Journal Review in Thoracic Surgery: Adjuvant Therapy in Lung Adenocarcinoma

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 22 November 2021

⏱️ 24 minutes

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Summary

November is Lung Cancer Awareness Month, and what better way is there to spend your time than getting to know the recent advances in adjuvant therapy for early-stage lung adenocarcinoma?

Learning Objectives

- Review work-up and treatment of lung adenocarcinoma
- Review evidence behind Osimertinib as an adjuvant therapy in EGFR mutation positive disease
- Review recent advances in gene expression profiles for targeted application of adjuvant chemotherapy
- Discuss future directions for research
- Discuss additional advancements in diagnosis, monitoring, and immunotherapy

Referenced Material

- Wu Y, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med 2020; 383:1711-1723. DOI: 10.1056/NEJMoa2027071 https://www.nejm.org/doi/full/10.1056/NEJMoa2027071
- Woodard GA, Wang SX, Kratz JR, et al. Adjuvant Chemotherapy Guided by Molecular Profiling and Improved Outcomes in Early Stage, Non-Small-Cell Lung Cancer. Clin Lung Cancer 2018;19(1):58-64. DOI: 10.1016/j.cllc.2017.05.015
https://www.clinical-lung-cancer.com/article/S1525-7304(17)30150-X/fulltext
- Woodard GA, Kratz JR, Haro G, et al. Molecular Risk Stratification is Independent of EGFR Mutation Status in Identifying Early-Stage Non-Squamous Non-Small Cell Lung Cancer Patients at Risk for Recurrence and Likely to Benefit From Adjuvant Chemotherapy. Clin Lung Cancer. 2021;20:S1525-7304(21)00212-6. DOI: 10.1016/j.cllc.2021.08.008
https://www.clinical-lung-cancer.com/article/S1525-7304(21)00212-6/fulltext

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Transcript

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0:00.0	behind the knife the surgery podcast where we take a behind the scenes intimate look at surgery
0:06.0	from leaders in the field.
0:21.2	Hello and welcome back. This is your thoracic team from Swedish Medical Center in Seattle with
0:26.0	myself Megan Lennahan joined by the esteemed doctors Brian Louis and Peter White. Hello.
0:33.5	Today we will be talking about some recent advancements in the management of early stage adenocarcinoma
0:39.5	of the lung. Dr. White in particular has been so excited for this episode. Dr. White would you
0:45.1	like to speak briefly about why you are so enthused? Thanks Megan. So lung cancer continues to be the
0:51.2	deadliest cancer in the United States by a huge margin. In fact if you look at mortality and you
0:56.8	add up the next three highest cancers colon breast and prostate it's higher than all three combined.
1:03.1	Even for early stage disease not only do we see that high mortality but there's such a wide
1:08.4	range of median survival. When you look at the non-small cell lung cancer five-year survival it ranges
1:15.2	from 68 to 92 percent just for stage one and anywhere from 53 to 60 percent for stage two.
1:22.3	While surgical resection remains the mainstay of treatment for early stage non-small cell lung cancer
1:28.1	the benefit of adjuvant therapy has been much more limited. Older trials such as the Anita trial
1:34.0	and JBR-10 showed only modest improvements in survival but more substantial advances in adjuvant
1:39.9	therapy have been made just within the last few years. On today's podcast we're going to discuss
1:44.4	some of the exciting developments in targeted therapy by taking a deeper dive at the adjuvant
1:48.9	trial and this evaluates osomurtinib a tyrosine kinase inhibitor targeted to the epidermal growth
1:55.4	factor receptor or EGFR and it's benefit for stage one B to three A patients with EGFR mutations.
2:03.6	Then we'll present two new papers that use a 14 gene expression profile to identify early stage
2:10.1	patients who are likely to benefit from adjuvant cytotoxic chemotherapy. Before we dive into
2:15.9	anything further I want to mention that none of us have any financial disclosures or relationships
	...

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