Lung Cancer Care Research Articles

Experience and Care Pathway of Patients with Lung Cancer: An Online International Survey.

This research soughtto identify trends in the patientwith lung cancer (LC) care pathway, experiences, and needs, across geographies and healthcare settings. Patients living with LC for more than 18years in nine countries completed an online survey covering these domains-demographic, disease, treatment, and patient preferences for information and support services. Recruitment was primarily from patient with LCcommunities on online platforms. A total of 1000 patients with LC completed the survey across Europe (49%), North America (29%), and Asia (22%). Demographics of participants were different to what has been reported in literature-there were a lower proportion of type non-small cell lung cancer (NSCLC), a higher proportion of type small cell lung cancer (SCLC), a higher rate of early-stage diagnosis, and a younger population. There were 56% male participants. Although physicians were the main stakeholders influencing treatment choice and quality of life (QoL) discussions, the patient's family/relatives ranked highly as important stakeholders. The top reasons patients reported choosing a treatment were related to efficacy, and hesitation to start a treatment was related to concerns about side effects. QoL was an important factor in both cases. Patients are impacted physically, socially, and mentally-50% report an impact on employment status, 48% report daily difficulties in mental well-being, and 64% have received psychological support or would like to. Disparities were observed across countries in genetic/biomarker testing completed or planned (30-88%) and being asked to participate in clinical trials (15-49%), which reflects the status of how differentpatientwith LC care pathways have adopted innovation in LC care. Both medical and external factors impact experiences and outcomes of patients living with LC, including the role of family in treatment and QoL discussions. There are intercountry differences in knowledge and disease management.

Anti-PD1 therapies induce an early expansion of Ki67+CD8+ T cells in metastatic non-oncogene addicted NSCLC patients

Pembrolizumab (an anti-PD1 antibody) alone or combined with chemotherapy represented the standard of care for advanced non-oncogene addicted non-small cell lung cancer (NSCLC) patients. These therapies induced early modifications of the immune response impacting the clinical outcome. Identifying early changes in the immune system was critical to directing the therapeutic choice and improving the clinical outcome. In this study, we aim to analyze the activating and inhibiting immune cells of NSCLC patients before and during therapy to identify patients who will benefit from immunotherapies. Forty-eight NSCLC patients were analyzed before (T0) and after the first cycle of immunotherapy (T1), evaluating several activating (CD137+and PD1+), proliferating (Ki67+) and immunosuppressing immune subsets (Tregs: total, active, resting, and non-suppressive; MDSCs: PMN(Lox1+)-MDSC and M-MDSCs) by cytofluorimetry. Concurrently, 14 soluble immune checkpoints were analyzed by Luminex assay. Immunotherapy significantly increased the levels of Ki67+(total and CD8+) T cells, PMN(Lox1+)-MDSCs, non-suppressive Tregs (nsTregs), and soluble PD1 from T0 to T1 in the entire NSCLC population, while decreased active Tregs. These changes were partially attributed to responding patients who showed an increase of Ki67+ and CD8+T cells and nsTregs at T1. CD137+(total, CD8+, and CD4+) T cells and soluble LAG3 were predictor factors at T0 and T1. A low ratio of Tregs/CD137+ T cells and high levels of Ki67+CD137+ T cells positively correlated with response to therapy at T0 and T1, respectively. Results highlighted that immunotherapy improved the immunological fitness of those patients who benefited from immunotherapy, changing the immunological balance towards immune activation.

Emerging Molecular and Clinical Challenges in Managing Lung Cancer Treatment during the Covid-19 Infection

The COVID-19 pandemic now had a broad impact on the health care system since its start. Cancer patients, specifically lung cancer patients, are undergoing a more vulnerable group due to their complex pathophysiological and immunological characteristics. Therefore, they need more attention and care about health and treatment. It is yet unknown how SARS-CoV-2 (COVID-19) infected lung cancer patient's health and management of treatment impacts them. From a clinical and multidisciplinary perspective, we aimed to explain our main priorities concerning COVID-19 infection in the scenario of lung cancer patients’ group in this chapter. Various types of lung cancer therapeutic strategies, including chemotherapy, radiation therapy, and immunotherapy, can all significantly increase the risk, therefore making a patient's chances of a poor outcome higher. Patients with lung cancer need regular clinical and radiologic examinations and follow-ups, which the COVID-19 pandemic might hamper. COVID-19-related lung cancer patients’ incidental radiologic abnormalities might show up in regular radiology exams, making it challenging to understand disease progression and the effect of therapy. The COVID-19 pandemic has profoundly impacted lung cancer care, highlighting challenges in patient management, treatment outcomes, and ethical dilemmas. Quantitative analysis and exploration of future directions would enhance clinical and research impact. In addition, cancer treatment-induced pneumonitis can exhibit radiologic characteristics that are identical to those seen in acute SARS-CoV-2 pneumonia, possibly due to a wrong diagnosis and misinterpretation. The current COVID-19 health crisis is affecting many healthcare requirements, including the necessity for regular healthcare accessibility, particularly follow-ups, and the clinical trials in which this patient group may be included. The COVID-19 epidemic has placed healthcare practitioners, scientists, researchers, and institutions in a complex and dangerous situation, forcing them to address challenges with ethical scenarios.

Home-Based Exercise and Self-Management After Lung Cancer Resection

Patients with lung cancer have poor physical functioning and quality of life. Despite promising outcomes for those who undertake exercise programs, implementation into practice of previously tested hospital-based programs is rare. To evaluate a home-based exercise and self-management program for patients after lung resection. A randomized clinical trial with assessor blinding was conducted among 116 patients undergoing surgery for non-small cell lung cancer from November 23, 2017, to July 31, 2023, at tertiary hospitals in Australia. Patients were followed up for 12 months postoperatively. Patients randomized to the intervention group received a postoperative 3-month home-based exercise and self-management program, supported by weekly physiotherapist-led telephone consultations. Patients randomized to the control group received usual care. The primary outcome was self-reported physical function (30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30] score) at 3 months. Secondary outcomes included objective measures of physical function and exercise capacity (at 3 and 6 months) and patient-reported outcomes including quality of life (at 3 and 6 months, with some questionnaires completed at 12 months). Analysis was performed on an intent-to-treat basis. A total of 1370 patients were screened, with 177 eligible and 116 consented (mean [SD] age, 66.4 [9.6] years; 68 women [58.6%]). Of these 116 patients, 58 were randomized to the intervention and 58 to the control. A total of 103 patients (88.8%) completed assessments at 3 months, 95 (81.9%) at 6 months, and 95 (81.9%) at 12 months. There were no statistically significant differences between the intervention and control groups for self-reported physical function (EORTC QLQ-C30 physical functioning domain score) at the 3-month primary end point (mean [SD] score, 77.3 [20.9] vs 76.3 [18.8]; mean difference, 1.0 point [95% CI, -6.0 to 8.0 points]). Patients in the intervention group, compared with the control group, had significantly greater exercise capacity (6-minute walk distance: mean difference, 39.7 m [95% CI, 6.8-72.6 m]), global quality of life (mean difference, 7.1 points [95% CI, 0.4-13.8 points]), and exercise self-efficacy (mean difference, 16.0 points [95% CI, 7.0-24.9 points]) at 3 months as well as greater objectively measured physical function (Short Physical Performance Battery score: mean difference, 0.8 points [95% CI, 0.1-1.6 points]), exercise capacity (6-minute walk distance: mean difference, 50.9 m [95% CI, 6.7-95.1 m]), and exercise self-efficacy (mean difference, 10.1 points [95% CI, 1.9-18.2 points]) at 6 months. One minor adverse event and no serious adverse events occurred. In this randomized clinical trial, a postoperative home-based exercise and self-management program did not improve self-reported physical function in patients with lung cancer. However, it did improve other important clinical outcomes. Implementation of this program into lung cancer care should be considered. http://anzctr.org.au Identifier: ACTRN12617001283369.

Genomic insights for personalised care in lung cancer and smoking cessation: motivating at-risk individuals toward evidence-based health practices

Lung cancer and tobacco use pose significant global health challenges, necessitating a comprehensive translational roadmap for improved prevention strategies such as cancer screening and tobacco treatment, which are currently under-utilised. Polygenic risk scores (PRSs) may further motivate health behaviour change in primary care for lung cancer in diverse populations. In this work, we introduce the GREAT care paradigm, which integrates PRSs within comprehensive patient risk profiles to motivate positive health behaviour changes. We developed PRSs using large-scale multi-ancestry genome-wide association studies and standardised PRS distributions across all ancestries. We validated our PRSs in 561,776 individuals of diverse ancestry from the GISC Trial, UK Biobank (UKBB), and All of Us Research Program (AoU). Significant odds ratios (ORs) for lung cancer and difficulty quitting smoking were observed in both UKBB and AoU. For lung cancer, the ORs for individuals in the highest risk group (top 20% versus bottom 20%) were 1.85 (95% CI: 1.58-2.18) in UKBB and 2.39 (95% CI: 1.93-2.97) in AoU. For difficulty quitting smoking, the ORs (top 33% versus bottom 33%) were 1.36 (95% CI: 1.32-1.41) in UKBB and 1.32 (95% CI: 1.28-1.36) in AoU. Our PRS-based intervention model leverages large-scale genetic data for robust risk assessment across populations, which will be evaluated in two cluster-randomised clinical trials. This approach integrates genomic insights into primary care, promising improved outcomes in cancer prevention and tobacco treatment. National Institutes of Health, NIH Intramural Research Program, National Science Foundation.

Breakthrough Biomarkers in Lung Cancer: Pioneering Early Detection and Precision Treatment Strategies.

There are several biological, genetic, and environmental variables that contribute to lung cancer, which is one of the main causes of cancer-related death globally. In addition to exposure to radon gas, air pollution, and occupational dangers like asbestos, smoking is a major risk factor because it releases carcinogens like nitrosamines and polycyclic aromatic hydrocarbons (PAHs) into the lungs. The risk of developing lung cancer is also influenced by genetic predispositions, such as variations in genes like EGFR, KRAS, and TP53. Additionally, new research emphasises how epigenetic changes, such as DNA methylation and histone acetylation, affect the expression of genes connected to the development of cancer. In determining risk and spotting early indicators of lung cancer, biomarkers have become important instruments. Cell-free DNA (cfDNA), circulating tumour cells (CTCs), and certain microRNAs (miRNAs) in blood are non-invasive biomarkers that indicate tumour heterogeneity and load. Molecular indicators include anaplastic lymphoma kinase (ALK) rearrangements, epidermal growth factor receptor (EGFR) mutations, and programmed death-ligand 1 (PD-L1) expression have proved very important in tailoring the therapy of lung cancer. Inflammatory indicators such as interleukins and C-reactive protein (CRP) are also linked to the prognosis of lung cancer. Finding and confirming these biomarkers is essential for improving early detection, tracking the course of the disease, and directing focused treatments. As research progresses, combining molecular, genetic, and environmental insights might improve lung cancer care, prevention, and early diagnosis, thereby lowering the disease's worldwide burden.

Early Palliative Care in Advanced Non-Small Cell Lung Cancer Patients: A Meta-Analysis.

This study aims to assess the efficacy of Early Palliative Care (EPC) in non-small cell lung cancer (NSCLC) through a meta-analysis approach. A computerized search was conducted in databases such as PubMed, Cochrane Library, Scopus, Embase, and Web of Science for prospective randomized controlled trials (RCTs) investigating the application of EPC in advanced NSCLC. Outcome measures including Overall Survival (OS), quality of life, and psychological status were extracted and subjected to pooled analysis. After the computerized search, a total of 7 studies comprising 1185 participants were included, with 597 patients receiving EPC intervention and 588 patients receiving Standard Care (SC) intervention. Three studies reported OS after the intervention, demonstrating a significant improvement in OS for patients receiving EPC (pooled HR = 1.60, 95% CI: 1.22, 1.98). Five studies analyzed the Functional Assessment of Cancer Therapy (FACT) scores after the intervention, revealing a significant improvement in FACT scores for patients receiving EPC (pooled SMD = 1.18, 95% CI: 1.04, 1.31). No significant differences were found in anxiety and depression scores between the 2 interventions in the 5 studies. In advanced NSCLC, EPC provides benefits in terms of increased survival rates and improved quality of life. EPC should be considered as part of multidisciplinary treatment for patients with advanced NSCLC.

Timeliness of lung cancer care and area-level determinants in Victoria: A Bayesian spatio-temporal analysis.

It has been reported that the timeliness of lung cancer care varies significantly across different regions. According to the Victorian Lung Cancer Registry (VLCR) report, the timeliness of lung cancer care in Victoria has changed over time. Therefore, we aimed to quantify the extent of these spatial inequalities over time and to identify area-level determinants contributing to these changes. The study analysed lung cancer cases reported to the VLCR between 2011 and 2022. Bayesian spatio-temporal Conditional Autoregressive (CAR) models were fitted, incorporating spatial random effects, temporal random effects, as well as spatio-temporal interactions. The best-performing model was selected using the Deviance Information Criterion (DIC). For the final best-fit model, the adjusted Relative Risks (aRR) and their 95% Credible Interval (CrI) were reported. Over half (51.24%) of lung cancer patients experienced treatment delays, while approximately one-third (30.98%) encountered diagnostic delays. Moderate spatio-temporal variations were observed in both delayed diagnosis and treatment. In the final best-fit model for treatment delay, an increase in the percentage of smokers was significantly associated with a higher risk of treatment delay (RR = 2.13, 95% CrI: 1.13, 4.20). Identifying high-risk areas provides useful information for policymakers, helping in the reduction of delays in lung cancer diagnosis and treatment. This study has revealed spatio-temporal inequalities in diagnostic and treatment delays, providing valuable insights for identifying areas that should be prioritized to ensure timely care for lung cancer.

Lung stereotactic radiation therapy: Early results from the Salah Azaiez Institute.

Stereotactic Body Radiation Therapy (SBRT) has transformed lung cancer care, delivering precise treatment with minimal harm to healthy tissue. This study examined the experience at the Salah Azaiez Institute (SAI) in lung cancer patients. we conducted a retrospective study on patients treated with SBRT from 2019 to 2022. Planification imaging included four-dimensional CT scans and delineation of target volumes and organs-at-risk was done as per international guidelines. Treatment doses were tailored based on tumour location. A total of 10 cases were included. The male-to-female sex ratio was 4:1, with a median age of 69.5 years. Three had unconfirmed primary lung tumours, while five had inoperable stage I-IIA adenocarcinomas primarily due to compromised respiratory function. Two had oligometastatic lung diseases. All underwent recent thoracic-CT and PET-CT evaluations to exclude pulmonary fibrosis. The median lesion size was 40mm. Karnofsky's performance status ranged from 70 to 90, with no contraindications to the supine position. Eight out of 10 patients received 8 fractions of 7.5 Gy at the 80% isodose. For that regimen, the D95%, D99%, and Dmax were respectively, 60 Gy, 56 Gy, 73 Gy. All organs-at-risk dosimetric criteria were met. Acute toxicities included worsened coughs in 2 patients and fatigue in 6. After a mean follow-up of 23 months, no rib fractures or haemoptysis were observed, and no local recurrence was reported on the last chest CT scan. SBRT demonstrates promise for lung cancer treatment, though challenges persist in precise targeting and motion management. Effective multidisciplinary collaboration and local protocols are crucial for successful implementation.

State of Lung Cancer in Egypt: Moving Towards Improved Guidelines for Prevention, Screening, Treatment, and Clinical Care Programs

Lung cancer remains a leading cause of cancer-related mortality globally and presents significant challenges in Egypt. In 2023, the first annual meeting of the Thoracic Oncology Multidisciplinary Faculty, organized by the Egyptian Cancer Research Network and the Egyptian Society of Respiratory Neoplasms, was held in Cairo, Egypt. The meeting aimed to address gaps in lung cancer management across Egypt and the broader Middle East and North Africa region. The discussions focused on the challenges posed by NSCLC and SCLC and emphasized the need for enhanced prevention, early detection, and treatment strategies. Key areas of concern include limited access to advanced diagnostics, such as comprehensive genomic profiling, and the underutilization of targeted therapies and immunotherapies, mainly owing to financial barriers. The meeting highlighted the importance of strengthening lung cancer screening programs, improving smoking cessation efforts, and addressing environmental risk factors like air pollution. Furthermore, the event underscored the need for greater research and collaboration, particularly in areas like precision oncology. The conference concluded with strategic recommendations to improve lung cancer prevention, screening, and treatment, aligning Egypt’s lung cancer care with global advancements and ensuring equitable access to cutting-edge therapies.

The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System.

Broad-based molecular testing with next-generation sequencing (NGS) is now the standard of care in advanced non-small cell lung cancer (NSCLC). Two approaches to molecular testing are (1) reflexive testing at pathologic NSCLC confirmation, often using an in-house molecular panel, and (2) send-out testing to private vendors, ordered by a clinician. This study explored the outcomes with reflex versus send-out testing. A retrospective chart review was conducted of patients diagnosed with de novo stage IV NSCLC in 2019 and 2020 at three hospitals in the same system, one academic hospital (Northwestern Memorial Hospital, or NMH) utilizing reflex, in-house NGS, and two community-based hospitals (Central DuPage Hospital, or CDH, and Delnor, or D) sending out tissue samples for testing. The outcomes assessed were the time from biopsy to results, biopsy to treatment, the incidence of first-line targetable mutations and the use of first-line targeted therapies, and overall survival. In total, 191 patients met the inclusion criteria, 85 at NMH, 106 at CDH + D, and in total, 131 in 2019 and 60 in 2020. The time to results was significantly shorter with reflexive NGS when compared with send-out testing; the time to treatment was also shorter but not statistically significant. At CDH + D, the time to results was significantly shorter with a limited panel than with comprehensive testing, but the time to treatment was similar. NGS testing rates were 95% at NMH and 84.5% at CDH + D (p = 0.009), with 31.0% at NMH receiving 1L targeted therapies versus 20.8% at CDH + D (p = 0.08). In 2019, the median time from biopsy to treatment was 35 days at NMH and 38 days at CDH and Delnor; in 2020, time to treatment was 26 days and 37 days, respectively. Overall survival trended longer in 2020 relative to 2019 independent of site. Reflexive NGS testing is associated with a shorter time to actionable results and higher rates of first-line targetable mutations than send-out testing. In practices with send-out testing, limited panels had slightly faster turnaround times but no difference in time to treatment. If resources allow, reflexive NGS should be considered in healthcare systems for patients with NSCLC.

Transforming Lung Cancer Care: The Role of Transferosomes in Modern Drug Delivery.

Cancer stands as one of the leading causes of death worldwide, and lung cancer represents its most aggressive and persistent form. Traditional strategies for addressing lung cancer involve various medical therapies such as radiotherapy, chemotherapy, and surgical excision. Despite their prevalence, these conventional methods lack precision and inadvert-ently cause collateral damage to neighboring healthy cells. Recently, nanotechnology has emerged as a potential strategy for the treatment and management of lung carcinomas, bring-ing about a transformative shift in existing approaches. The primary focus of this shift is on minimizing harmful effects and improving the bioavailability of chemotherapy drugs specif-ically targeted at tumour cells. Currently, transferosome nanocarrier systems are widely em-ployed to overcome the obstacles presented by lung cancer. The utilization of transferosome-loaded therapeutic medication administration technology holds tremendous potential in reg-ulating tumour cell growth and treating lung cancer. The purpose of this study is to provide an overview and analysis of current advancements in transferosome-based drug delivery sys-tems, employing inhalational nanoparticle strategies for precise drug targeting in lung cancer management.

Impact of COVID-19 on lung cancer care in New South Wales, Australia: real-world data from the EnRICH Program.

The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems worldwide, causing substantial changes to routine healthcare delivery. National and international modelling studies have predicted adverse impacts of this disruption. This study aimed to assess the real-world impact of the COVID-19 pandemic on quality of care and outcomes for patients with lung cancer in New South Wales (NSW). Pre-post observational cohort study using data prospectively collected for the Embedding Research (and Evidence) in Cancer Healthcare (EnRICH) Program. The study population comprised 2000 patients with lung cancer from six specialist cancer centres in metropolitan and regional NSW. We split this population into two cohorts: the pre-COVID-19 cohort (1143 patients diagnosed from 8 September 2016 to 10 March 2020) and the post-COVID-19 cohort (857 patients diagnosed from 11 March 2020 to 28 October 2021). The main outcome measures were lung cancer clinical quality indicators, 1-year and 2-year overall survival, and patient-reported health-related quality of life and psychological distress. Patient and disease characteristics (e.g. age, gender, cancer stage) were similar for the pre-and post-COVID-19 cohorts, except for histology (non-small cell lung cancer (NSCLC) 88% in the pre-COVID-19 cohort and 84% in the post-COVID-19 cohort; p = 0.008) and region of residence (62% and 55%, respectively, lived in metropolitan areas; p = 0.002). Compared to the pre-COVID-19 cohort, fewer patients in the post-COVID-19 cohort received a diagnosis within 28 days of the first investigation of symptoms (clinical diagnosis: 77% compared with 72%; p = 0.017, pathological diagnosis: 60% compared with 53%; p = 0.005). However, the median time from the first investigation of symptoms to treatment initiation did not differ. One- and 2-year overall survival, quality of life and psychological distress did not differ between cohorts. This analysis found that the COVID-19 pandemic did not significantly adversely affect quality of care and outcomes for patients with lung cancer in NSW. Reassuringly, these results suggest that prioritising urgent health services, such as cancer care and implementing protective mitigation measures were effective in avoiding the predicted adverse outcomes of healthcare service disruption.

MA10.03 Paying the Price: How Lung Cancer Care Impacts Wallets and Well-Being

MA10.03 Paying the Price: How Lung Cancer Care Impacts Wallets and Well-Being

Small cell transformation in EGFR-mutated non-small cell lung cancer: DLL3 expression and efficacy of immune checkpoint inhibitors or tyrosine kinase inhibitors combined with chemotherapy

IntroductionSmall cell transformation (SCT) is a typical mechanism of adaptive resistance to third generation epidermal growth factor receptor inhibitors (EGFRi) which have become the standard of care for EGFR-driven non-small cell lung cancer (EGFR+ NSCLC). Little is known about the optimal management of SCT patients. This study aimed to compare outcomes under platinum/etoposide chemotherapy alone (chemo) or in combination with EGFR inhibitors (EGFRi+chemo) or immune checkpoint inhibitors (ICI+chemo). In addition, DLL3 expression was explored as potential novel therapeutic target. MethodsWe conducted a retrospective study on patients with EGFR+ NSCLC and SCT treated at 19 centers in Europe and the United States. A total of 47 patients were included of whom 17 received chemo, 20 ICI+chemo, and 10 EGFRi+chemo. We analyzed DLL3 expression by immunohistochemistry. ResultsIn the entire cohort, median overall survival (OS) from start of first SCT therapy was 11 months (95 % confidence interval [95 %CI] 9.1–12.9) and median progression-free survival (PFS) was 5 months (95 %CI 4.2–5.8). Median PFS was similar in all three groups (chemo and ICI+chemo 4 months, EGFRi+chemo 6 months), and 12-months PFS was 12 % (95 %CI 2 %−31 %), 13 % (95 %CI 0 %−43 %), and 0 % for ICI+chemo, EGFRi+chemo, and chemo, respectively. Median OS in the ICI+chemo group was 13 months (95 %CI 5.5–20.5) compared to 10 months (95 %CI 7.6–12.4) with chemo and EGFRi+chemo (95 %CI 8.1–11.9), respectively. Before and after SCT, 0 % and 93 % of tumors were DLL3-positive. ConclusionsOur results suggest that ICI+chemo and DLL3-targeting agents are worth further exploration in EGFR+ NSCLC undergoing SCT. Presented elsewherePart of this work has been presented at ESMO annual meeting in Madrid, Spain in October 2023 (Poster 1336 P).

EP.16F.02 Availability of Supportive Care in Lung Cancer: A Global Perspective

EP.16F.02 Availability of Supportive Care in Lung Cancer: A Global Perspective

EP.15B.02 Real-World Data from Advanced Practice Nurse Care in Lung Cancer in a Private Clinic in Brazil

EP.15B.02 Real-World Data from Advanced Practice Nurse Care in Lung Cancer in a Private Clinic in Brazil

Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management.

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients' symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient-physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.

OA07.05 Improving Supportive and Social Care in Lung Cancer with the 4R Oncology Model for Patient Care Planning and Delivery

OA07.05 Improving Supportive and Social Care in Lung Cancer with the 4R Oncology Model for Patient Care Planning and Delivery

P4.15E.02 Acceptability and Feasibility of Integrating A Chatbot into Routine Lung Cancer Care: Patient and Clinician Perspectives

P4.15E.02 Acceptability and Feasibility of Integrating A Chatbot into Routine Lung Cancer Care: Patient and Clinician Perspectives