Dr. Graziano on Sequencing Targeted Therapy in NSCLC

Stephen L. Graziano, MD, professor of medicine, division chief of medicine, and division chief of Upstate Cancer Center Adult Hematology/Oncology at the Upstate University Hospital, discusses sequencing targeted therapy for patients with non—small cell lung cancer (NSCLC).

In terms of next steps for research, a lot more has to be done to determine the optimal sequencing of therapy, says Graziano. Following frontline therapy, the patient’s specific molecular abnormalities should be taken into account to determine the next line of therapy.

In lung cancer, targeted therapy has become a common practice; however, this approach differs from that of chemotherapy in those with localized disease, says Graziano. If a patient develops localized progression, sometimes they can continue on the same targeted agent and then be treated locally with local radiation and, occasionally, surgery. An example would be a patient with lung cancer who has multiple pulmonary nodules who is treated with a targeted agent. If the nodules stay stable, except for 1 that may be growing, the patient can be given localized radiation and continued on the targeted therapy.