Thoracic Cancers Symposium 2019: Evidence-Based Decision-Making in NSCLC
Posted: Monday, March 25, 2019
Exposing patients with non–small cell lung cancer (NSCLC) to versions of nationally recognized treatment guidelines, such as the National Comprehensive Cancer Network® (NCCN) Clinical Practice Guidelines in Oncology for NSCLC, may lead to smoking cessation, testing for potential biomarkers, and more patient-centered use of chemotherapy after surgery for early-stage disease, according to findings presented at the 2019 Multidisciplinary Thoracic Cancers Symposium (Abstract 3) in San Diego. The study results support the clinical benefits of evidence-based decision-making and patient communication, concluded Matthew A. Gubens, MD, of the University of California, San Francisco (UCSF), Helen Diller Family Comprehensive Cancer Center, and colleagues. Dr. Gubens is a member of the NCCN Panel on NSCLC.
“The process of making treatment decisions can be extremely stressful for lung cancer patients, as treatment options are nuanced and may change significantly over the course of their staging workup,” said coauthor Susan Wu, MD, also of the UCSF, in a press release from the American Society for Radiation Oncology, a co-sponsor of the Multidisciplinary Thoracic Cancers Symposium. “Educational tools can guide patients through the decision-making process and help them to synthesize the large amount of information available.”
Study patients used an interactive Web-based tool that presented guidelines tailored to their clinical and pathologic features. The prospective clinical trial evaluated 6 metrics for 76 patients with NSCLC before and after use of the tool.
Researchers found that among active smokers exposed to the informative tool, 80% increased smoking cessation counseling/intervention (versus 4% in the retrospective cohort). A decrease in the use of adjuvant chemotherapy after surgery for stages IB to IIB disease was observed for patients who used the Web-based tool, as well as an increase in molecular testing prior to initiation of systemic therapy (96% vs. 68%, respectively). In contrast, there seemed to be no differences between the study groups in the frequency of pathologic mediastinal staging performed prior to surgery or nonsurgical treatment of patients with stage III NSCLC, as well as the use of upfront chemoradiation in nonoperative candidates.
Disclosure: The study authors’ disclosure information may be found at thoracicsymposium.org.
