Robert M. Jotte, MD, PhD, medical director and co-chair of the USON Thoracic Committee at Rocky Mountain Cancer Centers, discusses the low rate of screening for lung cancer.

There are many reasons why there is such a low rate of lung cancer screening, explains Jotte. The primary reason is that the topic is not being brought up. Primary care providers are expected to address a variety of problems in a relatively short office visit, and so lung cancer screening is often overlooked. Physicians must decipher what the immediate risk to the patient is, and proceed accordingly. 

In a 15-minute appointment, a patient is expected to disclose all their problems, have the physician address those problems, and take a couple minutes to discuss a risk that may never materialize. However, for the patients in whom it does materialize, it can be lifesaving, says Jotte.

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Dr. Jotte on the Low Rate of Screening in Lung Cancer

Robert M. Jotte, MD, PhD, medical director and co-chair of the USON Thoracic Committee at Rocky Mountain Cancer Centers, discusses the optimal frequency of lung cancer screening.

Though screening is recommended for patients who meet the appropriate criteria based on age and smoking history, the optimal frequency is unknown, explains Jotte. When a screening program is implemented, a lot of patients will come in at once. There are the patients whose CT scan at that time was negative, but 2 years from now might turn positive, says Jotte. That might be the one patient whom a physician can capture and operate on early so that they have an improvement in overall survival, despite their diagnosis.

The problem, explains Jotte, is that once patients get screened and find that do not have cancer, they think they do not have to be screened anymore. Therefore, a lot of patients are lost in the screening process that should continue down the road.

Physicians do not have any specific recommendations as to how often someone should get a CT scan. If an abnormality is identified, such as a solitary pulmonary nodule, the Fleischner criteria can be very helpful, explains Jotte. The criteria are used to capture those patients who are potentially going to develop a lung cancer versus those who have benign etiologies.

Dr. Jotte on the Optimal Frequency of Lung Cancer Screening

Robert M. Jotte, MD, PhD, medical director and co-chair, USON Thoracic Committee, Rocky Mountain Cancer Centers, discusses the phase III findings of the IMpower131 trial, which looked at the addition of atezolizumab (Tecentriq) to frontline carboplatin and nab-paclitaxel (Abraxane) in patients with advanced squamous non-small cell lung cancer (NSCLC). Jotte discussed these findings in an interview with 

IMpower131 was a 1000-patient study in treatment-naive patients with squamous NSCLC and, regardless of their level of PD-L1 expression, were randomized to receive carboplatin and paclitaxel plus atezolizumab (arm A), carboplatin and nab-paclitaxel plus atexolixumab (arm B) and carboplatin and paclitaxel (arm C), explains Jotte.

The primary endpoints of the study were investigator-assessed progression-free survival and overall survival. Data showed that arms B and C, which were able to analyzed at this time, demonstrated that a doubling in PFS from 12% in the control arm to 24.7% in the atezolizumab-containing arm, and the response rates increased in the PD-L1—high category from 33% to 60%, and the duration of response was also improved, concludes Jotte.

Robert M. Jotte, MD, PhD, medical director and co-chair, USON Thoracic Committee, Rocky Mountain Cancer Centers, discusses the phase III findings of the IMpower131 trial, which looked at the addition of atezolizumab (Tecentriq) to frontline carboplatin and nab-paclitaxel (Abraxane) in patients with advanced squamous non

Robert M. Jotte, MD, PhD

Articles

Dr. Jotte on the Low Rate of Screening in Lung Cancer

Dr. Jotte on the Optimal Frequency of Lung Cancer Screening

Dr. Jotte on the IMpower131 Findings in Squamous NSCLC