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Non-small cell lung cancer (NSCLC) is one of the most common types of lung cancer with many different subtypes that are caused by specific genetic changes. One of these mutations involves the ROS1 gene.1,2
According to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), lung cancer diagnosis and treatment should be informed by the consensus of specialists.3 In lung cancer, this typically includes radiation oncologists, medical oncologists, surgical oncologists, pathologists, palliative care experts, oncology nurses, social workers, and pharmacists. 3,4
While the practice landscape is rapidly evolving, there remains a need for many hospitals and health systems to prioritize a collaborative multidisciplinary team (MDT) approach, particularly in the community setting. 5
Physician’s Weekly (PW) spoke with Edgardo Santos, MD, medical oncologist and director of Broward County for the Oncology Institute of Hope and Innovation, to better understand why an MDT approach is beneficial for patients with ROS1+ NSCLC.
PW: Can you share with us any personal experience working on a multidisciplinary team and how you feel that it enhanced the management of this patient population? What are some of the key benefits that you’ve observed?
Dr. Santos: The value of an MDT approach in cancer care lies in the diverse perspectives and expertise it brings to the table.4,6 Involving specialists such as radiation oncologists, medical oncologists, surgical oncologists, pathologists, palliative care experts, oncology nurses, social workers, and pharmacists significantly enhances patient management.4,6 This collaborative approach helps ensure that every aspect of a patient’s care is addressed comprehensively, from diagnosis through treatment.6
One of the key benefits I have observed is that an MDT provides a broad range of insights and solutions, which can streamline the diagnostic and treatment processes.6 For instance, during tumor board discussions, immediate input from pathologists can help determine the most appropriate testing methods, such as next-generation sequencing.4 This real-time collaboration allows for smoother progress and timely adjustments if any issues arise, with all relevant experts contributing to the decision-making process.6
Moreover, having a multidisciplinary team means that patients can experience a higher level of care and support throughout their treatment journey.7 They benefit from a coordinated approach where the treatment path is clearly outlined, and they feel reassured knowing that a team of professionals is working together towards achieving the best outcomes.7
That said, I truly see the benefit in every hospital or network adopting this collaborative, MDT approach for all types of tumors, not just lung cancer.
PW: What strategies do you use to ensure clear communication and consistent coordination among the care team, especially during care transitions?
Dr. Santos: It always starts with a strong MDT. We want to make sure that our team has the right people on the team and that everyone has a clearly defined role to ensure communication is streamlined.
For example, one important individual on the team is the navigator.8 The navigator, typically an experienced nurse, plays a crucial role in coordinating care and communication among the different divisions involved in patient treatment.8 For hospital administrators aiming to create an effective tumor board and multidisciplinary team, including navigators is essential to the success of the program.8
PW: How do you prioritize the holistic well-being of patients with ROS1+ NSCLC regarding supportive care measures?
Dr. Santos: I like to involve a social worker and dietician and consider integrative mapping for a holistic approach, especially for patients with a rare mutation such as ROS1+. I also recommend encouraging patients to connect with others; there are many online platforms for both the public and patients with ROS1 alterations, where one can find information and share experiences.
I encourage doctors to check with their hospital or cancer center on how comprehensively they can support patients with both treatment and holistic care.
PW: How do you stay updated on the latest advancements and best practices for managing this specific subset of patients?
Dr. Santos: One key approach is joining professional associations such as the American Society of Clinical Oncology (ASCO®). Accessing its virtual presentations and online webinars allows me to connect with global experts and stay informed about the latest research and treatment modalities.
Additionally, I participate in regional meetings and continued medical education activities offered by various consortiums, organizations and educational vendors throughout the United States. These events provide valuable opportunities for learning and networking.
I also engage with organizations specifically focused on lung cancer, such as the Lung Cancer Foundation of America, to further enhance my knowledge and expertise in this area. Through these combined efforts, I ensure that I remain at the forefront of lung cancer management and can provide the best possible care for my patients.
Read on to learn more about the role of pharmacists in oncology care for NSCLC patients.
