Navigating Diagnostic and Treatment Decisions in Non-Small Cell Lung Cancer: Expert Commentary on the Multidisciplinary Team Approach

Author:

Popat Sanjay12,Navani Neal3,Kerr Keith M.4,Smit Egbert F.5,Batchelor Timothy J.P.6,Van Schil Paul7,Senan Suresh8,McDonald Fiona12

Affiliation:

1. Lung Unit, Royal Marsden Hospital, London, United Kingdom

2. The Institute of Cancer Research, University of London, London, United Kingdom

3. Lungs for Living Research Centre, University College London (UCL) Respiratory, UCL and Department of Thoracic Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom

4. Department of Pathology, Aberdeen University Medical School and Aberdeen Royal Infirmary, Aberdeen, United Kingdom

5. Department of Pulmonary Diseases, VU University Medical Center and Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

6. Department of Thoracic Surgery, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, United Kingdom

7. Department of Thoracic and Vascular Surgery, Antwerp University Hospital and Antwerp University, Antwerp, Belgium

8. Department of Radiation Oncology, Amsterdam University Medical Center, Free University Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands

Abstract

Abstract Non-small cell lung cancer (NSCLC) accounts for approximately one in five cancer-related deaths, and management requires increasingly complex decision making by health care professionals. Many centers have therefore adopted a multidisciplinary approach to patient care, using the expertise of various specialists to provide the best evidence-based, personalized treatment. However, increasingly complex disease staging, as well as expanded biomarker testing and multimodality management algorithms with novel therapeutics, have driven the need for multifaceted, collaborative decision making to optimally guide the overall treatment process. To keep up with the rapidly evolving treatment landscape, national-level guidelines have been introduced to standardize patient pathways and ensure prompt diagnosis and treatment. Such strategies depend on efficient and effective communication between relevant multidisciplinary team members and have both improved adherence to treatment guidelines and extended patient survival. This article highlights the value of a multidisciplinary approach to diagnosis and staging, treatment decision making, and adverse event management in NSCLC. Implications for Practice This review highlights the value of a multidisciplinary approach to the diagnosis and staging of non-small cell lung cancer (NSCLC) and makes practical suggestions as to how multidisciplinary teams (MDTs) can be best deployed at individual stages of the disease to improve patient outcomes and effectively manage common adverse events. The authors discuss how a collaborative approach, appropriately leveraging the diverse expertise of NSCLC MDT members (including specialist radiation and medical oncologists, chest physicians, pathologists, pulmonologists, surgeons, and nursing staff) can continue to ensure optimal per-patient decision making as treatment options become ever more specialized in the era of biomarker-driven therapeutic strategies.

Funder

Medical Research Council / NIHR Clinical Academic Research Partnership

NIHR Biomedical Research Centre

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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