Standard-of-care therapy in lung cancer: be open to new ideas. OncTwitter lungcancer oncology
You need NGS testing to find those targets and give patients a targeted therapy. Even if you want to give a checkpoint inhibitor with or without chemotherapy, you need to have NGS testing.
Bottom line: NGS testing should be done for everybody, and you need to do the most comprehensive panel available both for DNA and RNA. There are a couple of things to consider, though. Number one, these drugs do have chemotherapy and they have side effects from chemotherapy. I think the consensus is that when you treat patients with an antibody-drug conjugate, you need to give antiemetic regimens, at least for trastuzumab and the other deruxtecan drugs. You need to give a regimen for highly emetogenic chemotherapy as prophylactic antiemetics. I think that was a consensus thought.
I think the experts thought lorlatinib would be a good drug. Yes, it has a different spectrum of side effects. The central nervous system side effects are something we have to learn how to take care of; however, we can do that. Generally, with dose reduction, those side effects are manageable.
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