The landscape of Stage 3A lung cancer treatment is being transformed through an innovative multidisciplinary approach, as revealed by experts at the NCODA Fall Summit in Orlando, Florida. The Moffitt Cancer Center's integrated care model demonstrates how coordinated efforts between various healthcare professionals are improving patient outcomes through personalized treatment strategies.
Advancing Precision Medicine Through Genetic Testing
Stage 3A adenocarcinoma, representing approximately 40% of all primary lung cancer cases in the United States, requires sophisticated diagnostic approaches. The center's molecular pathology team, led by Dr. Theresa Boyle, employs next-generation sequencing (NGS) to identify crucial genetic alterations that guide treatment decisions.
"When we're doing the sequencing, we're looking for a whole slew of mutations and a whole slew of genes," explains Dr. Boyle. The evolution from EGFR mutation testing to comprehensive genomic profiling has revolutionized treatment selection, enabling more precise therapeutic interventions.
Coordinated Care Delivery
The treatment journey begins with nurse navigators, who serve as crucial patient advocates. Donna Gallenstein, BSN, RN, GERO-BC, highlights their comprehensive role: "We want to make sure that they can get around in our clinic... understanding the disease process, and that goes along with low health care literacy."
Medical oncologists, including Dr. Sonam Puri, coordinate with surgical and radiation teams to develop optimal treatment strategies. In cases of ALK-positive tumors, targeted therapies such as alectinib (Alecensa) are implemented based on promising clinical trial results.
Innovative Treatment Protocols
Recent clinical trials have shaped current treatment approaches. The PACIFIC trial, which originated at Moffitt, demonstrated significant progression-free survival benefits with durvalumab immunotherapy following chemoradiation in stage 3 non-small cell lung cancer patients.
Pharmacy Integration and Patient Support
The pharmacy team plays a vital role in treatment delivery and patient education. Daniel Melzer, PharmD, BCOP, emphasizes their focus on addressing financial barriers and providing comprehensive medication counseling: "There's a lot of anxiety... It's a lot of setting expectations and knowing that, yes, some of these drugs are horrible, but not all these drugs are horrible."
Technology-Driven Pathology
The center's pathology department utilizes advanced technology, including high-throughput sequencing machines like NovaSeq, capable of processing up to 50 samples simultaneously. This technological integration enables rapid and accurate genetic profiling, essential for personalized treatment planning.
Financial Navigation and Access
A significant component of the team's effort focuses on addressing treatment access barriers. The pharmacy team, working alongside financial counselors, helps navigate insurance coverage challenges and copayment assistance programs, ensuring patients can access their prescribed treatments.
The multidisciplinary approach at Moffitt Cancer Center represents a significant advancement in lung cancer care, combining scientific innovation with patient-centered support services. This integrated model not only improves treatment outcomes but also addresses the complex challenges faced by patients throughout their cancer journey.
