Podcasts about nonsmall

Dr. Raja Mudad is a medical oncologist specializing in lung cancer at Florida Precision Oncology. In today's ASCO eLearning Podcast, Dr. Mudad will discuss two patient cases related to the treatment of advanced non-small cell lung cancer harboring an EGFR mutation. While the two cases are similar, the recommended treatments can be different. We hope you enjoy this episode. To hear the latest eLearning Podcast episodes as soon as they are available, please subscribe on Apple Podcasts [https://podcasts.apple.com/us/podcast/asco-elearning-weekly-podcasts/id1375021523] or Google Play [https://play.google.com/music/listen?u=0#/ps/Igjyhvqqrvuc5mjvlljhzkpvgeu]. We truly value your feedback, so please leave a review. To access our entire library of podcasts and other amazing eLearning content, visit elearning.asco.org [https://elearning.asco.org/homepage]. The purpose of this podcast is to educate and inform. This is not a substitute for medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello. My name is Raja Mudad. I'm a medical oncologist specializing in lung cancer. I work at Florida Precision Oncology, a practice dedicated to an academic approach in the treatment of cancer. Today, we compare two patient cases that relate to the treatment of advanced stage non-small cell lung cancer harboring an EGFR mutation. These two cases have similarities, yet the recommended treatments may be different. Let us look at the cases. Patient case 1, our first patient case is Roberto. He is a 34-year-old man with stage 4 non-small cell lung cancer harboring an EGFR deletion 19 mutation. The patient, a never smoker, presented with chest pain and was diagnosed with a pulmonary embolus. CT scan of the chest also demonstrated bilateral lung nodules. Biopsy revealed adenocarcinoma. Staging workup revealed multiple small brain metastases. Patient case 2, our second patient case is Heidi. She is a 60-year-old woman with stage four non-small cell lung cancer with an exon 21 mutation in EGFR gene. She presented with a cough. A CT scan of the chest showed a left lung mass. An endobronchial ultrasound guided biopsy revealed no evidence of mediastinal disease. And a biopsy was positive only in the mass showing adenocarcinoma. She was taken to surgery but found to have multiple pericardial nodules. No distant metastases were seen on the PET scan. The two cases are clinically similar. Would any of the differences lead you to select a different treatment for each patient? Let's take a look. The two patients have the exact disease, a similar stage, and mutations in the same EGFR gene. Their initial treatment is the same. The initial treatment in both cases, osimertinib, is considered the standard of care in the United States, with a median progression-free survival of 19 months. Roberto started on treatment with osimertinib, and the follow-up PET scan and brain MRI showed complete resolution of all of the abnormalities. In the second case, surgery was aborted, and the patient started on osimertinib. About 1.5 years after Roberto started on osimertinib, progressive disease developed with a new adrenal mass, a new bone metastasis, and progression in the brain. He received stereotactic radiosurgery to the brain. A repeat biopsy of the adrenal mass revealed the same histology but with a MET amplification detected on next-generation sequencing. About eight months after starting osimertinib, Heidi developed progressive disease, and a repeat biopsy confirmed the same histology and the original EGFR mutation but no additional abnormalities. As you can see, the two cases are similar at presentation. However, upon progression, both cases have peculiarities that make them different. Which differences in the two cases do you think may inform treatment choices? Would the differences lead your choice of treatment in a different direction, or would both patients receive the same treatment? If treatment is different, what is the difference that changes your choice of treatment? The standard of care for non-small cell lung cancer with an EGFR mutation upon progression on first-line tyrosine kinase inhibitor is generally chemotherapy, possibly combined with immunotherapy. In non-small cell lung cancer with an EGFR mutation, there are multiple suggested mechanisms of resistance to osimertinib. These involve new mutations in the EGFR gene, alterations in parallel or downstream oncogenes, such as MET, KRAS, and PIK3CA, or histological transformation to small-cell carcinoma. MET amplification is a very common abnormality seen in those patients. Upon progression, patients have several options, and their treatment should be directed based on the results of the repeat molecular evaluation. That is why it is important to repeat a biopsy on patients with disease progression. Nowadays, liquid biopsy is also helpful in detecting these abnormalities without the need for an actual biopsy. Roberto can benefit from a MET-directed therapy using a tyrosine kinase inhibitor. He did receive stereotactic radiosurgery to the brain due to the presence of mild symptoms. He is clinically doing well, so the need to initiate immediate systemic cytotoxic chemotherapy is not urgent. In this patient, I would offer him an oral MET inhibitor and repeat his imaging in three months. On the other hand, the second patient, Heidi, did not have an actionable mutation upon re-biopsy. The patient is best served by a clinical trial. However, if a trial is not available, or if she is not eligible, then systemic chemotherapy and immunotherapy would be the standard of care. In my practice, and based on the results of the IMpower 150 trial, the use of the combination of carboplatin, paclitaxel, atezolizumab, and bevacizumab is preferred. The subset analysis of the EGFR-positive patients in this trial favored the use of the quadruplet combination. Thank you for listening to this episode of the ASCO eLearning Podcast. For more information on the treatment of non-small cell lung cancer, including additional patient cases and opportunities for self-evaluation, please visit the comprehensive eLearning center at elearning.asco.org. Thank you for listening to this week's episode of the ASCO eLearning weekly podcast. To make this part of your weekly routine, click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive eLearning center at elearning.asco.org.

Colin Lindsay discusses the trial results for AMG 510 – a novel inhibitor targeting the KRAS G12C mutation –  in patients with locally advanced or metastatic non-small-cell lung cancer. Find more on Medicine Matters oncology More from WCLC 2019

A presentation on non-small cell lung cancer featuring perspectives from Dr Matthew Gubens. Introduction (00:00) Evolving Paradigms for Patients with Non-Small Cell Lung Cancer (NSCLC) and EGFR Tumor Mutations (01:12) Immune Checkpoint Inhibition for Patients with Locally Advanced NSCLC (19:27) Recently Approved and Investigational Immunotherapeutic Combinations for Patients with Metastatic NSCLC (32:12) CME information and select publications  

A new treatment gives hope to patients with Unresectable Stage III Non-small Cell Lung Cancer. My guest is Dr. Kristin Higgins, Radiation Oncologist at Winship Cancer Institute of Emory University.        

A new treatment gives hope to patients with Unresectable Stage III Non-small Cell Lung Cancer. My guest is Dr. Kristin Higgins, Radiation Oncologist at Winship Cancer Institute of Emory University.        

Recent research has shown an association between intestinal microbiota and response to immunotherapy in the setting of various tumor types. Listen to Jennifer Wargo, from The University of Texas MD Anderson Cancer Center in Houston, USA, share her insights into the findings. Find more on Medicine Matters oncology This content was originally published on Medicine Matters oncology (https://oncology.medicinematters.com/) on January 28, 2019.

Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the primary treatment options for stage IIIA NSCLC, including chemoradiation and surgery, and discusses trial evidence for each approach.

Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the primary treatment options for stage IIIA NSCLC, including chemoradiation and surgery, and discusses trial evidence for each approach.

Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the primary treatment options for stage IIIA NSCLC, including chemoradiation and surgery, and discusses trial evidence for each approach.

Dr. Mark Socinski, University of Pittsburgh Medical Center, defines the three compartments in stage III (locally advanced) NSCLC, each of which must be treated.

Dr. Mark Socinski, University of Pittsburgh Medical Center, defines the three compartments in stage III (locally advanced) NSCLC, each of which must be treated.

Dr. Mark Socinski, University of Pittsburgh Medical Center, defines the three compartments in stage III (locally advanced) NSCLC, each of which must be treated.

Dr. Jack West, Brendan Bietry, and Janet Freeman-Daily take questions from the audience about financial assistance, legal protections, and patient support.

Dr. Jack West, Brendan Bietry, and Janet Freeman-Daily take questions from the audience about financial assistance, legal protections, and patient support.

Dr. Jack West, Brendan Bietry, and Janet Freeman-Daily take questions from the audience about financial assistance, legal protections, and patient support.

Brendan Bietry of the Patient Advocate Foundation discusses the financial assistance programs available to lung cancer patients who receive targeted therapies.

Brendan Bietry of the Patient Advocate Foundation discusses the financial assistance programs available to lung cancer patients who receive targeted therapies.

Brendan Bietry of the Patient Advocate Foundation discusses the financial assistance programs available to lung cancer patients who receive targeted therapies.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Drs. Jack West and Greg Riely field questions about which treatments should EGFR lung cancer patients consider when their cancers progress.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Dr. Jack West suggests that progression in T790M-negative EGFR lung cancer patients may not require a change in therapy. In this video he details what should go into the decision to modify treatment for those patients.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

Janet Daily-Freeman moderates a question & answer session with Drs. Leora Horn and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for ALK+ and ROS1 patients.

The brain is a common site of disease in patients with ALK+ lung cancer. In this video, Dr. Horn illustrates the line-up of ALK+ treatments and how they work breaking through the blood/brain barrier.

The brain is a common site of disease in patients with ALK+ lung cancer. In this video, Dr. Horn illustrates the line-up of ALK+ treatments and how they work breaking through the blood/brain barrier.

The brain is a common site of disease in patients with ALK+ lung cancer. In this video, Dr. Horn illustrates the line-up of ALK+ treatments and how they work breaking through the blood/brain barrier.

Xalkori (critzotinib) was the first approved treatment for ALK+ and ROS1 lung cancer. Since then, other drugs have been approved or are currently undergoing scientific review. In this video, Dr. Owonikoko outlines these options for patients.

Xalkori (critzotinib) was the first approved treatment for ALK+ and ROS1 lung cancer. Since then, other drugs have been approved or are currently undergoing scientific review. In this video, Dr. Owonikoko outlines these options for patients.

Xalkori (critzotinib) was the first approved treatment for ALK+ and ROS1 lung cancer. Since then, other drugs have been approved or are currently undergoing scientific review. In this video, Dr. Owonikoko outlines these options for patients.

Dr. West moderates a question & answer session with Drs. Leora Horn and Taofeek OwonikokGreg Riely on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. West moderates a question & answer session with Drs. Leora Horn and Taofeek OwonikokGreg Riely on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. West moderates a question & answer session with Drs. Leora Horn and Taofeek OwonikokGreg Riely on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. Greg Riely from Memorial Sloan-Kettering Cancer Center reviews the limited data that help clarify the probability of benefit from new immunotherapy agents among patients with advanced NSCLC and an identified driver mutation.

Dr. Greg Riely from Memorial Sloan-Kettering Cancer Center reviews the limited data that help clarify the probability of benefit from new immunotherapy agents among patients with advanced NSCLC and an identified driver mutation.

Dr. Greg Riely from Memorial Sloan-Kettering Cancer Center reviews the limited data that help clarify the probability of benefit from new immunotherapy agents among patients with advanced NSCLC and an identified driver mutation.

Dr. Leora Horn of Vanderbilt University reviews the rapidly evolving issue and growing value of repeat biospies, including plasma sampling as a "liquid biopsy" option, in the setting of acquired resistance to a driver mutation in advanced NSCLC.

Dr. Leora Horn of Vanderbilt University reviews the rapidly evolving issue and growing value of repeat biospies, including plasma sampling as a "liquid biopsy" option, in the setting of acquired resistance to a driver mutation in advanced NSCLC.

Dr. Leora Horn of Vanderbilt University reviews the rapidly evolving issue and growing value of repeat biospies, including plasma sampling as a "liquid biopsy" option, in the setting of acquired resistance to a driver mutation in advanced NSCLC.

Dr. West moderates a question & answer session with Drs. Karen Reckamp and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.

Dr. West moderates a question & answer session with Drs. Karen Reckamp and Taofeek Owonikoko on issues of acquired resistance to targeted therapies for patients with advanced NSCLC that harbors a driver mutation.