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QUESTION: What happens when you ask four astute community-based medical oncologists to present some of their most challenging lung cancer cases to two hotshot clinical investigators from Houston? ANSWER: Lots of interesting stuff.

This program focuses on a tumor panel discussion that quickly narrowed in on the most controversial issues in contemporary lung cancer management. To hear how our faculty responded to the following research to practice questions, pop in the enclosed CDs and tapes into your car or download the MP3s to your iPod.

— Neil Love, MD
NLove@ResearchToPractice.net
April 7, 2006

Where do tyrosine kinase inhibitors (TKIs) fit into the management of a patient with non-small cell lung cancer (NSCLC) who is a nonsmoker or has an abnormality in tumor epidermal growth factor receptor? (Case 1)

Trials are under way to answer this critical question, but in the interim, which data set do we believe?

What is the optimal management of a patient with a short disease-free interval after receiving adjuvant chemotherapy for NSCLC? (Case 2)

This patient had mediastinal recurrence, which raised the issue of bevacizumab concurrent with radiation therapy, an untested strategy in lung cancer.

What is the optimal management of unresectable Stage III NSCLC? (Case 3)

Is the current “standard of care” the SWOG-S9504 strategy of etoposide/cisplatin/radiation therapy followed by docetaxel?

How should elderly and poor-performance status patients with metastatic NSCLC be managed? (Cases 4 and 5)

Is erlotinib a kinder, gentler first-line therapy for these patients? Does bevacizumab have a role? What about the combination?

How should patients with small cell lung cancer and an unknown primary tumor be managed? (Case 6)

In this case, our two faculty members and the treating physician all had different recommendations.

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