Dr. Luis Raez Discusses the Impact of Precision Medicine on Lung Cancer Treatment

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In honor of lung cancer awareness month, we had the opportunity to speak with Dr. Luis Raez, Medical Director and Chief of Hematology Oncology at Memorial Cancer Institute who focuses on treating lung cancer. Our conversation covered how the emergence of next-generation sequencing has changed his approach to lung cancer treatment, what notable discoveries in lung cancer have occurred over the last year, and how COVID-19 has impacted the treatment of cancer.

Dr. Raez first pointed out that next-generation sequencing allows him to treat patients without empirical chemotherapy, which is notable since just 10 years ago chemotherapy was the only option.

Now, oncologists can customize treatment based on the driver for the tumor and find the right treatment – not just the standard treatment.

Dr. Raez adds that for precision medicine to work, testing must be done, and some oncologists still do not test enough because they don’t want to spend precious weeks on tests that may or may not show that something other than chemotherapy will work. For instance, he says that 20% of patients may not have the tissue to do NGS, but that doesn't mean they can't be tested by liquid biopsy. He suggests that oncologists need to be more aggressive in doing NGS for new patients, especially lung cancer patients. One solution is to do liquid biopsy for every patient and tissue in the ones that you can, because that 20% of patients represents nearly 40,000 cancer patients who may benefit from being tested each year.

When we asked about significant developments in precision medicine over the last year, Dr. Raez said that there have been so many advancements in precision oncology for lung cancer that it was a hard question to answer. He notes stand out advances including one drug with a response rate of at least 30% to 40% for a very common genetic aberration. He also notes that oncologists can now use a combination treatment with IPI/NIVO (ipilimumab + nivolumab) without chemotherapy, which provides an important alternative for older patients who cannot tolerate chemo.

Lastly, we asked about how COVID-19 has impacted oncology care, and were stunned to hear that a JAMA Oncology article showed a 46% decrease in diagnosis of the six most common cancers in the U.S.—not because cancer is being cured, but because fewer patients are getting into the doctor to have their cancer diagnosed. As a result, he is on a mission to get patients to come in by participating in an ongoing PSA campaign.

Our discussion with Dr. Raez was full of enlightening and encouraging information. We hope you tune in to the full episode above!

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