Dan Costin, MD, co-medical director, White Plains Hospital Center for Cancer Care, director, Cancer and Blood Specialists of New York, discusses initial considerations in early-stage lung cancer.

Patients with early-stage lung cancer typically require a multidisciplinary approach to treatment, says Costin. For example, thoracic surgeons, in addition to medical oncologists, will often be involved in initial treatment decisions.

In the early-stage setting, tissue diagnosis and appropriate staging are needed, says Costin. The majority of patients will undergo a CT-guided biopsy or a navigational bronchoscopy to determine tissue diagnosis. For staging, patients typically undergo a PET scan.

For a patient with a confirmed diagnosis of early-stage lung cancer, initial treatment selection is based on factors such as patient comorbidities, surgical eligibility, and results of molecular testing, concludes Costin.

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Dan Costin, MD, discusses initial considerations in early-stage lung cancer.  



Dr. Costin on Initial Considerations in Early-Stage Lung Cancer 

Daniel Costin, MD, hematology and oncology, White Plains Hospital, discusses the potential with immunotherapy agents in the frontline setting as treatment for patients with non—small cell lung cancer (NSCLC).

Immunotherapy has become a standard of care in the second-line setting, Costin explains. A question among researchers now is: can immunotherapy be introduced as first-line therapy in patients with early-stage lung cancer?

Traditionally, early-stage patients are treated with surgery followed by chemotherapy; however, he adds, many of them still recur and will potentially die from their cancer. Since immunotherapy has had a significant impact in NSCLC treatment, researchers are considering moving them up in patients with early-stage diseas. This is being explored in ongoing trials.

For example, the ANVIL study is investigating standard surgery followed by chemotherapy, if appropriate, followed by randomization with nivolumab (Opdivo) or placebo in patients with early-stage lung cancer. This is a very important question to answer, he says.

Daniel Costin, MD, hematology and oncology, White Plains Hospital, discusses the potential with immunotherapy agents in the frontline setting as treatment for patients with non–small cell lung cancer (NSCLC).

Daniel Costin, MD

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Dr. Costin on Initial Considerations in Early-Stage Lung Cancer

Dr. Costin on Frontline Immunotherapy for Patients With NSCLC