Dr Singh on Unmet Medical Needs in Lung Cancer Treatment

Raj Singh, MD, assistant professor, radiation oncology, The Ohio State University Comprehensive Cancer Center—James, discusses unmet medical needs in the treatment of patients with lung cancer and the growing role of radiation therapy in the management of this disease.

Addressing unmet needs in cancer care remains paramount, particularly concerning the accessibility and burden of treatment for patients, Singh begins. Even a relatively short treatment course consisting of 5 or fewer treatment sessions can prove daunting, especially in areas lacking the necessary infrastructure, Singh emphasizes. Despite providing care within a large academic center, Singh says he often witnesses the challenges patients face when confronted with the prospect of extended treatment durations. Although the efficacy and safety of these treatment regimens are well established, the primary barrier to care may lie in the logistical constraints of accessing specialized centers capable of providing these services, he reports.

Access to care is a multifaceted issue, influenced by geographical proximity as well as socioeconomic factors, Singh expresses. Patients with lung cancer, for instance, often belong to lower socioeconomic strata, owing to their significant smoking histories or broader struggles with social circumstances, Singh says. Consequently, the use of advanced treatment modalities becomes contingent upon addressing these systemic barriers, he adds. Ideally, the proliferation of such treatment techniques within local communities would alleviate the burden on patients, facilitating access to care closer to home, Singh explains.

In the realm of thoracic malignancies, stereotactic radiation therapy assumes an increasingly prominent role, offering a viable treatment option with minimal toxicity, he continues. This expanded utility broadens the scope of available treatments and holds promise for patients with oligometastatic disease, Singh elucidates. By targeting metastases confined to the lungs, oncologists aim to optimize patient outcomes and simultaneously circumvent the deleterious effects of extensive surgical interventions, thereby preserving the timeliness of systemic therapy—a critical determinant of long-term prognosis, he concludes.

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Raj Singh, MD, discusses unmet medical needs in the treatment of patients with lung cancer.

Dr Singh on Treating Lung Cancer CNS Metastasis Management Strategies

Raj Singh, MD, assistant professor, Radiation Oncology, The Ohio State University, Comprehensive Cancer Center — James, discusses the treatment of patients with lung cancer who develop central nervous system (CNS) metastases, highlighting how to best approach disease management in these patients.

, Singh highlights key sessions from the meeting, including one that spotlighted the treatment of patients with CNS disease due to their lung cancer. This session featured Paul Brown, MD, of Mayo Clinic, who has been instrumental in conducting studies on neurocognitive outcomes in patients with brain metastases, Singh begins. Dr Brown’s research consistently demonstrates that the use of stereotactic radiosurgery, which targets specific brain lesions rather than employing whole-brain radiotherapy, does not compromise patient survival, Singh reports. Importantly, neurocognitive outcomes have improved with stereotactic radiosurgery compared with the standard approach, Singh says. However, small cell lung cancer (SCLC) presents a unique challenge among solid tumors due to the likelihood of patients developing micrometastatic disease in the brain, he notes.

Traditionally, patients experiencing partial or complete response after upfront chemoradiotherapy have been offered prophylactic cranial irradiation, despite presenting with no visible signs of brain disease, Singh elucidates, adding that criticism arises from the outdated nature of studies supporting this practice, which were conducted prior to the MRI era at a time when the accuracy of staging was limited.

Two crucial ongoing studies aim to address this concern by randomly assigning patients with limited-stage SCLC to receive either prophylactic cranial irradiation or observation with MRI surveillance, Singh continues. Additionally, a growing interest in the use of stereotactic radiosurgery for patients with SCLC brain metastases is challenging the historical reliance on whole-brain radiotherapy, he elucidates.

Retrospective studies have also found no survival differences for patients who received stereotactic radiosurgery vs those who received standard whole-brain radiotherapy, prompting ongoing research to compare these 2 approaches, with a focus on hippocampal sparing, Singh says. Accrual to these trials is eagerly awaited to provide insights into optimizing treatment strategies and simultaneously prioritizing neurocognitive quality of life for patients, he concludes.

Raj Singh, MD, discusses treating patients with lung cancer with CNS metastases.

Dr Singh on the Utility of Radiation Therapy in Lung Cancer

Raj Singh, MD, assistant professor, Radiation Oncology, The Ohio State University, Comprehensive Cancer Center (OSUCC) OSUCC– James, discusses the utility of radiation therapy in patients with metastatic lung cancer, highlighting the evolution of treatment within this landscape.

Raj Singh, MD, discusses radiation therapy in patients with metastatic lung cancer, highlighting the evolution of treatment within this landscape.

Raj Singh, MD

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Dr Singh on Unmet Medical Needs in Lung Cancer Treatment

Dr Singh on Treating Lung Cancer CNS Metastasis Management Strategies

Dr Singh on the Utility of Radiation Therapy in Lung Cancer