Clinical Oncology Training Pathways: A Guide for NSCLC
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Targetable Molecular Algorithm for Next Generation DNA Sequencing in Non-Small Cell Lung Cancer
Introduction
The goal of the project is to build a comprehensive clinical pathway system to increase the understanding and use of Next Generation Sequencing (NGS) in Non-Small Cell Lung Cancer (NSCLC) by general oncologists, pathologists, and oncology nurse navigators.
Clinical pathways are systems-based tools for creating greater transparency around care decision making, therapeutic selection, and care delivery, and they improve quality and efficiency by reducing non value-added intra-provider variability in care.
One of the goals is to train approximately 100 providers on how to use this clinical pathway system. This new and innovative pathway training system will make decision-making easier for clinicians who are trying to understand the appropriate tests and treatment algorithms for their patients.
Background about NSCLC
Over the last decade, the treatment of patients with advanced non-small cell lung cancer (NSCLC) has become dependent on tissue and/or blood biomarkers to help guide treatment decisions. There have been multiple studies citing the superiority of targeted therapies as compared to conventional therapies. Unfortunately, the proportion of patients with advanced adenocarcinoma receiving tumor genetic testing remains low, and it is therefore important to increase awareness regarding potentially targetable genetic alterations, that if tested and identified can potentially affect a patient's prognosis. There is a critical need to provide a better understanding and more information about molecular testing for the lung cancer community.
How I manage CNS metastasis
Radiation Oncology or Neurosurgery evaluation for the following:
Negative molecular profile
Pending/positive molecular profile and any of the following:
Symptomatic brain metastasis – headache, gait disturbances, altered mental status, etc.
Lesions greater than 3 cm
Edematous lesions
Lesions in critical areas or concern for herniation, e.g. pons, medulla
Leptomeningeal disease