Harvey I. Pass, MD, director, thoracic surgery, thoracic oncology, NYU Langone Medical Center, discusses what it means to take a personalized approach to surgery in lung cancer.

Unlike it medical oncology, it is difficult to define what a personalized approach is in surgery, says Pass. However, the main idea behind a personalized surgical approach is that patients that are atypical or unusual need to be treated differently than the average patient.

For example, if a patient has a small nodule and the randomized trial data is not in yet on whether a lobectomy is necessary, a personalized surgical approach means talking with the patient about the pros and cons of treatment options. Most of the time, in a patient with a small lesion, instead of doing a lobectomy, Pass says he considers a segmentectomy.

A personalized care approach can also be considered for patients with advanced disease when determining if surgery is a good decision. There are patients that need to be operated on that get good local control, says Pass. Overall survival rates are often similar with or without surgery. But the ultimate decision should be based on what’s right for the individual patient.

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 Harvey I. Pass, MD, director, Thoracic Surgery, Thoracic Oncology, NYU Langone Medical Center, discusses what it means to take a personalized approach to surgery in lung cancer.

Dr. Harvey I. Pass on Personalized Surgical Approaches in Lung Cancer

Harvey I. Pass, MD, director, Thoracic Surgery, Thoracic Oncology, NYU Langone Medical Center, discusses treatment resistance in mesothelioma.

Researchers are trying to determine the difference between cells that are resistant to mesothelioma treatment and those that are not. Only about 4% of mesothelioma cells have unique properties that allow them to survive treatment with pemetrexed, stress conditions, or radiation therapy.

When the majority of mesothelioma tumor cells are killed, these unique cells will not respond — they will stay behind and repopulate the tumor, Pass says.

Dr. Pass Discusses Resistance in Mesothelioma

Harvey I. Pass, MD, Stephen E. Banner Professor of Thoracic Oncology, Vice-Chair Research, Department of Cardiothoracic Surgery, Division Chief, General Thoracic Surgery, NYU Langone Medical Center, discusses blood-based markers in lung cancer.

Pass says the Early Detection Research Network, an NCI-approved group, is handling the research on biomarkers for early detection of lung cancer. The group is looking at blood-based markers, such as micro RNAs and proteomic platforms, in order to try to determine if a nodule on a CT scan is malignant or benign.

Pass says that though there is not a definitive profile, there is a company that is currently commercializing one. However, the sensitivity and specificity of the profile is still not perfect and further tests are being performed.

Dr. Pass on Blood-Based Markers in Lung Cancer  

Harvey I. Pass, MD, Stephen E. Banner Professor of Thoracic Oncology, Vice-Chair Research, Department of Cardiothoracic Surgery, Division Chief, General Thoracic Surgery, NYU Langone Medical Center, discusses the challenges of treating patients with mesothelioma.

Mesothelioma is a notorious disease of elderly people, Pass says, and symptoms may go unnoticed or develop slowly. Additionally, a delay in treatment could arise. Pass says that only about 20% of patients with mesothelioma are seen that may be good surgical candidates for a multimodality treatment.

It remains important to find the disease earlier, when effective treatment may have a chance.

Harvey I. Pass, MD, from the NYU Langone Medical Center, discusses the challenges of treating patients with mesothelioma.


Harvey I. Pass, MD

Articles

Dr. Harvey I. Pass on Personalized Surgical Approaches in Lung Cancer

Dr. Pass Discusses Resistance in Mesothelioma

Dr. Pass on Blood-Based Markers in Lung Cancer

Dr. Pass on the Challenges of Treating Mesothelioma