Dr Lee on the Importance of Multidisciplinary Collaboration in NSCLC Management

“The collaboration between medical oncologists, radiation oncology, and surgeons, enables us to have a cohesive plan for the patient.”

Percy Lee, MD, vice chair of Clinical Research in the Department of Radiation Oncology, medical director of Orange County & Coastal Region Radiation Oncology, and a professor in the Department of Radiation Oncology at City of Hope, discussed the critical nature of multidisciplinary collaboration in oncology. He also highlighted questions that remain regarding the optimal use of stereotactic ablative body radiotherapy (SABR) in patients with NSCLC.

Multidisciplinary collaboration facilitates the development of a unified and cohesive treatment plan for patients with NSCLC, Lee began. This essential cooperation involves medical oncologists, radiation oncologists, and surgeons, he noted. When patients receive consistent information—for example, when an initial oncologist suggests radiation and a radiation oncologist confirms the appropriateness of the treatment based on favorable anatomical considerations and the ability to safely deliver SABR doses—patients’ level of reassurance increases, according to Lee. The patient often recognizes that the proposed therapy is the result of a consensus reached by a coordinated team, rather than a collection of separate therapies offered independently by individual providers, Lee summarized.

The radiation oncology field has substantially improved its ability to treat a greater number of lesions safely due to continuous advancements in treatment technology, Lee reported. However, a major hurdle remains, which is the difficulty in precisely identifying the specific patient population that will derive the most profound benefit from SABR, he added. To address this challenge, Lee emphasized the future necessity of incorporating advanced molecular tools. Specifically, using circulating tumor DNA (ctDNA)–based biomarkers will be helpful, he said. These biomarkers, which could function as prognostic or predictive markers and be assessed both before and after treatment, would be instrumental in making treatment decisions, he continued. Integrating ctDNA assays into the decision-making process would allow oncologists to select appropriate candidates for SABR in the context of oligometastatic disease, moving beyond the current reliance on merely counting the number of lesions that can be treated at a given time, he concluded.