Better Predictions of Detectable Tumor Cells Still Needed to Improve Outcomes for Patients With Resectable Non-Small Cell Lung Cancer

Jonathan Spicer, MD, medical director of the McGill University Health Center Thoracic Oncology Network, discusses what is still needed to be investigated in the future following the phase 3 trial assessing nivolumab plus platinum-doublet chemotherapy as neoadjuvant treatment for resectable non-small cell lung cancer.

Pharmacy Times interviewed Jonathan Spicer, MD, associate professor of surgery at McGill University and medical director of the McGill University Health Center Thoracic Oncology Network, on his presentation at the 2021 American Society of Clinical Oncology Annual Meeting on surgical outcomes from the phase 3 CheckMate 816 trial assessing nivolumab plus platinum-doublet chemotherapy (chemo) vs chemo alone as neoadjuvant treatment for patients with resectable non-small cell lung cancer.

During the discussion, Spicer addresses what is still needed to be investigated for future research on this topic, and how this research is important to the field.

Jonathan Spicer: Well, I think there's always the need for more research. Even though we're excited about these new findings, we know that we're a long way from fixing all the problems.

I think with about a quarter of patients—and it's important to remember that this is an intent-to-treat basis, so even people who didn't make it to surgery are in that denominator, which means that the actual number who had complete responses may actually be higher, but I think the conservative estimate of 25% of people having no detectable tumor cells that are still alive in the resected specimen tumor and lymph nodes is a very important finding. We need to figure out how to predict that.

Since other studies have shown that this might occur in as many as 60% of people, really finding out what that real number is with more of these similar studies that will be coming out over the coming years—being able to predict that event so maybe one day we may not need to consider surgery or we may be able to significantly curtail the extent of the operation or other ways of knowing whether the patient has had a complete response or not—I think these are really the key questions.

Local therapy generally brings consequences, morbidity, function loss, and so if we can find ways of reducing the need for that, I think that would be valuable to patients.