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Expert Insights into NSCLC Unmet Needs


Experts offer concluding insights on unmet needs in NSCLC treatment and the future of patient care.

David Carbone, MD, PHD: Any final comments relating to unmet needs and barriers before we close?

Martin Dietrich, MD, PhD: Maybe I want to get started. I am very excited about the future. I do think with all the challenges that we discussed today, I think we are seeing the benefit of the existing therapies extending across all stages now post-radiation, around surgery. Obviously there are many trials that are going to be enhancing what we can already do. Some of them complement what we do, epitope-directed therapy, injection therapies to enhance immunotherapy responses, and obviously also seeing better and better combination strategies for targeted therapies, looking at clonal evolution. If I were to look at the future of lung cancer, I'm very convinced that in 2 or 3 years we'll be quite a bit further than we are now. I think with all the challenges that we're facing, I do think there is a tremendous amount of opportunity for treatment. Doing what we already know is the first step. But the growth in lung cancer is going to be fueled by the suggestions that you made about pragmatic trials, larger trials capturing and really making our voice heard as clinical investigators to really exert our influence to say, well, these trials don't need to meet the needs of our patients and then help modify those protocols in a positive direction.

David Carbone, MD, PHD: Final comments, Dr Gillaspie?

Erin A. Gillaspie, MD, MPH, FACS: Yeah, I am equally excited. Every year we have new opportunities, new hope. We are doing things, I think, better across the board in all of our different specialties for our patients, which is so exciting. I think my 1 hope above everything else is that we all remain curious and that we keep pushing to make things better and we keep asking more questions. At the end of every trial, we must ask, “Is this the best we can do, or can we push it further? How can we combine things in a better way? How can we all continue to provide excellent care to our patients?”

David Carbone, MD, PHD: Now, I would totally second that. To me is particularly exciting. When I got a PhD in genetics with my medicine degree and at that time those 2 fields didn't interact at all. It's very exciting to see how molecular biology, basic science, understanding of what's going on in the patient and in the tumor really is now directly impacting patient care in a terrific way. Where I used to tell metastatic patients that they were treatable but not curable. I can't say that anymore. I've had multiple patients who live normal lives off therapy and die of something else, and that's, in effect, a cure. That's super exciting to me because of science and research directly. Closing comments.

Salma Jabbour, MD, FASTRO: Yeah, I'm very excited about the future as well. I think that we have done a great job to date, but we have to ask the questions like everyone has said, we have to continue to individualize care. What do we do with that patient who doesn't have the great response after neoadjuvant therapy? We still have no answers there. We don't have the clear answers yet. I think that the clinical trials continue to help us, and we have to all push to improve the therapies through those trials, but we have to generalize the trials to make them more inclusive, to get them to different populations, to make the results really. Basically, if applicable, to everybody. We don't have that right now. We have work to do on that front. Also, earlier finding of cancers, finding cancers earlier means that we have higher cure rates and certainly shooting for that will get us to better cure rates long term for lung cancer. I'm optimistic about the future. We have great therapies. We have more to come, and I'm just hopeful that we continue to do the work to optimize the care for patients going forward.

David Carbone, MD, PHD: Dr Forde?

Patrick Forde, MBBCh: I agree completely. I think we are curing far more patients compared to now, even compared to 10 years ago. I think there are 2 tracks. There's the moonshot where we're doing all these new therapies, and then in Europe they have something called the ground shots where you're trying to implement the therapies. And I think actuallyboth tracks are really important because we can cure, say, 5% of patients here. We might bring that up to 30, 40% by implementing everything in practice. I think that's something really important for all of us to keep in mind when we're designing trials and also working with colleagues. In industry and also in different specialties, epidemiology, all different types of scientists who work in this area.

David Carbone, MD, PHD: It's all very exciting, but I think we'll all agree that there's a lot of room for improvement. I think the future is bright. Thanks to all of you for this rich and informative discussion and thank you, again, to our viewing audience. We hope that you found this agency peer exchange to be useful and informative.

Transcript is AI-generated and reviewed by an AJMC editor.

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