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Medical Oncology

Non-small cell lung cancer   

Questions discussed in this category

How would you approach local therapy (surgery or RT) in a patient with radiographic complete response after chemoimmunotherapy for non-small-cell lung cancer?
Would you consider omitting local therapy? 
2 Answers available
How would you approach first-line treatment in metastatic NSCLC for a patient with ALK-EML4 V3a/b variant and MSI-high status?
Both ALK and MSI-high status were noted on a liquid biopsy since there was not enough tissue available for molecular testing. Some reports suggest lo...
1 Answer available
Under what circumstances, if any, would you wait on initiating a TKI for metastatic recurrence of a Stage III NSCLC which occurred while on consolidative durvalumab to minimize pneumonitis risk?
One particular circumstance involved detecting a ROS1 fusion upon the metastatic recurrence.  Is this pneumonitis risk seen with osimertinib alon...
2 Answers available
How do you counsel patients with Stage IIIA EGFR+ lung cancer regarding treatment intent with concurrent chemoRT + consolidative systemic therapy?
With low #s of patients on the durvalumab PACIFIC trial with EGFR mutated disease, and LAURA trial design of osimertinib until progression, should we ...
3 Answers available
Given the results of LU002 presented at ASCO 2024, are there situations and/or patient subgroups who still derive benefit from local consolidative therapy for oligometastatic NSCLC?
6 Answers available
For NSCLC patients treated with neoadjuvant chemoimmunotherapy and surgery with ypN2 disease, what factors would cause you to recommend PORT?
2 Answers available
In oligometastatic NSCLC with a solitary brain metastasis and lung primary amenable to SBRT, how would you sequence first-line systemic therapy versus local therapy to the lung after treatment of the CNS metastasis?
5 Answers available
How would you treat a patient with newly diagnosed ALK+ Stage IIIB non-small cell lung cancer (NSCLC)?
Would you recommend concurrent chemoradiation or targeted therapy with lorlatinib?
1 Answer available
How do you approach a patient with stage IIA non-small cell lung cancer who received SBRT?
Would you offer chemotherapy after radiation is completed?
3 Answers available
Do you still offer adjuvant chemotherapy and chemoradiation for NSCLC after neoadjuvant chemoimmunotherapy?
NCCN states that all operable NSCLC patients should be evaluated for pre-op therapy with strong consideration of nivolumab + chemotherapy for those wi...
2 Answers available
How do you treat Stage IIIC T4N3 NSCLC?
Some consider T4N3 Stage IIIC to be a borderline case. None of these patients were included in either PACIFIC or KEYNOTE-024 for example. Would y...
4 Answers available
Which patients with Stage II-III lung adenocarcinoma, in whom you are considering neoadjuvant chemoimmunotherapy, can you rely on liquid NGS to exclude driver mutations in lieu of repeat tissue biopsy?
Per NCCN exclusion of EGFR/ALK alterations at a minimum is recommended prior to consideration of neoadjuvant chemoimmunotherapy.
1 Answer available
How are you approaching patients who receive neoadjuvant chemo immunotherapy for resectable NSCLC who after completion of neoadjuvant treatment are no longer surgical candidates due to factors such as toxicity, decline in PS, or patient preference?
1 Answer available
What is the preferred second line, systemic therapy for NSCLC patients following first line chemoimmunotherapy?
How does the changing landscape of first-line treatment impact your decision making for second line therapy?
10 Answers available
What is your preferred approach for managing oligoprogressive NSCLC during second-line or later systemic therapy if patient is otherwise responding well at other sites of disease?
2 Answers available
Would you offer adjuvant pembrolizumab to a stage II-III adenocarcinoma of the lung who had a complete pathologic response to 4 cycles of cisplatin/pemetrexed/pembro (KN-671)?
And would your answer be different if you had used pre-op nivolumab (CM-816)?
3 Answers available
Do you offer local consolidative therapy for patients with polymetastatic driver mutation-positive NSCLC who respond well to targeted therapy?
If so, when and to what extent? 
2 Answers available
Would you consider omission of PORT for node+ NSCLC with a positive margin in the setting of a high tumor PD-L1 score and plans for immunotherapy?
2 Answers available
Did NRG LU004 demonstrate safety with hypofractionated lung radiation and concurrent ICI?
Can you explain the expansion cohorts into larger trials and the current amendments to the the protocol?
1 Answer available
Are you offering durvalumab to patients with Stage III NSCLC with known targeted mutations (ie ALK, EGFR, ROS1, BRAF) after completion of chemoradiation per PACIFIC?
2 Answers available
Do you consider NSCLC with multistation N2 involvement appropriate for treatment with neoadjuvant chemoimmunotherapy followed by surgery?
6 Answers available
In what situations would immunotherapy alone be appropriate for non-metastatic NSCLC?
1 Answer available
In patients with EGFR mutant L858R stage III NSCLC who are unresectable due to multistation N2 disease, would you consider upfront osimertinib over definitive intent CCRT?
If CCRT is pursued, would you move forward with durvalumab consolidation? Assume the patient with ECOG PS 0 and no co-morbidities. How might this chan...
4 Answers available
How many days do you hold osimertinib during or around SBRT for oligometastatic EGFR mutated advanced lung cancer?
Does the site of treatment factor into your decision? 
2 Answers available
How would you approach Grade 2-3 rash due to erlotinib for a patient with metastatic EGFR mutated lung adenocarcinoma that is well controlled for > 5 years and NED by PET?
1 Answer available
How are you approaching patients with early-stage NSCLC who progress on neoadjuvant chemo-immunotherapy and are no longer surgical candidates?
5 Answers available
Will you consider definitive concurrent chemoradiation for stage IV lung adenocarcinoma with metastasis limited to an internal mammary lymph node?
1 Answer available
What is your approach to adjuvant therapy for an R0, ALK+ resected lung adenocarcinoma with N2 disease?
1 Answer available
How would you manage a left sided triple negative breast cancer with a concurrent left sided locally advanced non-small cell lung cancer?
The left breast cancer is an ER-negative, PR-negative, HER2-negative cT2N0 invasive ductal carcinoma, while the left lung primary is a cT2N1 squamous ...
5 Answers available
Would you offer a different ALK inhibitor to a patient receiving alectinib who had decompensation of liver function in the setting of preexisting cirrhosis?
1 Answer available
Is there ever a role for adjuvant chemotherapy and/or immunotherapy for early stage, N0 non-small cell lung cancer treated with SBRT alone?
5 Answers available
Do you prefer cisplatin or carboplatin in combination with nivolumab per CheckMate 816 for patients with resectable NSCLC?
Based on subgroup analysis, do you have a preference for cisplatin over carboplatin? 
1 Answer available
Would you consider using sotorasib first line in patient with metastatic KRAS G12C NSCLC who declines chemotherapy?
3 Answers available
What are your top takeaways in Thoracic Cancers from ASCO 2023?
5 Answers available
Which targeted therapies should we be more cautious of giving after recent immunotherapy in NSCLC?
Do you ever consider bridging with chemotherapy, and if so for how long? 
1 Answer available
How do you decide between checkpoint monotherapy versus chemo-immunotherapy approach for patients with PD-L1 High (>50%) NSCLC?
IMPower110 data add further support to use of checkpoint monotherapy; however guidelines continue to support either I/O monotherapy vs chemo-immunothe...
7 Answers available
What is your preferred first line approach to patients with Stage IV non-squamous NSCLC with good performance status, no driver mutations, PD-L1 low-positive, and CKD IIIB or worse, CrCl < 45 mL/min?
Assuming the patient had no contraindications to immunotherapy and no other significant comorbidities.
1 Answer available
How do you define an adequate EBUS when staging NSCLC?
Is there a minimum standard for which stations to sample? Does lymph node size affect your recommendations?
3 Answers available
Are you treating patients with RET-fusion+ metastatic NSCLC with RET inhibitors as the first line of therapy regardless of PD-L1 expression?
Are there scenarios in which you would proceed with checkpoint inhibitor for PDL1+ disease before having full molecular testing results?
5 Answers available
For NSCLC patients with limited diagnostic tissue that is insufficient for genetic testing, do you offer repeat biopsy (of accessible site), blood based testing, or both to evaluate for actionable driver mutations?
3 Answers available
What is the role for "liquid biopsy" for patients with newly diagnosed metastatic NSCLC?
5 Answers available
Do you consider using 160 mg osimertinib in patients with EGFR-positive metastatic NSCLC to the brain?
1 Answer available
How would you treat a potentially resectable stage III lung adenocarcinoma with an EGFR mutation?
Do you consider any neoadjuvant therapy or proceed to surgery followed by adjuvant chemotherapy and osimertinib? Does the type of mutation (ex a rare ...
1 Answer available
What is your current practice for obtaining PD-L1 and mutation testing for newly diagnosed metastatic NSCLC?
What specific platforms do you use, individual biomarker/PD-L1 status vs NGS, tissue vs liquid or both? Must you wait for PD-L1 testing if mutation t...
6 Answers available
Are PD-L1 and molecular markers from pleural fluid specimens reliable enough to guide decision making in metastatic NSCLC?
Or would you conduct tissue or blood testing if no actionable results are found? 
4 Answers available
Would you send a lung cancer patient for genetic counseling/germline mutation testing if they are harboring mutations in NGS with variation allele frequency between >=50%?
Ex. TP53, BRCA, T790M, or another? As of now, T790M mutation is one of the few de novo mutations found in treatment naïve patients that have been...
4 Answers available
Do you ever start immunotherapy along with WBRT in patients with PDL1 >50% metastatic NSCLC with significant visceral tumor burden in addition to symptomatic brain mets?
4 Answers available
How do you approach a patient with discordant mutation testing in liquid vs tissue biopsy for mNSCLC?
4 Answers available
For patients with NSCLC on osimertinib who progress, would you continue osimertinib when moving onto chemotherapy for 2nd line therapy?
1 Answer available
Based on results from ADAURA, in clinical practice, how likely are you to recommend adjuvant chemotherapy prior to adjuvant osimertinib for stage IIA T2bN0 EGFR mutant NSCLC?
1 Answer available
How do you decide which immunotherapy agent to utilize for 1st line in PD-L1 high (>50%) NSCLC?
Are there specific clinical factors, efficacy, or treatment tolerability issues that lead you to favor one agent over another? How do you compare or ...
8 Answers available
Do you see any role for PARP inhibitors in NSCLC given the recent PIN trial of maintenance olaparib did not show significant improvement in PFS?
Based on results of the recently published study. 
1 Answer available
What is your approach and preferred first line treatment regimen for advanced/metastatic adenosquamous NSCLC?
1 Answer available
What adjuvant therapy would you offer following adjuvant chemotherapy for a patient with Stage III lung adenocarcinoma with an atypical EGFR mutation such as EGFR L861R?
Would you offer adjuvant atezolizumab, osimertinib, or neither? Both IMpower010 and ADAURA only had patients with EGFR exon 19 deletion or L858R mutat...
1 Answer available
Should durvalumab consolidation still be offered to Stage III NSCLC patients with PD-L1< 1%?
Do the results of the unplanned subset analysis of the PACIFIC trial showing no OS benefit in this population lean you away from consolidation?
3 Answers available
Should IMPower010 results be extrapolated to superior sulcus tumors treated with chemoradiation and surgery?
1 Answer available
For patients with KRAS G12C mutated NSCLC, how would you decide between using targeted therapy with sotorasib vs adagrasib?
Is there anything to differentiate the two agents? CNS penetration reportedly with adagrasib, FDA accelerated approval has been given with sotorasib.&...
2 Answers available
How do you choose between neoadjuvant chemotherapy alone vs neoadjuvant chemoradiation in patients with potentially resectable stage III NSCLC who are not upfront surgical candidates?
1 Answer available
Do you hold or avoid pemetrexed in patients with NSCLC and pleural effusions?
1 Answer available
Would you ever consider definitive thoracic RT with concurrent immunotherapy in Stage III NSCLC?
I recently saw a patient who had been treated with concurrent pembrolizumab-RT elsewhere. Is this an acceptable practice outside the setting of a clin...
2 Answers available
How do you manage a patient with metastatic NSCLC whose initial mutation testing was limited or results are no longer available?
How do you operationalize finding biomarker information in EHRs/testing portals, either for your own patients or if they have changed providers? If a...
4 Answers available
What are your treatment considerations for a patient with stage IVb NSCLC who is KRAS G12C mutated and PD-L1 high (>50%)?
3 Answers available
Are there best practices for managing or mitigating toxicity from sotorasib such as hyperbilirubinemia or edema?
3 Answers available
Do you offer durvalumab to patients with stage IIIB NSCLC after chemoradiation if they are also on long term dialysis for ESRD?
Are there data for using checkpoint inhibitors in this setting? 
1 Answer available
Which patients with resectable Stage IB-IIIA NSCLC would most benefit from using neoadjuvant chemoimmunotherapy as per CheckMate 816?
1 Answer available
What are best practices for engaging with multidisciplinary colleagues to ensure patients with earlier stage NSCLC are being appropriately considered for novel adjuvant therapies?
How are your teams effectively evaluating and counseling patients to ensure they are prepared for potential extended adjuvant treatment approaches? Is...
4 Answers available
Would you extrapolate IMPower010 data to offer adjuvant atezolizumab to a patient with N2 PDL1-high (>50%) NSCLC who had been treated with induction chemotherapy followed by definitive R0 resection after partial response?
Can atezo be used even if patient has completed chemotherapy preoperatively?
2 Answers available
What is your preferred first line treatment approach for a patient with PDL-1 high (>50%) NSCLC presenting with CNS mets?
If a patient is asymptomatic at presentation, how do you incorporate local treatment options (RT/surgery) and when?
2 Answers available
What high risk features for stage IB NSCLC would lead you to consider adjuvant chemotherapy?
Do you consider size > 2cm, visceral pleural invasion or vascular invasion as indications for cisplatin-based chemotherapy? 
2 Answers available
Would you hold osimertinib in a patient with a STEMI, and for how long?
1 Answer available
Are there any data for second line nivolumab-ipilimumab in patients with metastatic NSCLC treated with either single agent pembrolizumab or chemotherapy + ICI as first line therapy?
Would you consider second line nivo-ipi for patients with a specific histology or tumor PD-L1 expression? 
1 Answer available
How would use of adjuvant atezolizumab for PDL1+ NSCLC potentially impact your treatment choice at recurrence?
Is there a certain time interval where you would feel comfortable to rechallenge with immunotherapy at recurrence (6m vs 1y vs 2y?) Does degree of PDL...
2 Answers available
Should 1 year of atezolizumab be the standard of care for stage II-IIIA resected PDL1+ NSCLC?
Are the experts convinced by DFS when the OS is immature?  How many in BSC arm went on to receive immunotherapy and was that adequate?
2 Answers available
What is your recommended adjuvant approach to resected NSCLC with both PD-L1>1% and EGFR mutation?
What would you do for a patient with a non-EGFR actionable mutation?IMpower010 included EGFR and ALK mutated NSCLC. Is there any concern in the use of...
2 Answers available
How do you approach patients with Stage IIIB/C NSCLC with ipsilateral supraclavicular (N3) disease?
Do you initially start with systemic therapy alone or do you proceed directly to chemo-radiation? 
1 Answer available
Are there clinical features that would lead you to consider combining SBRT + immunotherapy in a high risk early stage NSCLC?
1 Answer available
Are you selecting any specific patient cohort with metastatic NSCLC for treatment with the CheckMate 9LA protocol of ipilimumab + nivolumab + 2 cycles of chemotherapy?
5 Answers available
What is your preferred first line regimen for PDL1-negative squamous cell lung cancer?
What is your general rationale for selecting from available options?
6 Answers available
What factors do you take into account for recommending chemo/IO vs IO/IO vs CheckMate 9LA regimen in front line therapy for PD-L1 negative advanced squamous cell carcinoma?
How do you interpret the comparative efficacy in squamous cell subsets among the CM vs KN vs EMPOWER studies?
4 Answers available
Do you avoid immunotherapy in patients with Stage IV NSCLC with atypical EGFR mutations such as G719S or S768I?
1 Answer available
How do you approach EGFR mutated NSCLC with isolated progression in the chest who is planned for a course of radiation at least 3-4 weeks?
How do you balance the risk of an EGFR flare while holding osimertinib vs the risk of pneumonitis when continuing?
1 Answer available
How would you treat a patient with stage 4 NSCLC with EGFR R776H mutation?
2 Answers available
Do you have a maximum size cutoff for lung SBRT in central NSCLC?
E.g. for a 7cm central NSCLC, would you offer 8 fx SBRT or ChemoRT? Patient is not a surgical candidate.
6 Answers available
What would you offer as adjuvant therapy for a resected stage IIIB adeno NSCLC in a patient who refuses chemotherapy?
Can adjuvant durvalumab or other I/O or osimertinib (if EGFR+) be considered?
2 Answers available
How do you approach patients with driver mutation positive, Stage IV NSCLC who don't benefit from upfront first-line TKI?
Although a small subset, do you generally move these patients directly on to chemotherapy +/- immunotherapy or does it depend on the specific mutation...
1 Answer available
Are there specific ROS1 fusions/mutations that confer sensitivity or resistance to therapy to help guide treatment selection in first line or at progression?
3 Answers available
How would you treat a patient with squamous NSCLC with NRG1 amplification (no fusion) who has progressed on first-line treatment?
Would you consider afatinib? Afatinib has shown some activity in NRG1 fusion + patients but amplifications is unclear. 
2 Answers available
When giving single agent docetaxel for patients with metastatic NSCLC who have progressed on platinum and immunotherapy, do you stop after 6 cycles or do you continue as long as tolerated and disease is stable?
1 Answer available
What is your approach to a patient with an EGFR exon 19 mutated NSCLC who develops progression on osimertinib and repeat biopsy demonstrates the EGFR exon 19 mutation and a new BRAF V600E mutation?
1 Answer available
For a patient with metastatic NSCLC, PD-L1>50%, after progression on first line checkpoint inhibitor, do you prefer chemotherapy alone or chemotherapy added to the immunotherapy?
9 Answers available
What is your preferred first line therapy in metastatic ALK+ NSCLC?
The ALTA and ALEX trials showed better PFS with brigatinib v. crizotinib and alectinib v. crizotinib. How do you choose your first...
6 Answers available
How do you approach treatment for patients with ALK+ mNSCLC who have multifocal or leptomeningeal CNS progression while on first-line targeted therapy?
Would you test for resistance mutations in this setting, using blood-based sample if no progression outside CNS?
5 Answers available
How do you manage ALK-inhibitor AEs which are low grade but significantly impact patient QOL over time?
Such as dysgeusia, headache, rash, fatigue, etc
4 Answers available
How can you adjust neoadjuvant or adjuvant platinum based chemotherapy for stage Stage II-III non-small cell lung cancer in patients with significant renal insufficiency?
2 Answers available
In locally advanced EGFR-mutated NSCLC with initial good response to osimertinib, how do you manage local progression of the primary?
Would you consider SBRT and continue osimertinib?
2 Answers available
How do you approach missed doses of durvalumab consolidation in patients with Stage III NSCLC?
Do you aim to give a total of 26 doses or do you stop at one year from first dose no matter how many were given?
1 Answer available
Is there a preferred ALK targeting agent for patients with ALK+ mNSCLC presenting with CNS metastases?
2 Answers available
Should 3 years of adjuvant osimertinib be the standard of care for resected Stage IB-IIIA EGFRm NSCLC?
6 Answers available
For patients with early stage resected giant cell lung cancer and other less common histologies, are there any specific considerations for adjuvant therapy?
1 Answer available
How do you approach patients with unresectable NSCLC planned for concurrent chemoradiation who develop a serious infusion reaction to paclitaxel?
1 Answer available
Would you consider maintenance immunotherapy following chemoradiation for a patient with an isolated mediastinal recurrence of NSCLC?
1 Answer available
How would you approach metastatic NSCLC (adenocarcinoma without brain mets) with PD-L1 >50% and BRAF V600E driver mutation?
2 Answers available
How would you treat oligometastatic NSCLC (brain and bone) with Non-V600E BRAF mutations?
SRS done to the single brain met, PD-L1 5%,  BRAF G469A mutation
1 Answer available
How would you treat a patient with metastatic NSCLC with repeated episodes of CNS brain metastases but otherwise with good systemic disease control on maintenance therapy?
The patient remains without evidence of systemic disease outside of the CNS on serial imaging. Would you continue treating with SRS as lesions appear,...
2 Answers available
Would you offer systemic therapy after rendered NED from SRS to isolated CNS metastases in a patient with prior curative intent treatment of lung adenocarcinoma and clear cell RCC?
0 Answers available
How do you manage pneumonitis in patients with Stage III NSCLC receiving durvalumab?
How do you prescribe a steroid taper? If it is grade 2, would you keep them on low dose prednisone while continuing? When do you feel comfortable re-c...
2 Answers available
Are there any subsets of patients where you would consider first-line dacomitinib for EGFR mutations positive NSCLC?
Are there specific mutations or co-mutations were you would consider use of this agent? 
1 Answer available
Would you offer EGFR inhibitors to a patient with metastatic lung adenocarcinoma EGFR L858R mutation and concomitant NRAS mutation both on blood based testing?
1 Answer available
In patients with metastatic lung SCC who are on pembrolizumab maintenance after starting pembrolizumab/carboplatin/nab-paclitaxel, what is your treatment strategy if they progress while on pembrolizumab alone?
Would you continue pembrolizumab with a re-challenge with carboplatin/taxane or move to second line therapy?
4 Answers available
Should we consider deferring adjuvant chemotherapy for resected early-stage NSCLC in light of COVID-19?
If so, how long is too long to wait?
1 Answer available
Would you discontinue dabrafenib/trametinib in a patient with BRAF mutant metastatic lung cancer if you see mild cardiomyopathy which could be related to the drugs?
Patient does not want chemo but is tolerating these well otherwise. 
1 Answer available
How do you counsel patients with metastatic NSCLC who have a sustained response (> 2 years) to checkpoint inhibitors who wish to discontinue therapy?
How do you approach this given the limited # of patients this applies to?  Checkmate 017 and 057 only had 5-7% of patients still on nivolumab at ...
4 Answers available
Do patients with Stage III unresectable NSCLC with lepidic features require a different approach to chemo-radiation?
Would your choice of concurrent chemotherapy be impacted by this histologic finding? 
0 Answers available
Do you offer consolidative thoracic radiation for oligometastatic NSCLC following upfront immunotherapy?
In patients who have a mixed response or progression and are poor candidates for other systemic agents, would you consider consolidating the chest? Wo...
2 Answers available
Would you rather start radiation for Stage III NSCLC in the middle of a chemotherapy cycle or wait for the 2nd cycle if it could not be started on cycle 1 day 1?
1 Answer available
How would you manage a patient with no driver mutation, PD-L1 <50%, with systemic relapse of lung adenocarcinoma within a year after resection and completion of adjuvant platinum based chemotherapy?
Would you consider single agent immunotherapy given recent exposure to platinum agent or chemoimmunotherapy?
2 Answers available
How do you approach patients for definitive chemoradiation in locally advanced NSCLC who have severe neuropathy?
Are the other options of chemotherapy that can be used instead of platinum based doublets, including with paclitaxel? 
2 Answers available
How long do you continue surveillance imaging for NSCLC after definitive treatment?
NCCN recommends annual CT surveillance indefinitely after year 5, but I’m curious how many physicians continue and for how long?
3 Answers available
How do you decide between carboplatin vs not recommending adjuvant chemotherapy entirely for patients with resected NSCLC with relative or absolute contraindications to cisplatin?
 ie renal dysfunction, hearing loss, neuropathy
1 Answer available
Would you deliver SRS/XRT for isolated asymptomatic CNS metastasis before start of immunotherapy for stage IV lung cancer (negative for driver mutation) with high positive PDL1?
1 Answer available
Do you consider additional chemotherapy or durvalumab after definitive concurrent chemo/RT for Stage II NSCLC for patients who are not surgical candidates?
Would PDL-1 status impact your decision?
3 Answers available
How do you approach elderly patients with stage III NSCLC who have a reasonable performance status?
Do you recommend or make any modifications in the PACIFIC regimen for patients > 75 years of age?
1 Answer available
Aside from MET exon 14 skip mutations, are there other targetable MET mutations or fusions that you would consider for TKI therapy?
Would you reserve TKI for after standard of care chemotherapy and immunotherapy or consider earlier line of treatment?
1 Answer available
Do you offer consolidation chemotherapy prior to durvalumab in locally advanced, unresectable NSCLC?
In clinical practice, consolidation chemotherapy is sometimes used, though this was not implemented in the PACIFIC trial.Antonia et al., PMID 28885881...
3 Answers available
How do you monitor response for stage III NSCLC patients receiving consolidation immunotherapy?
CT or PET? If so, how often?
3 Answers available
Does consolidation durvalumab increase the risk of pneumonitis in Stage III NSCLC?
Rate of pneumonitis was low in the PACIFIC trial but does it mirror the real world setting? We are seeing increased pneumonitis in our practice.
2 Answers available
For patients with inoperable stage III NSCLC who are unable to receive or refuse definitive chemoradiation, how do you decide among radiation alone, pembrolizumab alone, or radiation followed by either pembrolizumab or durvalumab?
5 Answers available
How do you time re-staging studies and adjuvant durvalumab for stage III NSCLC treated with definitive cCRT?
Do you feel it is important to start durvalumab within 14 days of completing cCRT?  What real life challenges do you face in doing so and wh...
1 Answer available
What are the clear criteria for unresectability in locally advanced NSCLC patients, other than medical or anatomic?
Medical inoperability is clearly defined, anatomical resectability is also pretty much clear (invasion of trachea/carina/esophagus, etc). But what abo...
1 Answer available
Do you stop consolidative durvalumab after one year as per the PACIFIC trial or continue if the patient is otherwise tolerating well?
1 Answer available
Would you offer the PACIFIC protocol to a patient with stage III lung cancer with performance status 2-3?
If so, how would you modify this regimen?
1 Answer available
If you are treating a patient with palliative radiation for hemoptysis do you require chemotherapy to be held?
If you are using a standard 30/10 fractionation, is there a benefit to keeping chemo on board for radio-sensitization?
4 Answers available
For stage III NSCLC treated with definitive intent chemoRT, how do you decide to proceed with surgery vs consolidation immunotherapy?
1 Answer available
What would be your approach in a patient with MET amplification and PDL-1 80% expression?
Do you use crizotinib for first-line therapy?
1 Answer available
How are you treating patients who progress while on durvalumab after definitive chemoradiation for stage III NSCLC?
Is the timing of progression (in relation to chemoradiation) a factor, and is there any role for repeat PD-L1 testing at the time of progression?
2 Answers available
Do you consider MET amplification in your first-line treatment decisions for patients with metastatic NSCLC?
1 Answer available
When do you recommend broader molecular testing for clinical trials in stage IV NSCLC patients who have negative initial molecular testing for FDA-approved targetable mutations?
0 Answers available
Would you resume durvalumab after several month hiatus due to IO unrelated medical comorbidities that has since resolved?
If it is still within the 12 month period and no disease recurrence?
3 Answers available
How do you decide between enrolling an oligometastatic NSCLC patient on LU-002 versus treating them with SBRT off trial?
Since the randomized phase II data from Gomez et al presented at ASTRO 2018 showed a survival benefit, is there concern about randomizing patients to ...
1 Answer available
Would you offer upfront osimertinib rather than whole brain irradiation for a patient with stage IV, EGFR exon 19 mutated lung adenocarcinoma who presents with leptomeningeal metastases?
1 Answer available
Should radiotherapy be utilized in stage IVA NSCLC with a malignant pericardial effusion?
If there is no other evidence of metastatic disease, would you offer thoracic radiation? Either upfront with chemo or after initial system therapy if ...
1 Answer available
For oligometastatic NSCLC that would be otherwise considered stage 3, would you consider consolidative immunotherapy with durvalumab after definitive treatment for both the primary and oligometastatic site?
2 Answers available
What would you choose as the second line treatment option for a stage IV EGFR mutant lung adenocarcinoma that has progressed on osimertinib?
Carbo/pemetrexed/pembrolizumab, carbo/pemtrexed without immunotherapy or second line immunotherapy (Nivo, Pem or atezolizumab)?
1 Answer available
What is the role of upfront pembrolizumab in metastatic PD-L1 positive NSCLC presenting with SVC syndrome?
Would starting with chemotherapy be preferred in this situation and consider concurrent radiation, then switch over to Pembrolizumab once some control...
1 Answer available
Would you offer immunotherapy after chemoradiotherapy for Stage III lung cancer given results of PACIFIC Trial?
If so how would you select patients (ie. PS, histology, PD-L1 expression level)? 
2 Answers available
Do you ever recommend PORT or chemoRT rather than chemotherapy alone for NSCLC with adverse features other than positive margins or N2 disease?
For example, would a + vascular margin, extranodal extension of N1 disease, translobar disease, or high risk histologies (large cell neuroendocrine, s...
2 Answers available
What is your preferred first line approach to patients with good PS stage IV non-squamous NSCLC that is EGFR/ROS1/ALK/BRAF WT and PDL-1 < 1%?
Do you prefer carboplatin-paclitaxel-bevacizumab, carboplatin-pemetrexed-pembrolizumab, or chemotherapy alone?
2 Answers available
What is the role of "adjuvant" systemic chemotherapy in patients previously resected NSCLC, now with isolated solitary relapsed brain lesion, treated with resection and SBRT?
Is there any data for the benefit for systemic chemo in such situation?
1 Answer available
How do you decide on the sequence of systemic and local therapy for patients with oligometastatic NSCLC?
When would you favor delivering local therapy (e.g. SBRT) prior to systemic therapy?
1 Answer available
When do you recommend induction chemotherapy prior to concurrent chemoradiotherapy for locally advanced NSCLC?
If you treat pre-chemotherapy volumes, is there a benefit to induction chemotherapy even in bulky disease. If so, how do you define disease that ...
2 Answers available
Do you recommend concurrent or sequential radiation and chemotherapy for margin-positive, node negative NSCLC?
What factors influence your decision (R1 v. R2 resection? T stage?) If sequential, do you typically prefer radiation before or after chemotherapy?
2 Answers available
Do you use a TKI for resected EGFR+ non-small cell lung cancer?
In IB-IIIA cases?
1 Answer available


Papers discussed in this category

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2005-09-01
Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007-05-01
Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III Non-small-cell lung cancer: Cancer and Leukemia Group B.
Medical and pediatric oncology, 1990
Platinum-based combination chemotherapy in advanced non-small cell lung cancer: a randomized phase II trial of the Cancer and Leukemia Group B.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1986-01
A randomized trial of the four most active regimens for metastatic non-small-cell lung cancer.
N Engl J Med, 2017 Nov 16
Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer.
The New England journal of medicine, 2015-10-22
Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer.
Lancet (London, England), 2017-01-21
Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial.
The Lancet. Oncology, 2016-11
Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study.
The New England journal of medicine, 2018-05-31
Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer.
J. Clin. Oncol.,
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Sintilimab plus chemotherapy for patients with EGFR-mutated non-squamous non-small-cell lung cancer with disease progression after EGFR tyrosine-kinase inhibitor therapy (ORIENT-31): second interim analysis from a double-blind, randomised, placebo-controlled, phase 3 trial.
Lancet (London, England), 2023 Dec 14
Standard-of-care systemic therapy with or without stereotactic body radiotherapy in patients with oligoprogressive breast cancer or non-small-cell lung cancer (Consolidative Use of Radiotherapy to Block [CURB] oligoprogression): an open-label, randomised, controlled, phase 2 study.
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2019-01
Increased Hepatotoxicity Associated with Sequential Immune Checkpoint Inhibitor and Crizotinib Therapy in Patients with Non-Small Cell Lung Cancer.
The American journal of surgical pathology, 2020 Sep
Colorectal Adenocarcinomas Harboring ALK Fusion Genes: A Clinicopathologic and Molecular Genetic Study of 12 Cases and Review of the Literature.
The oncologist, 2024 Feb 21
Anaplastic Lymphoma Kinase (ALK) Inhibitors Show Activity in Colorectal Cancer With ALK Rearrangements: Case Series and Literature Review.
Molecular cancer research : MCR, 2009 Sep 08
Exon array profiling detects EML4-ALK fusion in breast, colorectal, and non-small cell lung cancers.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022 Apr 22
COAST: An Open-Label, Phase II, Multidrug Platform Study of Durvalumab Alone or in Combination With Oleclumab or Monalizumab in Patients With Unresectable, Stage III Non-Small-Cell Lung Cancer.
The Annals of thoracic surgery, 2015-02
Impact of adjuvant treatment for microscopic residual disease after non-small cell lung cancer surgery.
Lancet (London, England), 2010 Mar 24
Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: two meta-analyses of individual patient data.
The New England journal of medicine, 2024 Jun 02
Osimertinib after Chemoradiotherapy in Stage III -Mutated NSCLC.
The New England journal of medicine, 2018-01-11
Osimertinib in Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer.
International journal of radiation oncology, biology, physics, 2024 Feb 20
A Phase 2 Trial of Primary Tumor Stereotactic Body Radiation Therapy Boost Before Concurrent Chemoradiation for Locally Advanced Non-Small Cell Lung Cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-04-20
Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care.
Nature medicine, 2023 Nov 13
Association between pretreatment emotional distress and neoadjuvant immune checkpoint blockade response in melanoma.
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Gamma knife radiosurgery for thalamotomy in parkinsonian tremor: a five-year experience.
Pract Radiat Oncol, 2020 Oct 31
VMAT Grid Therapy: A Widely Applicable Planning Approach.
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Pembrolizumab with or without radiation therapy for metastatic non-small cell lung cancer: a randomized phase I/II trial.
J Immunother Cancer, 2019 Sep 4
Influence of low-dose radiation on abscopal responses in patients receiving high-dose radiation and immunotherapy.
Front Cardiovasc Med, 2023
Ventricular tachycardia ablation through radiation therapy (VT-ART) consortium: Concept description of an observational multicentric trial via matched pair analysis.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016 Sep 03
SPACE - A randomized study of SBRT vs conventional fractionated radiotherapy in medically inoperable stage I NSCLC.
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Local radiation therapy of B16 melanoma tumors increases the generation of tumor antigen-specific effector cells that traffic to the tumor.
International journal of radiation oncology, biology, physics, 2020 May 15
Effect of Low-Dose Radiation Therapy on Abscopal Responses to Hypofractionated Radiation Therapy and Anti-PD1 in Mice and Patients With Non-Small Cell Lung Cancer.
International journal of radiation oncology, biology, physics, 2022 Nov 24
Left Anterior Descending Coronary Artery Radiation Dose Association With All-Cause Mortality in NRG Oncology Trial RTOG 0617.
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2023 Feb 03
Demystifying the Results of RTOG 0617: Identification of Dose Sensitive Cardiac Subregions Associated With Overall Survival.
Frontiers in oncology, 2023 Sep 06
Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer.
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The New England journal of medicine, 2023 Oct 23
Perioperative Durvalumab for Resectable Non-Small-Cell Lung Cancer.
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Systematic endoscopic staging of mediastinum to guide radiotherapy planning in patients with locally advanced non-small-cell lung cancer (SEISMIC): an international, multicentre, single-arm, clinical trial.
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Pembrolizumab versus placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/KEYNOTE-091): an interim analysis of a randomised, triple-blind, phase 3 trial.
Front Oncol, 2023
ctDNA-based detection of molecular residual disease in stage I-III non-small cell lung cancer patients treated with definitive radiotherapy.
The New England journal of medicine, 2024 Apr 11
Alectinib in Resected -Positive Non-Small-Cell Lung Cancer.
Lancet Oncol, 2021 Dec 15
Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): an open-label, randomised, phase 3 trial.
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Brief Report: Safety and Antitumor Activity of Alectinib Plus Atezolizumab From a Phase 1b Study in Advanced -Positive NSCLC.

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