Discussing Maintenance Therapy in NSCLC

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The discussion about maintenance therapy as a treatment for non-small cell lung cancer (NSCLC) should begin early on with patients and their families, as it is important for patients to know the intent and goals of their therapy from the beginning, suggests Benjamin P. Levy, MD. Patients should be informed of the possibility of continuing to receive chemotherapy even after they have achieved stable disease.

Although the use of maintenance therapy in NSCLC has been associated with a survival advantage, not all patients will want to continue with treatment, notes Jyoti D. Patel, MD. When assessing whether to proceed with maintenance therapy, Patel weighs factors such as performance status, goals of therapy, and disease burden. Patel engages in shared decision making to ensure that maintenance therapy is a good fit for a particular patient.

When selecting the cytotoxic agents for maintenance therapy, toxicity and quality of life should be considered, notes Levy. Based on individual patient characteristics, standard approaches can be modified based on a patient’s tolerance of the regimen.