Treatment Options for Locally Advanced NSCLC and Their Particularities-Treatment Options for Locally Advanced NSCLC and Their Particularities PDF

Treatment Options for Locally Advanced NSCLC and Their Particularities PDF

Pdf Summary

The document is a case study and learning module regarding a 61-year-old Caucasian male, J.F.B., diagnosed with stage IIIA lung adenocarcinoma. The patient, a non-smoker, had prolonged exposure to pollutants and was found to have a deletion in EGFR exon 19 and a TP53 mutation, which is significant for treatment planning. The patient's tumor involved multiple mediastinal chains and was non-resectable at diagnosis.<br /><br />The learning goals focused on the understanding and application of biomarkers in treatment decisions, the importance of a multidisciplinary tumor board in managing locally advanced diseases, and the challenges in treatment, including managing disease progression.<br /><br />Through interactions and examinations (including tests like CT, MRI, and molecular testing), a structured treatment protocol was formulated. It involved neoadjuvant chemotherapy, surgery (bilobectomy), and post-surgery adjuvant osimertinib, according to protocols similar to the ADAURA study. This case emphasizes the importance of multidisciplinary discussions, which guided treatment decisions, such as considering the extent of radiotherapy due to possible toxicity. Re-staging showed no evidence of disease but indicated brain metastasis, leading to commencing first-line palliative treatment with osimertinib.<br /><br />Key takeaways highlight the crucial role of molecular testing in personalized medicine, particularly the detection of an EGFR exon 19 deletion, which influenced the application of targeted therapies like osimertinib. The study underscores the need for invasive mediastinal staging and how discussions among multidisciplinary teams can shape treatment strategies, which in this case, included adaptations based on disease progression and evidence from evolving research, such as trials like LAURA and NEOADAURA. This module is part of an educational initiative by the International Association for the Study of Lung Cancer (IASLC) to enhance knowledge in thoracic oncology.

Keywords

lung adenocarcinoma

EGFR exon 19 deletion

TP53 mutation

multidisciplinary tumor board

neoadjuvant chemotherapy

osimertinib

personalized medicine

molecular testing

thoracic oncology

IASLC