“The ultimate goal for all research in the treatment of patients with non-small cell lung cancer is to improve the cure rate.”
Studies have shown that the mortality rate of male patients with non–small cell lung cancer (NSCLC) has dropped by 58% between 1990 to 2020. The mortality rate for female patients has dropped by 36% between 2002 to 2020. Continuing breakthroughs bode well for an even greater decrease in years to come. To keep pace with the advancements in this field of study, the National Comprehensive Cancer Network (NCCN) regularly convenes a panel of experts to review research findings and current clinical recommendations to determine what updates should be included in the NCCN Clinical Practice Guidelines in Oncology for Non–Small Cell Lung Cancer. First published in 1996, these guidelines have been updated on at least a yearly basis with the input of those at the forefront of the field. Gregory J. Riely, MD, PhD, Member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panel for Non–Small Cell Lung Cancer/Mesothelioma/Thymomas and Thymic Carcinomas, spoke with Physician’s Weekly about some of the new recommendations found in these updated guidelines.
PW: Why did you feel these guidelines needed updating? What was missing in the knowledge base prior?
Dr. Riely: The NCCN Guidelines for the treatment of patients with non-small cell lung cancer are constantly reviewed to incorporate new advances, leading to the release of multiple new versions each year. These frequent updates are required to keep up with the rapid generation of new knowledge in this field. In just the past year, we have seen new data supporting the incorporation of drugs directed at new targets and new disease settings.
PW: What are the most important changes in the guidelines for physicians to be aware of?
Dr. Riely: In the past year, we have seen multiple publications that show improved outcomes for patients with early-stage non-small cell lung cancer who receive a combination of chemotherapy and immune checkpoint inhibitor prior to surgery. While treatment before surgery (aka neoadjuvant therapy) was sometimes used before, consideration for this is now a routine part of practice and the guidelines have been updated to incorporate this. The guidelines have also been updated to include new therapies approved in the past year as well (Figure).
PW: How can this information be incorporated into practice?
Dr. Riely: The NCCN Guidelines are formatted in a way that allows rapid understanding of guideline-supported therapy in most clinical situations.
PW: What still needs to be explored?
Dr. Riely: The ultimate goal for all research in the treatment of patients with non-small cell lung cancer is to improve the cure rate. We have seen dramatic advances with targeted therapy as well as immunotherapy, and the development of new drugs and evaluation of already approved drugs in new situations, which holds out the hope that we can, slowly but surely, increase the cure rate.
PW: Is there anything else that you feel Physician’s Weekly readers would benefit from knowing about the guidelines?
Dr. Riely: For the treatment of lung cancer, the NCCN Guidelines are the most comprehensive and most rapidly updated guidelines available to everyone
