Dr. Rami Manochakian Discusses the Evolution of Lung Cancer Treatment

Rami Manochakian, MD, FASCO, of the Mayo Clinic, Florida, who served as the lung cancer panelist during The Oncology Brothers Advancements in Oncology event, discusses how treatment for lung cancer has changed.

“It’s a great era for patients with lung cancer in all aspects, early stage and late stage,” he said. “Of course, we’re not where we want to be, but it’s evolving every year [with] more progress.”

Dr. Manochakian shared key updates on lung cancer from the 2024 American Society of Clinical Oncology Annual Meeting during the June 1 event with The Oncology Brothers, Rahul Gosain, MD, MBA, and Rohit Gosain, MD. One major area of discussion was the role of surgery and the evolution of the perioperative landscape in non-small cell lung cancer.

“For the early stage—and again, to be specific, the patients who have cancer without major actionable mutations—this is where the neoadjuvant versus perioperative versus nonsurgical approach [considerations are],” Dr. Manochakian said.

He explained how the situation and the considerations have changed with the advent of certain therapies.

“It’s really in the immunotherapy era, how you integrate the immunotherapy,” Dr. Manochakian said. “We have multiple regimens that have shown efficacy and better outcomes when they were compared with just simple neoadjuvant chemotherapy followed by surgery. Now we have multiple options.”

There are many factors that go into the decision, he said, emphasizing the importance of having a multidisciplinary team involved and receiving patient input on the path taken. Overall, it’s important to recognize that having many options for patients is a “good problem” to have, but the decision should be carefully considered and tailored to a patient’s disease stage, characteristics, and preferences.