James Stevenson, MD, medical oncologist and hematologist, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses the importance of early screening in lung cancer. 

Chest CT screening for lung cancer is an easy strategy to detect potentially cancerous nodules, Stevenson says. Being able to detect potentially cancerous nodules is the goal of any type of cancer screening that is completed in the early-stage setting when patients may be asymptomatic, Stevenson explains.

Additional data are likely to emerge regarding larger screening programs, which will reveal the percentage of small cell lung cancer vs non–small cell lung cancer vs other cancer types that are detected through screening. Moreover, data may indicate whether screening can lead to a stage migration in lung cancer where a higher percentage of patients are being diagnosed at earlier stages, Stevenson concludes.

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James Stevenson, MD, discusses the importance of early screening in lung cancer.  


Dr. Stevenson on the Importance of Early Screening in Lung Cancer  

James Stevenson, MD, medical oncologist and hematologist, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses ongoing research efforts that are generating excitement in extensive-stage small cell lung cancer (ES-SCLC). 

Standard-of-care treatment for ES-SCLC has evolved in recent years with the introduction of novel approaches; however, even with immunotherapy, these patients still experience a poor prognosis, according to Stevenson. Efforts are underway to improve outcomes for these patients as they have for those with non–small cell lung cancer, where longer durations of response are achieved with maintenance immunotherapy, Stevenson adds. 

The phase 2/3 RAPTOR trial (NCT04402788) will examine consolidation radiotherapy to the thorax and other sites of oligometastatic disease following initial chemoimmunotherapy, just as maintenance immunotherapy is initiated, Stevenson says. Participants will be randomized to either receive radiotherapy or not.

Local recurrences, especially in the chest, can be problematic in SCLC, and earlier studies examining thoracic consolidation radiotherapy have yielded promising results. As such, the results from RAPTOR are anticipated, Stevenson concludes.

James Stevenson, MD, discusses ongoing research efforts that are generating excitement in extensive-stage small cell lung cancer.

Dr. Stevenson on Ongoing Research Efforts in ES-SCLC

James Stevenson, MD, medical oncologist at Cleveland Clinic, discusses the potential of immunotherapy agents as treatment for patients with squamous non—small cell lung cancer (NSCLC).

Stevenson predicts that the landscape of squamous NSCLC will be completely different in the coming years, especially in the frontline setting. Here, immunotherapy may more often be a first choice by oncologists compared with chemotherapy. Additionally, combination therapies with chemotherapy plus monoclonal antibodies, such as necitumumab (Portrazza), will also likely be given as a later-line treatment for patients.

Further research will help oncologists decide on the first-, second-, and third-line regimens for squamous NSCLC, as well as their own clinical experience, Stevenson adds.

James Stevenson, MD, medical oncologist at Cleveland Clinic, discusses the potential of immunotherapy agents as treatment for patients with squamous non–small cell lung cancer (NSCLC).

Dr. Stevenson on Potential of Immunotherapy in Squamous NSCLC

James Stevenson, MD, medical oncologist, Cleveland Clinic Taussig Cancer Institute (TCI), discusses the impact of a stage IV non-small-cell lung cancer (NSCLC) care pathway on front-line and maintenance chemotherapy.

At the Cleveland Clinic, as well as at other similar cancer centers, treatment for frontline NSCLC varies significantly from patient to patient and treating oncologist to oncologist, says Stevenson.

His team of thoracic oncologists determined that the most effective and least toxic frontline treatment regimen for NSCLC was pemetrexed and carboplatinum and the most effective maintenance regimen was pemetrexed. This information was then communicated across the institution and to all affiliated regional sites.

Data confirmed that within six months of this standardized care pathway being implemented, 86% of patients were being treated with the preferred regimen of pemetrexed and carboplatinum. Prior to the creation of this care pathway different regimens were given at 20-30% rates.

James Stevenson, MD, medical oncologist, Cleveland Clinic Taussig Cancer Institute (TCI), discusses the impact of a stage IV non-small-cell lung cancer (NSCLC) care pathway on front-line and maintenance chemotherapy.


James Stevenson, MD

Articles

Dr. Stevenson on the Importance of Early Screening in Lung Cancer

Dr. Stevenson on Ongoing Research Efforts in ES-SCLC

Dr. Stevenson on Potential of Immunotherapy in Squamous NSCLC

Dr. James Stevenson on Standardized Care Pathways for NSCLC Treatment