From the Research
Systemic sclerosis patients with non-small cell lung adenocarcinoma should be managed with a multidisciplinary approach, considering the latest advances in lung cancer treatment, including targeted therapies and immunotherapy, while carefully monitoring for potential complications and maintaining systemic sclerosis management. The treatment of non-small cell lung cancer (NSCLC) in patients with systemic sclerosis requires careful consideration of the patient's overall health status, cancer stage, and systemic sclerosis severity. According to the most recent study 1, lung cancer remains the leading cause of cancer deaths, and NSCLC is the most frequent subtype of lung cancer. Treatment options for NSCLC include surgery, radiation, chemotherapy, immunotherapy, or molecularly targeted therapy, and the approach must be customized for each patient based on their specific medical condition. The study 2 highlights the importance of radiation therapy in NSCLC, including high-dose target radiation-stereotactic body radiation therapy (SBRT) for patients with comorbidities that prohibit major surgical procedures. Another study 3 emphasizes the importance of multidisciplinary consensus on the management of non-bulky/non-infiltrative stage IIIA N2 NSCLC, with agreement on the adoption of surgery and (neo)adjuvant chemotherapy in patients with single-station disease, and concurrent chemoradiotherapy followed by adjuvant immunotherapy in those with multi-station N2 disease. The study 4 discusses the integration of innovative therapies, including targeted therapies and immunotherapy, in the management of patients with newly diagnosed NSCLC. Additionally, the study 5 reviews the systemic therapy for locally advanced and metastatic NSCLC, highlighting the importance of molecular testing for relevant mutations and expression of the protein PD-L1, and the use of targeted therapy for specific biomarkers. Some key points to consider in the management of systemic sclerosis patients with NSCLC include:
- Careful monitoring for potential complications, such as pulmonary hypertension and autoimmune flares
- Individualized treatment approach based on cancer stage, systemic sclerosis severity, organ involvement, and patient's overall functional status
- Multidisciplinary care involving oncology, rheumatology, and pulmonology
- Supportive care, including oxygen therapy, pulmonary rehabilitation, and management of systemic sclerosis symptoms, to maintain quality of life and optimize outcomes. Overall, the management of systemic sclerosis patients with NSCLC requires a comprehensive and multidisciplinary approach, considering the latest advances in lung cancer treatment and the patient's overall health status.