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

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.

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

“…This approach reduces time wasted for travel to reach the referral center and shortens the time to case evaluation [13]. Such a collaborative strategy strongly depends on efficient and effective communication between vMTB team members [14]. To be efficient and effective, vMTB requires a collaborative approach, appropriately leveraging the diverse expertise of LC.…”

“…Some evidence suggests that implementing MDT discussions improves patients' outcomes, i.e., pretreatment evaluation, proper staging, adequate treatment, quality of survivorship, and overall survival [12][13][14]. Specchia et al very recently reported an umbrella review on MTB's impact on all types of cancer, reporting only one systematic review on LC published several years ago in 2008 [13,14]. However, Australian researchers recently published a scoping review of current evidence for LC-MDT data collection and analysis and its impact on clinical outcome [16][17][18].…”

Molecular testing in stage I–III non-small cell lung cancer: Approaches and challenges

“…Treatment modalities for stage I-IIIA NSCLC are heterogeneous requiring cooperation between many specialties. A MDT approach involving all those involved in a patient's treatment is key to establishing the need for molecular testing, developing any regional or institutional algorithm, and coordinating molecular testing [60,61]. Communication between specialties is vital to avoid delays and reduce unnecessary procedures and pathology tests, and is also helpful to communicate the adequacy of the sample, status of molecular testing, and the testing results to all specialists involved in the care of an individual patient.…”

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

“…This approach reduces time wasted for travel to reach the referral center and shortens the time to case evaluation [13]. Such a collaborative strategy strongly depends on efficient and effective communication between vMTB team members [14]. To be efficient and effective, vMTB requires a collaborative approach, appropriately leveraging the diverse expertise of LC.…”