The Fellow on Call: The Heme/Onc Podcast Episode 062: “Paging Heme/Onc: Updates from ASCO 2023” - Management of NSCLC and KEYNOTE 671
Jun 21, 2023
Dive into the evolving landscape of resectable non-small cell lung cancer (NSCLC) treatments. Discover insights from the KEYNOTE 671 trial, showcasing the benefits of combining neoadjuvant chemotherapy with immunotherapy. The hosts break down crucial statistics, including improved event-free survival and pathologic complete response rates. They also tackle complex topics like interaction tests and multiplicity in clinical trials, shedding light on their implications for practice. Tune in for a rich discussion that blends data with practical insights!
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When To Use Neoadjuvant Therapy
- Most resectable NSCLC still goes straight to surgery with adjuvant chemo when indicated.
- Reserve neoadjuvant (induction) therapy for tumors >7 cm, mediastinal/central nodal disease, or invasion of other structures.
Choose Platinum Doublet By Histology
- Use a platinum doublet postoperatively for node-positive disease or tumors >4 cm.
- Choose cisplatin+pemetrexed for adenocarcinoma and cisplatin+gemcitabine for squamous histology.
Rationale For Upfront Systemic Therapy
- Neoadjuvant therapy aims to treat occult micrometastatic disease and improve local control before surgery.
- It also avoids delays or poor tolerance of adjuvant chemo after complex thoracic operations.