Optimizing Early-Stage NSCLC Management: A Multidisciplinary Perspective - Episode 10
Evolving Targeted Therapy Approaches in Resectable Early-Stage NSCLC With Actionable Mutations
Panelists discuss how medical professionals are integrating targeted therapies, such as those for EGFR, ALK, and other mutations like RET and ROS1, into the treatment of resectable early-stage non–small cell lung cancer (NSCLC), with a focus on incorporating the ADAURA and ALINA regimens into clinical practice.
Video content above is prompted by the following:
The Evolving Role of Targeted Therapy in Resectable Early-Stage NSCLC
In the treatment of patients with resectable early-stage NSCLC, the evolving role of targeted therapies has become central to clinical decision-making. Medical professionals focus on identifying specific genetic mutations such as EGFR, ALK, RET, and ROS1 to guide personalized treatment strategies.
- EGFR Mutations: In patients with EGFR mutations, targeted therapies such as EGFR inhibitors (eg, osimertinib) are now integral, especially after resection. Studies like ADAURA have demonstrated that adjuvant osimertinib significantly improves disease-free survival (DFS) in patients with EGFR mutations, which is leading to its incorporation into clinical practice as a standard postsurgical therapy.
- ALK Rearrangements: For patients with ALK-positive NSCLC, the use of ALK inhibitors (eg, alectinib, brigatinib) is recommended. These therapies show strong efficacy in the adjuvant setting, and with the advent of studies like ALINA, the role of these agents post resection is becoming clearer, especially in high-risk patients.
- Other Mutations (RET, ROS1): Targeted therapies for RET and ROS1 mutations (eg, selpercatinib for RET and entrectinib for ROS1) are also gaining traction in clinical practice, though their incorporation into early-stage settings is still being explored. However, early results suggest promising outcomes with these therapies in the metastatic setting, prompting ongoing trials for their role in the adjuvant space.
Incorporating ADAURA and ALINA Regimens: The findings from the ADAURA and ALINA trials have paved the way for the routine integration of osimertinib and alectinib as adjuvant therapies in patients with EGFR and ALK mutations, respectively. As these therapies show significant improvements in DFS, physicians are increasingly incorporating them into their clinical practice as part of a personalized treatment plan, particularly for patients with high-risk features or residual disease following surgery.
Conclusion
The continued focus on genetic profiling and targeted therapy for resectable early-stage NSCLC is changing how clinicians approach treatment, enhancing the potential for long-term survival and better outcomes for these patients.
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