Optimizing Outcomes in NSCLC With Precision Medicine and Teamwork

Divya Gupta, MD, assistant professor at Feinberg School of Medicine at Northwestern University, highlighted the growing role of biomarker-driven therapies in non–small cell lung cancer (NSCLC), noting ongoing research to apply these treatments in earlier stages and to target currently untreatable mutations. She emphasized the importance of multidisciplinary care, with tumor boards serving as a critical platform for collaboration among medical, surgical, and radiation oncologists, as well as supportive services like palliative care and physical therapy, to optimize patient outcomes, particularly for early-stage cases now eligible for surgery due to advancements in treatment.

Gupta participated in a panel discussion immunotherapy advancements in NSCLC at a recent Institute for Value-Based Medicine^® event in Chicago, Illinois.

This transcript has been lightly edited for clarity.

Transcript

Precision medicine has made a big impact in oncology. How do you envision the role of biomarker-driven therapies in the future of NSCLC treatment?

I would say, in the future of [NSCLC] treatment, biomarker therapy is going to play a massive role. It already does with regards to both the treatment of patients with stage IV disease and early-stage disease. I think currently there's a lot of movement to take biomarker-driven therapy and put it in earlier stages.

Up until now, we've only done research in the later stages, like stage IV, and now, there are trials that are ongoing looking at biomarker-driven therapy and early-stage disease. There's also a lot of trials going on looking at patients that have certain mutations for which they don't have targeted therapies at this time, but there are drugs in the pipeline to target those therapies, so we're excited to how this all evolves, but I think biomarker-driven medicine is not going away anytime soon. It is really the future of [NSCLC] treatment.

How can multidisciplinary teams work more effectively together to improve outcomes for patients with NSCLC? Are there any collaborative practices you find particularly beneficial?

[NSCLC] is a multidisciplinary practice and field. Traditionally, it's been led by medical oncologists, radiation oncologists, and surgical oncologists. I think in this day and age, there's a lot of room for supportive services to also play a huge role in the treatment of these patients—so, for instance, palliative care, dietician, physical therapy, and things of that nature.

I think the best way in which we are able to address patients in a multidisciplinary manner is through a tumor board. That's when we're able to bring up cases that either people may have questions about, or there is a multidisciplinary approach indicated, and that's the best kind of realm to really bring together all of these different practices to come up with the best plan for patients.

This is especially relevant in patients now who have early-stage disease who were initially not thought to be surgical candidates, but with the advents of treatment, these patients are now potentially considered for surgery. So having that multidisciplinary discussion with radiation and surgery and medical oncology to figure out what is the best path for treating this patient is probably the best example of multidisciplinary care.