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NSCLC: Exploring Treatment Challenges and the Potential in Clinical Trials

Medically Reviewed by Neha Pathak, MD on May 24, 2021

By Jason Sager, MD, as told to Kara Mayer Robinson

Right now, treatment for NSCLC involves surgery, chemotherapy, and radiation therapy, either alone or in combination. Surgery is still our main tool. But often, it’s not curative. When cancer has spread to lymph nodes or beyond, it’s called metastasis. When this happens, you’ll need oral and IV medicines to treat cells everywhere in your body.

Doctors and researchers are trying to find therapies that work better to cure NSCLC. Although new therapies have been recently approved, a cure still remains out of reach for most people with metastatic cancer.

Clinical Trials: Another Treatment Option

For some people with lung cancer, a clinical trial is a good option. Clinical trials test innovative therapies. They’re often combined with therapies that we know work already. Unlike noncancer trials, very few have a placebo, or no-treatment, group. When you enroll in a clinical trial, you’ll be treated under the very close watch of an oncologist with expertise in the therapy. Their aim is to give people the best possible benefit.

I’ve worked with many people who have defied fate with the help of one or more clinical trials. Because they’re so carefully regulated, the care you receive is among the best available. The oncologists who offer these trials are very knowledgeable. They’re enthusiastic about understanding the reasons why cancer grows. They’re doing their best to benefit others with these new therapies.

Current Clinical Trials for NSCLC

Because there are so many people with NSCLC, there are more clinical trials for them than any other type of cancer. New, exciting therapies are being tested in hundreds of clinical trials. More than 900 are currently open and enrolling in the United States alone.

Some clinical trials look at bispecific antibodies that attack two cancer proteins at the same time. Others focus on medicines that attack a specific mutated protein in the cancer. One clinical trial may help boost the outcome of surgery. Another may offer a new type of imaging scan or reduce side effects.

For many people, clinical trials offer the best ways to treat advanced and metastatic cancer. These innovative approaches may use targeted therapy, or medicines that target your tumor cells specifically. Or they may stimulate your immune system to better attack the cancer, also called immunotherapy.

Clinical trials are most hopeful for those who have advanced stage NSCLC or for those whose cancer returns or grows after treatment. These people are most likely to need an innovative treatment offered only by a clinical trial.

When you’re enrolled in a clinical trial, you’ll have an imaging scan every few months to see if the cancer has grown, shrunk, or stayed the same. You may also have blood tests to monitor your body’s response to the therapy and biopsies. Your cancer center and doctor will give you more details about your trial.

The downside of clinical trials is that all this attention and extra care may mean more doctor visits, blood tests, and time spent in the clinic than you might have with standard therapies.

Finding the Right Clinical Trials

I recommend that you find out which treatment options exist to treat your cancer, right from the beginning and at every decision point in your journey. This includes clinical trials.

Finding the right trial for you or your loved one with NSCLC can be a challenge. I recommend enlisting the help of knowledgeable friends, doctors, or professional advisors to look at the best options at every decision point. Not every idea or clinical trial works, so I recommend lining up several trial options and trying them in sequence.

The best way to find the right match is to look at the specific alterations in your cancer cells with a test called next-generation sequencing (NGS), which is also called tumor genetic analysis.

These personalized tests look at more than 200 genes associated with cancer. They’re already approved by the FDA and covered by Medicare, Medicaid, and most health insurance plans. You can request one from your doctor and then share the results with your advisors to find out which trials may pair best with you.

The Future of NSCLC Treatment

The more people who participate in clinical trials, the faster we’ll find beneficial therapies and the faster we’ll find new cures for NSCLC and all cancers.

Because of this, the people who hold the key to accelerating cancer cures are actually the patients. By participating in a clinical trial, you may not only benefit yourself, but millions of others who also have NSCLC.

WebMD Feature

Sources

SOURCE:

Jason Sager, oncologist and president, Sagely Health, LLC, Boston.

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