POPULARITY
10 episodes with stage iii nsclc
10 episodes with stage iii nsclc
7 episodes with stage iii nsclc
5 episodes with stage iii nsclc
5 episodes with stage iii nsclc
2 episodes with stage iii nsclc
2 episodes with stage iii nsclc
2 episodes with stage iii nsclc
2 episodes with stage iii nsclc
Check out this week's QuadCast as we highlight the role of systemic therapy with SABR in oligometastatic disease, the role of immunotherapy in EGFR-mutated Stage III NSCLC, the role of mirtazepine in cancer-related anorexia, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom
In this episode of Lung Cancer Considered, host Dr. Stephen Liu leads a discussion on the role of neoadjuvant therapy for stage III NSCLC using a virtual tumor board format. This area has become increasingly complex of late, as we have seen several large studies report encouraging results with peri-operative immunotherapy and targeted therapy.
Out Landmarks of OncoPharm series returns to chronicle how treatment of stage III NSCLC has changed over time with an overview of three studies. 1. Dillman (1990) NEJM (sequential chemo --> RT): https://doi.org/10.1056/nejm199010043231403 2. Albain (1995) JCO (concurrent cisplatin/etoposide + RT): https://pubmed.ncbi.nlm.nih.gov/?term=7636530 3. Albain (2009) Lancet (concurrent cis/etposide + RT --> surgery --> consolidation chemo): https://doi.org/10.1016/s0140-6736(09)60737-6
Dr. Navneet Singh joins us again, this time to discuss the rapid recommendation update for stage III non-small cell lung cancer, incorporating updated data presented at the 2023 ASCO Annual Meeting. He discusses the new trials that prompted the guideline update and updated recommendations on adjuvant osimertinib for patients with EGFR exon 19 deletion or exon 21 L858R mutation, and the option of neoadjuvant chemoimmunotherapy for patients with stage III NSCLC. Read the update, "Management of Stage III Non-Small Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update" at www.asco.org/thoracic-cancer-guidelines TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest disclosures in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.23.01261 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Navneet Singh from the Postgraduate Institute of Medical Education and Research in Chandigarh, India, Co-chair on “Management of Stage III Non-Small Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update.” Thank you for being here, Dr. Singh. Dr. Navneet Singh: Thank you for having me. Brittany Harvey: Then, before we discuss this guideline, I'd just like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Singh, who is joining us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to dive into the content of this guideline, first, Dr. Singh, what prompted this rapid update to the ASCO management of stage III non-small cell lung cancer, which was initially published in 2021? Dr. Navneet Singh: There have been a number of studies that have involved patients with stage III non-small cell lung cancer since the publication of the stage III NSCLC management guidelines. Of note, three trials deserve special recognition and have actually formed the basis for this rapid update. These include the ADAURA trial for use of osimertinib as adjuvant treatment for completely resected stages Ib to IIIa NSCLC and harboring a sensitizing EGFR mutation. The other two trials have explored the use of PD-1 immune checkpoint inhibitor therapy in combination with chemotherapy as neoadjuvant treatment of potentially resectable stages I to III NSCLC. And these are the CheckMate 816 trial with nivolumab and the KEYNOTE-671 trial with pembrolizumab. Brittany Harvey: Great, thank you for that background. So then, based off these three new trials that you just mentioned, what are the updated recommendations issued in this rapid recommendation update? Dr. Navneet Singh: The first updated recommendation is based on the overall survival benefit observed in the ADAURA trial. And this recommendation is that patients with dissected stage III NSCLC and harboring an EGFR exon 19 deletion or an exon 21 L858R mutation should be offered adjuvant osimertinib after platinum-based chemotherapy. The second important update is that in the absence of contraindications, patients with stage III non-small cell lung cancer who are planned for surgical resection should receive a neoadjuvant combination of a platinum doublet chemotherapy, and immunotherapy. Now, both of these are based on high-quality evidence and have a strong strength of recommendation. Brittany Harvey: Understood. I appreciate you reviewing both the level of evidence and the strength of the recommendation for those as well. So then, what should clinicians know as these new recommendations are implemented? Dr. Navneet Singh: Now, it's very important for clinicians involved in the management of lung cancer to realize the importance of biomarker testing, something that was initially believed to have relevance only for metastatic disease. But now, with the availability of data indicating the benefit of immunotherapy and targeted therapy not just in metastatic disease but also in early-stage as well as locally advanced disease, clinicians need to ensure that biomarker testing, especially EGFR mutation and PD-L1 expression by approved and validated methods is performed in all patients with stages I to III non-small cell lung cancer. This is important to decide and select patients for the appropriate biological therapy, which is either targeted therapy or immunotherapy that can be used in conjunction with or following chemotherapy. I need to clarify here that the spectrum of biomarker testing that is recommended for metastatic disease is much larger than what is currently being advocated for early or locally advanced NSCLC. Brittany Harvey: Great, and I appreciate that clarification. So then you've just described what this guideline means for clinicians, but how does this rapid update impact patients diagnosed with stage III non-small cell lung cancer? Dr. Navneet Singh: Well, for patients with stage III non-small cell lung cancer, all the three trials that form the basis for this rapid update indicate very encouraging developments. The neoadjuvant chemo-immunotherapy approach is now the standard of care for potentially resectable stage III disease, as this combination has been shown to be superior to chemotherapy alone in terms of higher probability of achieving a complete or major pathological tumor response, as well as improving recurrence or event-free survival following surgical resection. Similarly, adjuvant osimertinib for resected stage III NSCLC patients having a sensitizing EGFR mutation has been shown to significantly improve overall survival compared to placebo. It is important to highlight here that osimertinib treatment in stage III NSCLC should be initiated following the completion of adjuvant chemotherapy. Brittany Harvey: Understood. So then this panel works to rapidly update this guideline, turning it around after the ASCO Annual Meeting. But what are the ongoing research developments that the panel is monitoring for future guideline updates? Dr. Navneet Singh: Well, the expert panel is eagerly awaiting overall survival data from the neoadjuvant chemo-immunotherapy trials. We have several unanswered questions which ongoing research will attempt to answer. And some of these questions include number one, whether adjuvant immunotherapy is beneficial for patients who have already received neoadjuvant chemo-immunotherapy, and if so, what is the optimal duration for the same? Second, is the three-year adjuvant osimertinib duration appropriate? Can lesser duration of treatment suffice for a subgroup of patients? And if so, it would lead to a reduction in both treatment costs as well as a reduction in potential treatment-related adverse effects. On the other hand, other patients in whom stopping at three years may not be warranted, and should patients with exon 19 deletion be treated differently from those with exon 21 L858R mutation? Third, does a similar adjuvant targeted therapy approach be warranted for ALK-rearranged NSCLC that has been surgically resected? And fourth, are there specific subgroups of patients undergoing neoadjuvant treatment in whom immunotherapy as a neoadjuvant treatment may not be effective? Examples are those with EGFR mutations or ALK rearrangements, or even those with no PD-L1 expression. Brittany Harvey: Absolutely. We'll look forward to finding the answer to those questions for future guideline updates. So I want to thank you so much for your work to rapidly update this guideline and thank you for your time today, Dr. Singh. Dr. Navneet Singh: Pleasure. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional 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. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
In this TOGA Podcast, we discuss what defines operability in locally advanced stage III NSCLC. A/Professor Tim Clay, Medical Oncologist from St John of God Subiaco and Rockingham General is joined by Professor Lucy Morgan, Board Chair of the Lung Foundation of Australia and Respiratory Physician from Concord & Nepean Hospitals; A/Professor Phillip Antippa, Cardiothoracic surgeon and the Head of Thoracic Surgical Services at the Royal Melbourne Hospital and the VCCC and also Dr Qurrat van den Blink, Radiation Oncologist from GenesisCare based in Perth (Joondalup) and Albany.
Practical Radiation Oncology associate section editor Ashley Weiner, MD, PhD, of University of North Carolina - Chapel Hill hosts a conversation on the ASTRO Radiation Therapy Summary of the ASCO Guideline on Management of Stage III Non-Small Cell Lung Cancer. Two of the authors, Charles Simone MD, of the New York Proton Center and Memorial Sloan Kettering Cancer Center and George Rodrigues, MD, PhD of the London Health Sciences Center and University of Western Ontario discuss the updated guidelines and review specific questions related to the management of patients with Stage III NSCLC. They focus on the key clinical questions around neoadjuvant therapy, adjuvant therapy, and definitive chemoradiotherapy for Stage III lung cancer with a thorough review of the guidelines and insights into their own clinical expertise in the multidisciplinary management of NSCLC.
In this episode of Lung Cancer Considered, host Dr. Stephen Liu, Director of Thoracic Oncology at Georgetown University, leads a discussion about the management of stage III NSCLC. Joining him are pulmonologist Dr. Martin Reck, Head of the Department of Thoracic Oncology and the Head of the Clinical Trials Department at the Lung Clinic Grosshansdorf and thoracic surgeon Dr. Paula Antonia Ugalde Figueroa, an Associate Surgeon in the Division of Thoracic Surgery at Brigham and Women's Hospital in Boston, MA. Dr. Reck has led many of the oncology trials that have defined the standard of care for lung cancer including KEYNOTE-024 and more recent efforts in stage III NSCLC like KEYNOTE-799. Dr. Ugalde has been a pioneer in minimally invasive surgery from her time as director of Thoracic Oncology research at Laval University in Quebec to her current position at the Dana Farber Cancer Institute. She is currently a member of the Board of Directors of IASLC.
Welcome to the Thoracic Oncology Group of Australasia Podcast series. Associate Professor Shankar Siva, Radiation Oncologist and current Cancer Council Victoria Colebatch Fellow who leads the SABR program at Peter MacCallum Cancer Centre discusses The Management of Stage III NSCLC in this podcast. Shankar is joined by Associate Professor Rachel Wong, Deputy Director of Oncology - Eastern Health, Adjunct Clinical Assoc Professor - Monash University and Clinical Research Fellow – WEHI and also Professor Drew Moghanaki, Chief of Thoracic Oncology, Department of Radiation Oncology at UCLA, Stanley Lezman and Nancy Stark Endowed Chair in Thoracic Radiation Oncology Research, Co-Director Greater Los Angeles Lung Precision Oncology Program and Co-Director Greater Los Angeles CSP NODES Program also joins us today. Our focus today is on what defines inoperable NSCLC, patient selection and how to manage the toxicities associated with treatment.Thank you to AstraZeneca for sponsoring this podcast.
Join our Expert Faculty, Drs. Joel W. Neal, MD, PhD and Victoria Sherry, DNP, CRNP, AOCNP as they discuss treatment principles across the continuum of care in unresectable, stage III NSCLC. During their presentations and discussion, they will examine the established treatment landscape for unresectable, stage III NSCLC as well as the emerging role of immunotherapy, and practical clinical considerations for anticipating, mitigating, and managing immune-related adverse events.Presented by Creative Educational Concepts, LLC.Supported through an independent educational grant from AstraZeneca.
Dr Jeffrey Bradley from the Emory University School of Medicine in Atlanta, Georgia, and Dr David Spigel from the Sarah Cannon Research Institute in Nashville, Tennessee, discuss the past, present and future management of unresectable Stage III non-small cell lung cancer. CME information and select publications here (http://www.researchtopractice.com/OncologyTodayStageIIINSCLC22).
An interview with Dr. Megan Daly from University of California in Davis, California and Dr. Navneet Singh from the Postgraduate Institute of Medical Education & Research in Chandigarh, India, co-chairs on “Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline.” They summarize guideline recommendations on five subtopics – evaluation & staging, surgery, neoadjuvant therapy, adjuvant therapy, and unresectable disease. Read the full guideline at www.asco.org/thoracic-cancer-guidelines. TRANSCRIPT [MUSIC PLAYING] ANNOUNCER: The purpose of this podcast is to educate and to inform. This is not a substitute for professional 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. BRITTANY HARVEY: Hello, and welcome to the ASCO Guidelines podcast series, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at ASCO.org/podcasts. My name is Brittany Harvey, and today, I'm interviewing Dr. Megan Daley from University of California in Davis, California, and Dr. Navneet Singh from the Post-Graduate Institute of Medical Education and Research in Chandigarh, India, co-chairs on management of stage III non-small cell lung cancer ASCO guideline. Thank you for being here, Dr. Daley and Dr. Singh. MEGAN DALEY: Thank you for having us. NAVNEET SINGH: Thank you for having us, too. BRITTANY HARVEY: First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Daley, do you have any relevant disclosures that are directly related to this guideline topic? MEGAN DALEY: I have research funding from EMD Serono, Merck, and Genentech. BRITTANY HARVEY: Thank you for those disclosures. Then Dr. Singh, do you have any relevant disclosures that are directly related to this guideline? NAVNEET SINGH: No, I have no financial conflicts of interest. BRITTANY HARVEY: Thank you. Getting into the content of this guideline, Dr. Singh, can you give us an overview of both the scope and the purpose of this guideline? NAVNEET SINGH: Yes, absolutely. So this guideline has been developed to assist clinicians involved in the management of patients with stage III non-small-cell lung cancer, or NSCLC, as we call it briefly. Now, stage III NSCLC represents one of the most heterogeneous subgroups of lung cancer. Consequently, it is also the subgroup in which the choice of multimodality treatment and the sequence of multimodality treatment varies significantly amongst clinicians, with variations being observed across institutes, as well as within an institute. And we sincerely hope that, with the help of this guideline, clinicians can accurately confirm the presence of stage III disease and offer the most appropriate treatment based on clinical and radiographic characteristics, as well as other medical factors that influence treatment decision-making. This evidence-based guidance also seeks to provide clarification on the common clinical dilemmas that clinicians may have while evaluating a patient with suspected or known stage III NSCLC. BRITTANY HARVEY: Thank you for that background information, Dr. Singh. Then, Dr. Daley, this guideline addresses five main sections, evaluation and staging, surgery, neoadjuvant therapy, adjuvant therapy, and unresectable disease. So starting with evaluation and staging, what are the key recommendations for workup for patients with suspected stage III non-small cell lung cancer? MEGAN DALEY: Our first recommendation for such patients is that they should undergo a history and physical exam and a CT scan of the chest and upper abdomen with contrast, unless it's contraindicated. If metastatic disease is not identified on CT, those patients should go on to a PET CT scan and MRI of the brain. If the patients are being considered for curative intent treatment, the guideline recommends pathologic mediastinal lymph node assessment. And we recommend that endoscopic techniques should be offered as the initial staging modality, if available. If not available, invasive surgical mediastinal staging should be offered. And finally, for patients who have suspected or confirmed stage III lung cancer, we recommend that multidisciplinary discussion should occur prior to any initiation of a treatment plan. BRITTANY HARVEY: Great, I appreciate your reviewing those recommendations. So following that, Dr. Singh, what does the guideline recommend regarding which patients with stage III non-small-cell lung cancer should be considered for surgical resection? NAVNEET SINGH: So in this guideline, the recommendation which has come forth is that for patients with stage IIIA, basically N2 disease, induction therapy should be followed by surgery with or without adjuvant therapy if several conditions are met. Basically, a complete resection of the primary tumor and the involved lymph nodes is deemed feasible, and three nodes or contralateral lymph nodes are deemed to be not involved, and the expected perioperative 90-day mortality is low, typically 5% or less. Another recommendation is that for selected patients with the P4N0 disease, surgical resection may be offered if medically and surgically feasible following multidisciplinary review. We would like to emphasize here that surgeons should always be involved in decisions regarding the feasibility of surgical resection. And they are an integral part of a multidisciplinary evaluation for surgical resection for stage III NSCLC patients. BRITTANY HARVEY: Great. Then Dr. Singh just reviewed who should be considered for surgical resection. So Dr. Daley, for patients with potentially resectable stage III non-small-cell lung cancer, what are the key recommendations for neoadjuvant therapy? MEGAN DALEY: Our first recommendation is that patients who are planned for a multimodality approach that will incorporate surgery should receive systemic neoadjuvant therapy. Second, that those patients with N2 disease who are planned for surgical resection should receive either neoadjuvant chemotherapy or neoadjuvant concurrent chemoradiation. And finally, for patients with a resectable superior sulcus tumor, neoadjuvant concurrent chemoradiation should be administered. BRITTANY HARVEY: Understood. Then in addition, Dr. Singh, for patients with resected stage III non-small-cell lung cancer, what are the key recommendations for adjuvant therapy? NAVNEET SINGH: So the panel came up with three recommendations for adjuvant treatment. The first is that patients with resected stage III NSCLC who did not receive neoadjuvant systemic therapy should be offered adjuvant platinum-based chemotherapy. The second recommendation which we came up was that for patients with resected stage III disease and presence of a sensitizing EGFR mutation-- classically, exon 19 deletion or the L858R exon 21 point mutation-- they may be offered adjuvant osimertinib, which is an EGFR inhibitor, after platinum-based chemotherapy. And this is based upon the ADAURA trial, which was published last year. And the third recommendation was that for patients with completely resected NSCLC and mediastinal involvement N2 disease, but without extracapsular extension, post-operative radiotherapy should not be routinely offered. BRITTANY HARVEY: OK. And then the last section of recommendations covers unresectable disease. So Dr. Daley, what does the guideline recommend regarding the management of unresectable stage III non-small-cell lung cancer? MEGAN DALEY: The guideline first recommends that these patients who have a good performance status should be offered concurrent, rather than sequential, chemoradiation, that concurrent chemotherapy delivered with radiation should include a platinum-based doublet, preferably cisplatin-etoposide, carboplatin-paclitaxel, or cisplatin-pemetrexed or cisplatin-vinorelbine. The patients who are not candidates for concurrent chemoradiation, but who are potentially candidates for chemotherapy, should be offered sequential chemoradiation, rather than radiation alone, that patients receiving concurrent chemoradiation should be treated to 60 gray. And that's based on the results of RTOG 0617. We also recommend within the guideline that doses higher than 60 gray and up to 70 gray could be considered for selected patients, with careful attention to doses to the heart, lung, and esophagus, among other organs. The guideline also recommends that patients receiving definitive radiation without chemotherapy, that hypofractionation using slightly larger doses could be considered-- over 2 gray per fraction, and up to 4 gray per fraction, and that patients without disease progression during concurrent chemoradiation should be offered consolidation durvalumab, based on the PACIFIC trial. BRITTANY HARVEY: Thank you both, then, for reviewing the key recommendations of this guideline. So, Dr. Singh, in your view, what is the importance of this guideline, and how does it impact clinicians? NAVNEET SINGH: I think this guideline will go a long way in helping clinicians who are involved in the diagnosis and treatment of lung cancer, especially stage III NSCLC. As mentioned earlier, this is a very heterogeneous disease. And there are several challenging situations, both in the context of diagnosis, as well as treatment. And using this guideline, which has an extensive evidence review, as well as the development of two very helpful algorithms, we sincerely hope that clinicians who are both in academic centers as well as in practice in the community are able to accurately diagnose stage III, appropriately stage it, and offer the best treatment, given the patient characteristics and the disease characteristics and available resources. BRITTANY HARVEY: Great. Those are important points. So then, finally, Dr. Daley, how will these guideline recommendations affect patients? MEGAN DALEY: Well, we hope very much that these guidelines will help patients consistently receive high-quality care for their stage III lung cancer. In particular, we're hoping that the recommendation from multidisciplinary assessment of patients prior to treatment is carefully followed. We're hoping that some of the recommendations surrounding the appropriate workup for patients may help ensure that all patients receive a thorough and complete workup prior to initiation of treatment. And the guideline, in particular, is highlighting some of the more recent developments in stage III lung cancer, such as the use of consolidation durvalumab based on the PACIFIC trial, the use of osimertinib in resectable disease based on the ADAURA trial. And we're hoping to make sure that these results are disseminated to practitioners everywhere so that patients can receive the latest and best care for their stage III lung cancer. BRITTANY HARVEY: Understood. Yeah, as you both mentioned, we hope that this has a positive impact for both clinicians and patients. So I want to thank you both for all of your hard work to develop this guideline and the evidence-based recommendations along with it. And thank you for taking the time to speak with me today, Dr. Daley and Dr. Singh. MEGAN DALEY: Thank you so much for having us. NAVNEET SINGH: Thank you. BRITTANY HARVEY: And thank you to all of our listeners for tuning into the ASCO Guidelines podcast series. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO guidelines app, available in iTunes or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. [MUSIC PLAYING]
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Go online to PeerView.com/DDV860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The broad implications of the expanding role of cancer immunotherapies in lung cancer necessitate multidisciplinary collaboration, especially in the locally advanced setting where appropriate patient evaluation and selection for immune checkpoint inhibitors (ICIs) along with other multimodal therapies requires input from a medical oncologist, a radiation oncologist, as well as a thoracic surgeon, among other specialists. Effective communication and coordination of care are also essential in the management of patients with unresectable stage III non–small cell lung cancer (NSCLC) deemed to be good candidates for consolidation ICI therapy after chemoradiation. How should this be operationalized in real-world settings? Learn useful strategies from this PeerView MasterClass and Tumor Board based on a recent web broadcast, which delivers evidence-based guidance on the best practices related to multidisciplinary patient assessment and treatment planning to help you improve outcomes in your patients with stage III NSCLC. Our panel of experts navigates through the latest evidence, key challenges, and controversies, as well as debates a series of real cases to demonstrate how to individualize patient care in the midst of rapid research and clinical advances. Upon completion of this activity, participants should be better able to: Discuss the latest clinical evidence on cancer immunotherapy in unresectable stage III NSCLC, Collaborate with relevant specialists to stage lung cancer, assess tumor resectability, and develop individualized treatment plans for patients with stage III NSCLC, Integrate cancer immunotherapies into the management of patients with unresectable stage III NSCLC according to the latest evidence and guidelines, multidisciplinary/interprofessional perspectives, and patient treatment and quality of life goals, Apply effective strategies to identify and manage immune-related adverse events in patients receiving cancer immunotherapy for unresectable stage III NSCLC treatment.
Dr. Aggarwal and Dr. Girard discuss the significance of the 5-year survival data from the pivotal PACIFIC trial and the real-world benefit of the study regimen in patients with unresectable stage III NSCLC.
Dr. Dietrich discusses the latest developments with immunotherapy and targeted therapy in stage III non–small cell lung cancer.
Featuring an interview with Dr Joel Neal, including the following topics: Analyze the biologic basis for the investigation of immune checkpoint inhibitors for nonmetastatic non-small cell lung cancer (NSCLC), and evaluate available and emerging data documenting the efficacy and safety of anti-PD-1/PD-L1 antibody-based approaches to (neo)adjuvant therapy. Review recent therapeutic advances with anti-PD-1/PD-L1 antibodies as monotherapy or in combination with chemotherapy or other immunotherapies for metastatic NSCLC, and discern how these approaches can be optimally employed in disease management. Appraise updated data on the efficacy of anti-PD-L1 antibody consolidation therapy for patients with unresectable Stage III NSCLC who have not experienced disease progression after standard platinum-based chemotherapy concurrent with radiation therapy, and discern how this strategy can be appropriately and safely integrated into routine clinical practice. Review published research data documenting the safety and efficacy of EGFR tyrosine kinase inhibitors alone or in combination with other systemic approaches for metastatic NSCLC with an EGFR tumor mutation, and discern how this information should be applied outside of a research setting. Assess the efficacy of commercially available ALK inhibitors for patients with metastatic NSCLC with an ALK rearrangement, and apply this understanding to the selection and sequencing of these drugs as first- and later-line therapy. Recognize other oncogenic pathways (ie, RET, MET, HER2, KRAS, ROS1) mediating the pathogenesis of tumors in unique patient subsets, and recall published and emerging data with commercially available and experimental agents exploiting these targets. Design an optimal approach to the clinical care of patients with small cell lung cancer, considering available and emerging clinical trial findings. Assess the biologic rationale for ongoing clinical trials evaluating novel agents and strategies for NSCLC, and counsel appropriate patients about availability and participation. CME information and select publications
Featuring slide presentations and related discussion from Dr Walter J Curran Jr and Ms Camille Usher, including the following topics: Immune Checkpoint Inhibition in the Management of Locally Advanced NSCLC — Walter J Curran Jr, MD (0:00) Case: A man in his mid-50s with unresectable Stage IIIA T2N2M0 squamous cell carcinoma of the lung who receives durvalumab after chemoradiation therapy — Dr Curran (11:42) Case: A woman in her mid-40s and a never smoker with Stage III NSCLC and an EGFR mutation — Dr Curran (14:32) Case: A man in his early 60s with locally advanced NSCLC and a recent myocardial infarction — Dr Curran (19:46) Case: A man in his early 70s and a past smoker who presents with a cough and fever and is diagnosed with Stage IIIB NSCLC — Camille Usher, MS, APRN NP-C (32:41) Case: A woman in her mid-70s and a smoker with a history of breast cancer who is diagnosed with lung adenocarcinoma — Ms Usher (47:27) Case: A woman in her early 60s with Stage IIIA T1bN2 adenocarcinoma of the lung — Ms Usher (52:40) Case: A man in his mid-70s who developed pneumonitis after chemoradiation therapy — Ms Usher (1:02:22) CME and NCPD information and select publications
This program includes faculty lectures by Drs Benjamin Levy of Johns Hopkins Sidney Kimmel Cancer Center and Stephen Liu of Georgetown University on immune checkpoint inhibitors after chemotherapy with radiation therapy for Stage III NSCLC and toxicity reported in the PACIFIC trial. Access NCPD information and select publications here.
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Victoria Villaflor, MD, Clinical Professor, Director Head and Neck Oncology at City of Hope, discuss unresectable stage III Non Small Cell Lung Cancer (www.azioinpractice.com)
Robert Figlin, MD, Steven Spielberg Family Chair in Hematology-Oncology, Cedars-Sinai Medical Center, and Victoria Villaflor, MD, Clinical Professor, Director Head and Neck Oncology at City of Hope, discuss unresectable stage III Non Small Cell Lung Cancer (www.azioinpractice.com)
Host: Jennifer Caudle, DO Guest: Alexander Whitley, MD Guest: Alejandro Calvo, MD Guest: Kim Rohan, MS APN, AOCN At the 2019 ASTRO Annual Meeting, radiation oncologist Dr. Alexander Whitley, medical oncologist Dr. Alejandro Calvo, and nurse practitioner Kim Rohan came together to share their experiences working as part of a multidisciplinary team to care for patients with unresectable Stage III non-small cell lung cancer. US-32360 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Kristin Higgins, MD Concurrent chemoradiation therapy is the recommended treatment for unresectable Stage III NSCLC patients. Dr. Jennifer Caudle is joined by Dr. Kristin Higgins to discuss advances in radiation that optimize the treatment plan and her best practices to help patients receive a full course of curative-intent treatment. US-32345 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Kristin Higgins, MD Concurrent chemoradiation therapy is the recommended treatment for unresectable Stage III NSCLC patients. Dr. Jennifer Caudle is joined by Dr. Kristin Higgins to discuss advances in radiation that optimize the treatment plan and her best practices to help patients receive a full course of curative-intent treatment. US-32345 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Kristin Higgins, MD Concurrent chemoradiation therapy is the recommended treatment for unresectable Stage III NSCLC patients. Dr. Jennifer Caudle is joined by Dr. Kristin Higgins to discuss advances in radiation that optimize the treatment plan and her best practices to help patients receive a full course of curative-intent treatment. US-32345 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Alexander Whitley, MD Guest: Alejandro Calvo, MD Guest: Kim Rohan, MS APN, AOCN At the 2019 ASTRO Annual Meeting, radiation oncologist Dr. Alexander Whitley, medical oncologist Dr. Alejandro Calvo, and nurse practitioner Kim Rohan came together to share their experiences working as part of a multidisciplinary team to care for patients with unresectable Stage III non-small cell lung cancer. US-32360 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Alexander Whitley, MD Guest: Alejandro Calvo, MD Guest: Kim Rohan, MS APN, AOCN At the 2019 ASTRO Annual Meeting, radiation oncologist Dr. Alexander Whitley, medical oncologist Dr. Alejandro Calvo, and nurse practitioner Kim Rohan came together to share their experiences working as part of a multidisciplinary team to care for patients with unresectable Stage III non-small cell lung cancer. US-32360 Last Updated 12/19
Host: Jennifer Caudle, DO Guest: Timothy Kruser, MD Recorded live at the 2019 ASTRO Annual Meeting in Chicago, Illinois, tune in to hear Dr. Timothy Kruser share key updates from the PACIFIC study. IMFINZI® (durvalumab) is indicated for the treatment of adult patients with unresectable Stage III NSCLC whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy. Select Safety Information: Serious, potentially fatal risks were seen with IMFINZI in the PACIFIC trial. The most frequent serious adverse events (occurring in greater than or equal to 2% of patients) were pneumonitis or radiation pneumonitis and pneumonia. Immune-mediated adverse reactions, including immune-mediated pneumonitis, hepatitis, colitis, endocrinopathies (including thyroid disorders, adrenal insufficiency, type 1 diabetes, and hypophysitis), nephritis, dermatologic reactions, and other immune-mediated adverse reactions, infection, and infusion-related reactions were reported in patients receiving IMFINZI in the PACIFIC trial. Scroll for additional Important Safety Information and Link to PI. US-36842 Last Updated 05/20
Host: Jennifer Caudle, DO Guest: Timothy Kruser, MD Recorded live at the 2019 ASTRO Annual Meeting in Chicago, Illinois, tune in to hear Dr. Timothy Kruser share key updates from the PACIFIC study. IMFINZI® (durvalumab) is indicated for the treatment of adult patients with unresectable Stage III NSCLC whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy. Select Safety Information: Serious, potentially fatal risks were seen with IMFINZI in the PACIFIC trial. The most frequent serious adverse events (occurring in greater than or equal to 2% of patients) were pneumonitis or radiation pneumonitis and pneumonia. Immune-mediated adverse reactions, including immune-mediated pneumonitis, hepatitis, colitis, endocrinopathies (including thyroid disorders, adrenal insufficiency, type 1 diabetes, and hypophysitis), nephritis, dermatologic reactions, and other immune-mediated adverse reactions, infection, and infusion-related reactions were reported in patients receiving IMFINZI in the PACIFIC trial. Scroll for additional Important Safety Information and Link to PI. US-36842 Last Updated 05/20
Visiting Professors: Lung Cancer Edition — Part 2: Our discussion with Drs Horn and Ma highlights the following topics as well as cases from Dr Ma’s practice: Case: A woman in her mid-70s with Stage IV lung adenocarcinoma and a PD-L1 TPS of 70% experiences a pathologic fracture of the right femur while receiving first-line pembrolizumab (00:00) Pembrolizumab monotherapy versus carboplatin/pemetrexed/pembrolizumab as first-line therapy for patients with metastatic NSCLC and a high TPS (02:30) Radiation necrosis as a potential cause of pathologic fractures (05:18) Thyroid dysfunction and pancreatitis associated with pembrolizumab (08:12) Case: A man in his early 50s with metastatic lung cancer of ambiguous histology experiences a dramatic response to first-line nab paclitaxel/carboplatin (11:11) Utility of liquid biopsies in therapeutic decision-making for patients with metastatic lung cancer (13:03) Therapy for patients with metastatic lung cancer and CNS metastases (15:11) Therapeutic approach for patients with metastatic lung cancer of undetermined histology (20:30) Second-line therapy for patients with metastatic lung cancer (22:41) Case: A woman in her mid-80s with metastatic lung adenocarcinoma and a PD-L1 TPS of 30% receives pemetrexed/pembrolizumab and experiences dyspnea (28:14) Perspective on the approach to metastatic lung adenocarcinoma in elderly patients (30:52) Efficacy of ramucirumab as second-line therapy for patients with metastatic NSCLC (36:24) REVEL: Results of a Phase III trial evaluating the addition of ramucirumab to docetaxel after disease progression on platinum-based therapy for patients with Stage IV NSCLC (37:44) Comparison of the activity and tolerability of ramucirumab to that of bevacizumab in patients with metastatic squamous cell carcinoma of the lung (40:11) Ongoing clinical investigation of novel combination approaches with immune checkpoint inhibitors and anti-angiogenic agents (41:49) Case: A man in his mid-70s, a former smoker, with Stage III NSCLC initially treated with adjuvant chemoradiation therapy develops metastatic disease and is found to have a RET tumor mutation (43:40) Effects of tumor mutation burden and PD-L1 expression on response to immune checkpoint inhibitors (47:32) Perspective on the use of targeted therapy as first-line treatment for patients with metastatic NSCLC (49:32) Sequencing targeted therapy and immune checkpoint inhibitors for patients with metastatic NSCLC and actionable tumor mutations (51:08) Case: A woman in her early 60s with lung adenocarcinoma and oligometastatic disease in the brain receives first-line chemoradiation therapy (56:39) Cardiomyopathy associated with checkpoint inhibitor therapy (1:00:08) Prolonged responses to anti-PD-1/PD-L1 antibodies after cessation of therapy (1:03:27) PD-L1 expression as a predictor of response to immune checkpoint inhibitors (1:07:40) Case: A man in his early 70s with metastatic NSCLC develops a severe carboplatin-related allergy during treatment with carboplatin/nab paclitaxel/pembrolizumab (1:09:41) Benefits of early palliative care in the management of metastatic NSCLC (1:15:22) CME information and select publications
Visiting Professors: Lung Cancer Edition — Part 1: Our discussion with Drs Levy and Lobins highlights the following topics as well as cases from Dr Lobins’s practice: Case: A man in his early 60s, a current smoker, with metastatic lung adenocarcinoma and a PD-L1 tumor proportion score (TPS) of 80% experiences a dramatic response to first-line pembrolizumab but a recurrence of small lymphocytic lymphoma (SLL) during therapy (00:00) Activity and tolerability of immune checkpoint inhibitors alone or with chemotherapy as first-line therapy in patients with metastatic non-small cell lung cancer (NSCLC) (02:30) Duration of therapy with immune checkpoint inhibitors (05:28) Perspectives on the effects of recent advances in the management of lung cancer on the practice of oncology (09:16) Potential correlation between recurrence of chronic lymphocytic leukemia or SLL and treatment with anti-PD-1/PD-L1 antibodies (11:02) Case: A woman in her late 50s with a history of autoimmune uveitis is diagnosed with NSCLC and multiple metastases in the brain (13:46) Side effects associated with whole-brain radiation therapy (14:55) Use of immune checkpoint inhibitors for patients with preexisting autoimmune disorders (17:45) Therapeutic options for patients with metastatic NSCLC in the second-line setting (22:05) Results of the Phase III REVEL trial investigating ramucirumab with docetaxel as second-line therapy for patients with metastatic NSCLC (24:16) Activity of ramucirumab in patients with squamous cell NSCLC and those with prior exposure to bevacizumab (25:45) Side effects and tolerability of ramucirumab and bevacizumab (26:46) Case: A man in his early 50s, a current smoker, with metastatic lung adenocarcinoma and a BRAF non-V600E tumor mutation receives first-line carboplatin/pemetrexed/pembrolizumab (29:19) Hemoptysis as a presenting symptom of lung cancer (30:28) Clinical care of patients with metastatic NSCLC and no identified targetable tumor mutations (32:58) Novel agents and approaches under investigation for lung cancer (36:11) Mechanisms of resistance to immunotherapy (39:15) Monitoring for immune-related adverse events in patients receiving immune checkpoint inhibitors (41:31) Case: A woman in her mid-50s with large cell neuroendocrine carcinoma of the lung and a solitary metastasis in the brain (43:20) Perspective on the management of oligometastatic disease (45:55) Therapeutic options for patients with metastatic large cell neuroendocrine carcinoma of the lung (48:10) Management of metastatic small cell lung cancer in the second-line setting (51:07) Case: A man in his early 80s with severe pulmonary fibrosis is diagnosed with metastatic NSCLC (54:40) Challenges in the management of pulmonary fibrosis in elderly patients with lung cancer (58:22) Biologic rationale for and emerging data with immune checkpoint inhibitors in combination with anti-angiogenic agents (1:01:13) Benefits and challenges of integrating early palliative care into the management of metastatic lung cancer (1:03:55) Case: A man in his late 60s with metastatic NSCLC with KRAS and p53 tumor mutations experiences disease progression on multiple lines of therapy (1:06:27) Therapeutic approach for patients with metastatic NSCLC in the late-line setting (1:08:26) Case: A woman in her early 20s initially diagnosed with unresectable Stage III NSCLC with mutations in ROS1 and p53 develops metastatic disease (1:13:22) Activity and tolerability of crizotinib and lorlatinib in patients with metastatic NSCLC and ROS1 tumor mutations (1:15:37) Sequencing therapies for patients with metastatic NSCLC and ROS1 tumor mutations (1:18:23) CME information and select publications
Video proceedings from the third in a series of 6 integrated symposia held at the 2019 ONS Annual Congress. Featuring perspectives from Dr Edward B Garon, Dr Matthew Gubens, Ms Blanca Ledezma and Ms Wendi S Lee. Introduction (0m0s) Program overview: Dr Love Historical Treatment Paradigms and Related Outcomes for Patients with Stage III Non-Small Cell Lung Cancer (NSCLC); Biologic Rationale for the Evaluation of Immune Checkpoint Inhibitors in This Setting (00:54) Case (Ms Lee): A woman in her early 70s with Stage IIIA adenocarcinoma of the lung who received concurrent chemoradiation therapy and developed Grade 2 esophagitis (1:16) Available Efficacy Data with and Indications for Durvalumab Consolidation in Unresectable Stage III Disease (16:22) Case (Ms Ledezma): A man in his early 70s who received chemoradiation therapy and consolidation durvalumab for new primary Stage III NSCLC after undergoing treatment for Stage IIIB disease 10 years prior (16:34) Case (Ms Lee): A woman in her early 70s with Stage IIIB adenocarcinoma of the lung who underwent concurrent chemoradiation therapy followed by durvalumab consolidation (28:59) Incidence, Recognition and Management of Immune-Mediated and Other Toxicities Associated with the Use of Durvalumab in Unresectable Stage III Disease (55:03) Case (Ms Ledezma): A man in his mid-70s with Stage IIIA NSCLC who enrolled on a clinical trial of neoadjuvant atezolizumab and developed pneumonitis (1:8:31) Case (Ms Ledezma): A woman in her early 50s who was found to have a Stage III adenocarcinoma of the lung with an EGFR tumor mutation while undergoing workup for breast cancer and received chemoradiation therapy and durvalumab consolidation (1:13:58) Case (Ms Lee): A man in his 50s with Stage IIIA adenocarcinoma of the lung who received chemoradiation therapy and consolidation durvalumab after undergoing lobectomy (1:17:10) Select publications
Lung Cancer for Radiation Oncologists — Part 1: Our interview with Dr Rimner highlights the following topics and cases from his practice: Evaluation, staging and typical disease management approaches for patients with locally advanced non-small cell lung cancer (NSCLC) (00:00) Selection and dose of postoperative radiation therapy (RT) (3:34) Stereotactic body RT (SBRT) versus surgery for patients with early-stage NSCLC (8:57) Case: A man in his mid-70s, a former smoker, with Stage IIIC adenocarcinoma of the lung receives durvalumab consolidation after chemoradiation therapy (CRT) (11:52) Optimal design of the radiation treatment field; mitigation of RT-associated side effects (14:05) Results of the Phase III RTOG-0617 trial evaluating carboplatin/paclitaxel in combination with standard- versus high-dose conformal RT, with or without cetuximab, for Stage III NSCLC (18:19) Role of RT in enhancing tumor immunogenicity (22:47) Avoiding safety concerns with the combination of CRT and immune checkpoint inhibitors (26:41) Activity and tolerability of pembrolizumab after RT in patients with NSCLC on the Phase I KEYNOTE-001 trial (29:09) PACIFIC trial: Efficacy and tolerability of durvalumab after CRT for patients with unresectable Stage III NSCLC (31:00) Activity of durvalumab after CRT; diagnosis and management of pneumonitis associated with durvalumab/CRT (36:14) Ongoing Phase II trial evaluating the activity and safety of nintedanib with prednisone for the treatment of radiation pneumonitis (39:51) Incidence of pneumonitis with CRT alone and with the addition of durvalumab (43:19) Survival outcomes and duration of consolidation therapy with durvalumab (44:33) Ongoing evaluation of immune checkpoint inhibitors with concurrent RT with or without chemotherapy (47:53) Activity of immune checkpoint inhibitors in the neoadjuvant setting (50:04) Selection of the optimal dose and technique of RT for locally advanced NSCLC (51:57) Case: A woman in her early 70s with unresectable Stage IIIB adenocarcinoma of the lung and a KRAS mutation receives CRT followed by durvalumab (56:12) Clinical experience with the use of durvalumab after CRT (58:44) Case: A woman in her mid-50s with Stage III adenocarcinoma of the lung and an EGFR mutation receives adjuvant osimertinib (1:1:44) Increased RT precision with the merging of MRI and a linear accelerator (1:5:46) Select publications
Lung Cancer for Radiation Oncologists — Part 2: Our interview with Dr Langer highlights the following topics and cases from his practice: Case: A woman in her mid-60s, a never smoker, with locally advanced, unresectable adenocarcinoma of the lung and an EGFR exon 18 tumor mutation receives CRT followed by consolidation durvalumab (00:00) Clinical significance and prognostic relevance of microsatellite instability testing in the management of lung cancer (1:29) Risk of recurrence after concurrent CRT for patients with Stage III NSCLC (3:05) Improvement in progression-free and overall survival with the addition of consolidation durvalumab after CRT for patients with Stage III NSCLC on the PACIFIC trial (5:25) Role of immune checkpoint inhibition in the treatment of locally advanced NSCLC with an EGFR tumor mutation (10:15) Perspective on the use of EGFR tyrosine kinase inhibitors in the adjuvant or neoadjuvant setting for patients with locally advanced NSCLC and EGFR tumor mutations (12:50) Initial diagnostic workup and disease management for patients with locally advanced NSCLC (17:17) RTOG-1308: An ongoing Phase III trial of photon versus proton CRT for patients with inoperable Stage II to Stage IIIB NSCLC (19:27) Role of proton beam RT in the treatment of locally advanced NSCLC (21:44) Rationale for the combination of RT and immune checkpoint inhibitors (24:20) Risk of pneumonitis with CRT (26:07) Design and results of the Phase III PACIFIC trial of durvalumab after CRT for unresectable Stage III NSCLC (27:55) Monitoring and management of the toxicities associated with immune checkpoint inhibitors (32:03) Use of durvalumab for patients with preexisting autoimmune disease and for transplant recipients (35:07) Results from the Phase II Hoosier Cancer Research Network LUN14-179 trial of consolidation pembrolizumab after CRT for unresectable Stage III NSCLC (36:45) Ongoing investigation of anti-PD-1/PD-L1 immune checkpoint inhibitors for locally advanced disease (38:56) Case: A man in his mid-80s, a former heavy smoker with multiple comorbidities, is diagnosed with locally advanced squamous cell carcinoma of the lung with a high PD-L1 TPS (tumor proportion score) (40:54) Use of liquid biopsies to detect targetable tumor mutations in patients with lung cancer (44:37) Case: A man in his mid-50s, a former smoker, is diagnosed with Stage IIIA mixed adenosquamous carcinoma of the lung with TTF-1 and p40 tumor mutations (47:17) Perspective on the use of anti-PD-1/PD-L1 antibodies as neoadjuvant therapy for patients with NSCLC (51:22) Case: A man in his early 70s, a current smoker, with adenosquamous carcinoma of the lung and a KRAS mutation receives SBRT (56:28) Optimal approach to RT for patients with locally advanced NSCLC (59:58) Select publications
Lung Cancer Update – Part 2: Our interview with Dr Chaft highlights the following topics as well as cases from her practice: Case: A 54-year-old woman and never smoker presenting with arthralgias, digital clubbing and leg edema is diagnosed with Stage IIIA NSCLC and an EGFR exon 19 deletion: 0m0s Evaluation of anti-PD-1/PD-L1 antibodies as neoadjuvant therapy for NSCLC: 3m2s Predictors of clinical benefit from neoadjuvant therapy with immune checkpoint inhibitors: 6m41s Selection of patients for neoadjuvant therapy with anti-PD-1/PD-L1 antibodies: 7m52s Choice of adjuvant therapy for patients with NSCLC and an EGFR tumor mutation: 12m10s Risks and benefits with osimertinib in the adjuvant setting: 14m38s Status of the Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials (ALCHEMIST) for patients with early-stage lung cancer: 17m31s Results of the Phase III SELECT trial of adjuvant erlotinib for resected NSCLC with an EGFR tumor mutation: 19m5s Case: A 59-year-old man and former smoker with unresectable, Stage III NSCLC receives durvalumab as consolidation therapy after chemoradiation therapy: 22m58s Management of superior vena cava syndrome in patients with lung cancer: 25m23s Activity and tolerability of durvalumab as consolidation therapy: 27m50s Perspective on the results of the PACIFIC trial of durvalumab after chemoradiation therapy for Stage III NSCLC: 29m15s Recognition and management of pneumonitis associated with durvalumab/radiation therapy: 30m53s Impact of baseline steroids on the efficacy of PD-1/PD-L1 blockade in patients with NSCLC: 35m7s Effects of tumor mutations and PD-L1 expression on response to checkpoint inhibitors: 36m54s Case: A 68-year-old woman and smoker experiences recurrent colitis after receiving nivolumab for metastatic NSCLC: 40m11s Incidence and mitigation of diarrhea and colitis associated with checkpoint inhibitors: 42m45s Management of metastatic nonsquamous NSCLC in the first-line setting: 46m0s Perspective on the results of the Phase III IMpower150 study: 49m47s Selection of first-line therapy for patients with metastatic squamous NSCLC: 53m3s Risks and benefits of nivolumab with ipilimumab for metastatic NSCLC: 54m44s Therapeutic approach for patients with metastatic small cell lung cancer: 58m18s Duration of therapy with immune checkpoint inhibitors: 1h0m23s Pseudoprogression and hyperprogression associated with immune checkpoint inhibitors: 1h2m18s Case: A 64-year-old woman with metastatic NSCLC and an ALK rearrangement receives alectinib after developing intolerance to crizotinib: 1h4m40s Efficacy and side effects of the ALK inhibitors alectinib, brigatinib and lorlatinib: 1h7m21s Select publications
Lung Cancer Update – Part 1: Our interview with Dr Ramalingam highlights the following topics as well as cases from his practice: Mechanisms of resistance to osimertinib and management of non-small cell lung cancer (NSCLC) with EGFR tumor mutations in patients who experience disease progression on first-line osimertinib: 0m0s Results of the Phase III IMpower150 trial: Atezolizumab and chemotherapy with or without bevacizumab versus bevacizumab and chemotherapy for chemotherapy-naïve metastatic nonsquamous NSCLC: 3m55s Role of bevacizumab in combination with EGFR tyrosine kinase inhibitors (TKIs) for patients with NSCLC and EGFR tumor mutations: 5m22s Emerging data with novel TKIs for patients with NSCLC and MET gene amplifications: 8m0s Incidence and clinical significance of MET amplifications and MET exon 14 mutations: 10m22s Use of liquid biopsies to detect mutations in patients with lung cancer: 13m52s FLAURA study results: Osimertinib versus erlotinib or gefitinib as first-line therapy for advanced NSCLC with an EGFR tumor mutation: 17m11s Ongoing evaluation of EGFR TKIs for Stage III NSCLC: 19m4s Perspective on the use of osimertinib in the adjuvant setting: 21m52s Case: A 62-year-old man and never smoker with Stage IV NSCLC and an EGFR exon 19 deletion receives osimertinib as first-line treatment: 23m30s Response to osimertinib in patients with brain metastases: 27m5s Case: A 44-year-old man and never smoker with metastatic NSCLC and an ALK rearrangement receives alectinib after disease progression on crizotinib with an anti-PD-1 antibody: 31m3s ALTA-1L: A Phase III trial evaluating brigatinib versus crizotinib for advanced NSCLC with an ALK rearrangement: 35m44s Efficacy and tolerability of lorlatinib in patients with NSCLC and an ALK rearrangement: 39m43s Case: A 52-year-old woman and nonsmoker with metastatic NSCLC and a BRAF V600E tumor mutation receives dabrafenib and trametinib as second-line therapy: 42m13s Use of targeted therapy as first-line treatment for patients with NSCLC: 44m42s Case: A 58-year-old man with locally advanced squamous cell carcinoma of the lung receives durvalumab as consolidation therapy after chemoradiation therapy: 46m59s Overall survival with the addition of durvalumab to chemoradiation therapy for patients with Stage III NSCLC: 48m45s Pulmonary toxicity associated with durvalumab: 50m47s Ongoing investigation of immune checkpoint inhibitors in the adjuvant setting: 55m30s Management of metastatic small cell lung cancer: 58m5s Novel agents under investigation for small cell lung cancer: 1h0m15s Emerging research aimed at enhancing the efficacy of immune checkpoint inhibitors: 1h5m2s Select publications
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
The Era of Immunotherapy in Stage III NSCLC: Exploring the Evidence and Practicalities of Integrating Checkpoint Inhibition Into the Multimodal Treatment Arsenal
Dr. Jack West explores the importance of following the overall survival of patients on the PACIFIC trial and considers still open questions of whether consolidation durvalumab (Imfinzi) in stage III unresectable NSCLC should be discontinued after a year.
Dr. Jack West reviews key results of the PACIFIC trial of the immunotherapy agent durvalumab (Imfinzi) vs. placebo in stage III NSCLC and explains the pros and cons of durvalumab as a new standard of care after concurrent chemoradiation.
Dr. Jack West reviews the implications of the PACIFIC trial that establishes a role for durvalumab immunotherapy in stage III NSCLC, and which will likely lead to some patients shifting away from surgery in favor of chemoradiation followed by durvalumab.
Dr. Jack West reviews data from ESMO 2017 & the NEJM paper on the PACIFIC trial of durvalumab vs. placebo as consolidation after chemoradiation for patients with unresectable stage III NSCLC, focusing especially on why these results are practice-changing.
Dr. Mark Socinski, University of Pittsburgh Medical Center, discusses the benefits of giving two additional cycles of chemotherapy in combination with radiotherapy for stage III NSCLC.
Dr. Mark Socinski, University of Pittsburgh Medical Center, discusses the benefits of giving two additional cycles of chemotherapy in combination with radiotherapy for stage III NSCLC.
Dr. Mark Socinski, University of Pittsburgh Medical Center, discusses the benefits of giving two additional cycles of chemotherapy in combination with radiotherapy for stage III NSCLC.
Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the different types of stage III (locally advanced) NSCLC, and states which of these types tend to be resectable.
Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the different types of stage III (locally advanced) NSCLC, and states which of these types tend to be resectable.
Dr. Mark Socinski, University of Pittsburgh Medical Center, describes the different types of stage III (locally advanced) NSCLC, and states which of these types tend to be resectable.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews a Swiss study comparing tri-modality therapy with chemoradiation followed by surgery to chemo followed by surgery for stage IIIA NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results of the START trial of tecemotide immunotherapy for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews results from RTOG 0617 that help clarify the optimal dose of radiation for stage III unresectable NSCLC.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
Dr. David Gerber, University of Texas-Southwestern, reviews the current questions in managing locally advanced NSCLC with chemo/radiation as introduction to key issues addressed in trials from ASCO 2013.
This slide presentation by Dr. Shirish Gadgeel, medical oncologist at Wayne State University, discusses the considerations and evidence about whether locally advanced (Stage III) NSCLC should be managed surgically or with chemo/radiation alone.
This slide presentation by Dr. Shirish Gadgeel, medical oncologist at Wayne State University, discusses the considerations and evidence about whether locally advanced (Stage III) NSCLC should be managed surgically or with chemo/radiation alone.
LungCancerUpdate.com/ThinkTank – Proceedings from a Clinical Investigator “Think Tank.” Stage III NSCLC. Interviews conducted by Neil Love, MD. Produced by Research To Practice.
Management of Stage III NSCLC
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