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How I optimize treatment for my NSCLC patients with advanced aggressive disease


Silvia Novello

Dr Novello opened up the session by stating that although we are not yet curing our patients with aggressive lung cancer, current treatments are able to improve patients’ quality of life. This symposium will review current treatment strategies with the following learning objectives:

  • To understand the reasons why there are limited treatment options for patients with advanced (aggressive) squamous NSCLC; hence, there remains a need for more effective therapies despite recent advances in treatment.
  • To be able to describe the current and emerging treatment modalities (targeted, angiogenesis, immuno-oncology), for both advanced squamous and non-squamous NSCLC, and to summarize their efficacy and safety in recent clinical trials.
  • To develop a care plan based on personalized treatment strategies that includes effective sequencing, and to optimize multidisciplinary management in daily practice.
  • To recognize the subset of patients with aggressive disease and to develop management

strategies for these patients.

Dr Novello asked the audience a series of questions, including the country attendees are from, their professional field (a large percentage were respiratory physicians, and about 1/3 were medical oncologists). Attendees knowledge was then tested with the following questions:

When is mutation testing recommended?

  1. Diagnosis of squamous and non-squamous NSCLC
  2. Diagnosis of non-squamous NSCLC and in some cases squamous NSCLC
  3. Diagnosis of non-squamous NSCLC only
  4. None of the above

The vast majority selected option 2.

In which stage of the treatment algorithms for advanced squamous and non-squamous NSCLC are anti-angiogenetic agents currently integrated?

  1. First line
  2. Second line
  3. Maintenance therapy
  4. All of the above
  5. None of the above

Fifty percent selected option 4, all of the above, the rest were divided among the other options.

Which of the following options are standard first-line treatments for advanced squamous and non-

squamous NSCLC?

  1. Nivolumab
  2. Paclitaxel
  3. Cisplatin + pemetrexed
  4. Carboplatin + paclitaxel

Seventy percent selected option 4, carboplatin + paclitaxel.