Dr Florez on the Importance of Establishing Consensus Within the Evolving Lung Cancer Treatment Landscape

“[Many] questions…remain, and we have the experts coming together to try to find some level of consensus to provide guidance to the lung cancer community globally. Every year, our consensus changes because the data are coming so fast. It’s truly a unique meeting because we are focused on answering questions that probably haven’t been answered until today."

Narjust Florez, MD, associate director of the Cancer Care Equity Program and a thoracic medical oncologist at Dana-Farber Cancer Institute; as well as a faculty member at Harvard Medical School, discussed the importance of establishing expert consensus in the evolving lung cancer treatment paradigm in 2025. She emphasized that the Bridging the Gaps in Lung Cancer meeting, now in its third year, is uniquely structured to identify and address clinical uncertainties in real time as new data emerge.

Given the rapid pace of therapeutic advances, unresolved clinical questions arise and shift from year to year, Florez began. Some knowledge gaps identified in 2024 have since been resolved by newly available trial results, whereas others persist or have expanded, she said. For example, the optimal duration of adjuvant targeted therapy in biomarker-selected non–small cell lung cancer remains undefined, she explained.

Similarly, management strategies for patients achieving a complete pathologic response following neoadjuvant chemoimmunotherapy continue to generate debate, according to Florez. Additionally, leptomeningeal disease—a rare but challenging manifestation—lacks robust, evidence-based treatment guidelines, she stated.

The Bridging the Gaps forum brings together global thoracic oncology experts to work toward alignment in these areas, Florez continued. By design, the meeting focuses exclusively on areas of clinical ambiguity, with participants reviewing the latest evidence, considering regional practice variations, and integrating multidisciplinary perspectives, she added. The aim is to reach a consensus that is both globally relevant and adaptable to different health care systems, she reported, saying that importantly, these recommendations are not static. Consensus statements issued one year may require significant revision the next, as phase 3 trial readouts, biomarker validation studies, or real-world data redefine optimal practice, she noted.

The iterative nature of consensus building is essential for maintaining high-quality care in an era of rapidly changing standards, Florez explained. Without these structured discussions, variability in practice patterns could widen, potentially affecting patient outcomes, she cautioned.

Notably, a manuscript published in a peer-reviewed journal following the meeting and shared broadly with the international lung cancer community will serve as a practical guide for oncologists navigating situations where randomized clinical trial evidence is either limited or absent.