BackTable Vascular & Interventional Ep. 595 Lung Cancer Staging and Systemic Therapies: Recent Advancements with Dr. Karen Reckamp and Dr. Scott Atay
Dec 5, 2025
Dr. Karen Reckamp, a thoracic oncologist at Cedars-Sinai, and Dr. Scott Atay, a thoracic surgeon at USC, delve into the complexities of lung cancer treatment. They discuss the latest in lung cancer staging and cutting-edge systemic therapies. Key insights include the evolving role of molecular diagnostics, the importance of tailored treatment plans, and the integration of new therapies in surgical decision-making. They also explore the implications of pollution and genetic factors on non-smoker EGFR risks, highlighting a future focused on personalized cancer care.
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New 2025 Staging Clarifies Treatment Targets
- The 2025 lung cancer staging (version 9) adds granularity in lymph node stations and metastatic categories to guide therapy selection.
- New M1 subcategories (M1A/B/C) help identify patients who may benefit from local therapy to solitary sites.
Prioritize NGS; Use Liquid When Needed
- Use tissue-based next-generation sequencing first when possible and wait for it before acting on PD-L1 in adenocarcinoma patients.
- Use liquid biopsy when tissue is insufficient or to monitor for resistance mechanisms like MET amplification.
Different Liquid Biopsies Fit Different Settings
- ctDNA liquid biopsies serve different roles: ultra-sensitive MRD assays in early-stage and higher-shedding ctDNA in metastatic disease.
- Tissue-informed MRD assays improve specificity for recurrence monitoring.