Dr Florez on Addressing Key Gaps in Lung Cancer Care

Narjust Florez, MD, associate director, Cancer Care Equity Program, Dana-Farber Brigham Cancer Center; physician, Dana-Farber Cancer Institute; member, faculty, Harvard Medical School, discusses the importance of addressing crucial gaps in care for patients with lung cancer.

The introduction of neoadjuvant chemoimmunotherapy into the lung cancer treatment paradigm has highlighted a significant lack of neoadjuvant therapies for patients with targetable mutations, Florez begins. Approximately 52% of patients with lung adenocarcinoma have disease with targetable mutations, Florez states. Accordingly, developing targeted neoadjuvant therapies could help more patients achieve objective responses, reduce surgical times, mitigate certain treatment complications, and increase the possibility of minimally invasive procedures, she notes. The advent of neoadjuvant chemoimmunotherapy in lung cancer underscores the importance of multidisciplinary approaches to treatment, which ensure that surgeons and medical oncologists can closely collaborate, Florez emphasizes.

Another area of interest in lung cancer care is improving guidance for treatment decision-making regarding multiple lines of therapy, Florez adds. The availability of FDA-approved agents in the frontline setting continues to increase, according to Florez. This variety necessitates careful patient selection and tailored treatment plans, as well as careful consideration of the benefits and risks of each agent, potential financial toxicity, and drug accessibility, Florez says. Providing guidance to oncologists both in the United States and globally is essential to address these gaps in lung cancer care, she notes. Managing the disease after first-line progression remains another crucial area of focus for the lung cancer field, Florez states.

Furthermore, understanding mechanisms of resistance to targetable mutations beyond chemotherapy in the metastatic setting is crucial, Florez states, adding that future research should focus on determining how lung cancer behaves after targeted therapy and before chemotherapy. Standardizing treatment in this area could help reduce treatment disparities and eliminate biases stemming from access issues or other influences, she emphasizes. In the community oncology setting, where approximately 80% of patients with lung cancer are treated, oncologists often manage multiple types of cancer, unlike specialists who focus solely on lung cancer, Florez says. Thus, providing consensus-informed guidance about lung cancer care is essential to assist community oncologists and ensure patients receive optimal care, she adds.

Patient education is also important, and reaching a consensus about certain unmet needs in lung cancer can help patients better understand their treatment options, Florez notes. Overall, identifying the most pressing research areas, such as leptomeningeal disease, allows the lung cancer field to concentrate its efforts on advancing treatments in areas with significant gaps and needs, ultimately improving patient outcomes, Florez concludes.