Contributed by: Lung Cancer Oncologist Unit in Vall d’Hebron Institute of Oncology
Edited by: Emma Tsai, Future Needs Management Consulting
Our clinical partner, Vall d’Hebron Institute of Oncology (VHIO) is a reference center for personalised medicine in oncology created in 2006. Their research focuses on understanding the fundamental biology of human cancer, from cellular and molecular biology and genetics through to therapeutics. VHIO is a clinical partner of AI4LUNGS, gathering clinically relevant data from retrospective samples of non-small-cell lung cancer patients.
Dr. Alexandre Martínez Martín and Dr. Ilaria Priano, medical lung oncologist at the Vall d'Hebron Hospital and researchers at VHIO’s Thoracic Tumors Group highlight the critical role of precision medicine, molecular analysis, and multidisciplinary collaboration in improving patient care, and key breakthroughs in the evolving treatment strategies for resectable NSCLC.
Resectable refers to cancers that can be removed completely through surgery. In the context of lung cancer, resectable NSCLC typically includes early-stage cancers (stages I to IIIA, and in some cases selected IIIB) where the tumor has not spread extensively beyond the lung or to distant organs, making it feasible to remove the affected lung tissue surgically.
Lung cancer remains a challenge for patients and clinicians, particularly when it comes to early-stage non-small cell lung cancer. While advances in early detection and treatment have improved survival rates, there are still significant obstacles. However, the treatment for resectable NSCLC has undergone a dramatic transformation with the integration of immunotherapy and targeted therapies, marking the era of precision medicine.
About the Current State of Early-Stage NSCLC Diagnosis it is important to keep in mind that in Spain, 35% of lung cancer patients are diagnosed with Stage I-II tumours, where the 5-year survival rates range from 92% for Stage IA1 to 53% for Stage IIB. However, the outlook is more challenging for the 24% of patients diagnosed with locally advanced Stage III disease, with 5-year survival rates between 13-36%. Despite complete anatomical resection, recurrence rates remain unacceptably high.
Dr. Alexandre Martínez Martín and Dr. Ilaria Priano answered some questions regarding transformative advances in the treatment of resectable NSCLC, the importance of molecular analysis and coordinated care, and how innovative approaches are optimising diagnosis and treatment strategies.
What are some Transformative Advances in NSCLC Treatment?
The treatment for resectable NSCLC has shifted dramatically with the introduction of immunotherapy and targeted therapies. Recent European Medicines Agency (EMA) approvals and recommendations reflect this shift, offering new hope to patients.
These therapies have not only enhanced the tools available for treatment but also introduced precision into clinical decision-making.
The Importance of Molecular Analysis and Multidisciplinary Coordination:
The integration of molecular analysis (EGFR mutations, ALK rearrangements) and PD-L1 evaluation as routine assessments for resected NSCLC has become crucial in providing and determining the optimal treatment. Coordination with pathologists to establish a Reflex Test is essential for providing clinicians with timely, actionable diagnostic information.
Multidisciplinary teams play a vital role in defining treatment strategies, particularly in complex cases like operable Stage III NSCLC. These teams ensure that all available data are incorporated into decision-making, allowing for the most informed choices.
The Hopeful and Bright Future of Oncology
Early-stage NSCLC has entered the era of precision medicine, where molecular analysis and innovative therapies provide improvements in patient care. By continuing to explore new strategies, optimise existing treatments, and ensuring collaborative research, we can further improve outcomes for patients battling lung cancer.
The data and key breakthroughs in the Lung cancer Unit from VHIO share the evolving treatment strategies for resectable Non-small cell lung cancer (NSCLC), which the critical role of precision medicine, molecular analysis, and multidisciplinary collaboration in improving patient care. These innovations are offering new hope for patients and enhancing decision-making for physicians, significantly impacting outcomes in resectable NSCLC.
What are the main challenges you have observed in the current process of stratifying lung cancer patients?
In the diagnosis, treatment and follow-up of patients with non-small cell lung cancer (NSCLC), we currently face many challenges in routine clinical practice. Not all the information is always available to make certain decisions. Artificial intelligence (AI) can be very useful to analyse, integrate and interpret data regarding radiological, clinical, anatomopathological and molecular characteristics. This interpretation of BIG data can help us predict the best therapeutic strategy for a patient as well as predict toxicities or select patients with a worse prognosis.
How can improved lung cancer patient stratification optimise the diagnosis and treatment of respiratory diseases?
It is always difficult to determine which operated NSCLC patients have a higher risk of recurrence and who require complementary treatment to reduce this percentage of risk and, on the contrary, which patients will not benefit from adjuvant treatment.
At the same time, it is not always easy to classify in the radiological follow-up with CT scan whether the appearance of pulmonary nodules will be suspicious of relapse or whether they will be inflammatory or infectious findings due to their previous underlying pulmonary pathology.
The AI4LUNGS platform can be a very useful tool for stratifying patients.
What recent advancements in technology or research do you believe have the most potential to enhance lung cancer patient stratification?
Integrating all molecular information will be of great importance to personalise treatments and follow-up.
The early-stage NSCLC treatment is evolving rapidly, with advancements in immunotherapy, molecular analysis, and AI-driven patient stratification. As highlighted by Dr. Alexandre Martínez Martín and Dr. Ilaria Priano, a multidisciplinary approach is essential in optimising diagnosis and treatment, ensuring that each patient receives the most effective and personalised care.
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