Gilberto Lopes Jr, MD, a medical director for International Programs at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, discusses steroid side effects in lung cancer management.

The use of immunotherapy, such as checkpoint inhibitors, often result in immune-related side effects. Once a patient is on steroids to treat autoimmune side effects from immunotherapy, Lopes says that physicians should be prepared to treat side effects from the steroids. For example, patients can develop pneumonitis after receiving a checkpoint inhibitor.

Lopes says that at Sylvester Comprehensive Cancer Center, he tends to give patients PCP prophylaxis to avoid the development of pneumocystis pneumonia in patients who are on steroids for a prolonged period of time.

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Dr. Lopes Discusses Steroid Side Effects in Lung Cancer Management

Gilberto Lopes Jr, MD, a medical director for International Programs at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, discusses the role of immunotherapy for patients with head and neck cancer.

Two of the major groups of patients with head and neck cancer are those who have HPV-related disease and those who do not, explains Lopes. For patients who were entered in trials investigating immunotherapy, it did not seem that having an HPV infection interfered with results. Patients who have PD-L1-positive disease did experience better responses.

There are 2 large randomized phase III trials, one which was clearly positive with the use of nivolumab (Opdivo), and one that trended to be positive with the use of pembrolizumab (Keytruda), states Lopes. Both drugs are available for patients who have failed initial therapy. Standard initial therapy involves a platinum therapy or cetuximab.

For patients in the locally advanced setting, immunotherapy is not used, but there are potential options. Patients who can receive concurrent chemoradiation are usually treated with cisplatin, and patients who cannot can often benefit from the addition of cetuximab to radiation.

Dr. Lopes on Immunotherapy in Head and Neck Cancer

Gilberto Lopes Jr, MD, a medical director for International Programs at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, discusses the important of addressing financial toxicity during the 5th Annual Miami Lung Cancer Conference.

The treatment of patients with lung cancer has improved markedly, but not all patients have access to new treatment modalities that could help prolong their life. There are many patients who do not have insurance, and because of this, they do not have access to diagnostic or therapeutic options. Additionally, studies have shown that patients who are on Medicaid, as opposed to commercial insurance, may also have worse outcomes.

Lopes says it is important for physicians to address cost and financial toxicity with their patients. With the rising cost of medications, it has become an increasing burden on patients, and many are unable to cope.

While addressing insurance is the best way to make certain a patient will receive proper treatment, it is also important to see if patients can receive additional support from programs that may be available to them, Lopes says.

Gilberto Lopes Jr, MD

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Dr. Lopes Discusses Steroid Side Effects in Lung Cancer Management

Dr. Lopes on Immunotherapy in Head and Neck Cancer

Dr. Lopes Discusses the Importance of Addressing Financial Toxicity in Lung Cancer