by targeted agents of by cytotoxic chemotherapy will be of growing importance in the future. Unlike classical cytotoxic chemotherapy these treatments are not characterized by a clear and defined number of cycles but by duration of treatment according to tumor response and tolerability. This new paradigm of treatment does have relevant implication on the interaction and communication between patient and physician. • Most of the efficacy information does come from highly selected trial populations in good Performance status. Unfortunately very few data are available for patients in restricted PS which represents a substantial subgroup of patients in daily life. In summary the integration of new agents and new strategies offers a great chance to improve outcomes of lung cancer patients but changes in diagnosis and treatment schedules will have great implications in clinical practice.

Disclosure

M. Reck: Member of Advisory Board (compensated): Hoffmann-La Roche, Lilly, AstraZeneca, Daiichi-Sankyo, BMS Honoraria for lectures: Hoffmann-La Roche, Lilly, AstraZeneca, Daiichi-Sankyo