This transcript has been edited for clarity.
It's Mark Kris from Memorial Sloan Kettering. I have been thinking lately about treatments after initial therapy for non–small cell lung cancers, what people often call second-line therapy.
I think the first thought is that, for all the regimens that are available and tested, the results are clearly not as good as seen with first-line therapy. I'll get into some specifics in a second. That being the case, it's really important to make the best choice for first-line therapy.
The second thing that is absolutely critical is to very carefully assess when that first-line therapy has stopped working and whether there is a need for a new systemic therapy. We very often have these situations where there is an oligoprogression, and by treating a single symptomatic lesion, you may get the patient in a very good place and may continue initial therapy. Very often, there is inconsequential growth of the cancer.
For example, if there is a 21% increase in the size of a primary tumor that is not associated with any symptoms in a person who is living their life and is not having any severe side effects, you have to think long and hard about changing that therapy.
COMMENTARY
How to Think About Second-Line Therapy in NSCLC
Mark G. Kris, MD
DisclosuresOctober 31, 2023
This transcript has been edited for clarity.
It's Mark Kris from Memorial Sloan Kettering. I have been thinking lately about treatments after initial therapy for non–small cell lung cancers, what people often call second-line therapy.
I think the first thought is that, for all the regimens that are available and tested, the results are clearly not as good as seen with first-line therapy. I'll get into some specifics in a second. That being the case, it's really important to make the best choice for first-line therapy.
The second thing that is absolutely critical is to very carefully assess when that first-line therapy has stopped working and whether there is a need for a new systemic therapy. We very often have these situations where there is an oligoprogression, and by treating a single symptomatic lesion, you may get the patient in a very good place and may continue initial therapy. Very often, there is inconsequential growth of the cancer.
For example, if there is a 21% increase in the size of a primary tumor that is not associated with any symptoms in a person who is living their life and is not having any severe side effects, you have to think long and hard about changing that therapy.
Medscape Oncology © 2023 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: How to Think About Second-Line Therapy in NSCLC - Medscape - Oct 31, 2023.
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Authors and Disclosures
Authors and Disclosures
Author
Mark G. Kris, MD
Professor of Medicine, Weill Cornell Medical College; Attending Physician, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY
Disclosure: Mark G. Kris, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca; Roche/Genentech; Ariad Pharmaceuticals
Received a research grant from: Pfizer Inc; PUMA; Roche/Genentech