12:57 CET
MS 1 - Lung cancer team
Chest Oncologic Imaging
Wednesday, February 27, 08:30 - 10:00
Type of session: Multidisciplinary Session
Topic: Chest, Oncologic Imaging
Moderator: A. R. Larici (Rome/IT)

Chairperson's introduction
A. R. Larici; Rome/IT
Learning Objectives

1. To understand how to carry out an accurate diagnosis of lung cancer.
2. To learn about the actual therapeutic approach to lung cancer in the era of "personalised treatment".
3. To appreciate how a multidisciplinary team can make the difference in effectively managing lung cancer.

Imaging and staging
M. Silva; Parma/IT
Learning Objectives

1. To learn how to optimise the diagnostic algorithm of lung cancer.
2. To understand the evolving meaning of TNM classification.
3. To become familiar with key imaging criteria to manage lung cancer.

Role of the pathologist: making the most of the sample
G. Rossi; Ravenna/IT
Learning Objectives

1. To learn about the best way to obtain tumour tissue using different approaches.
2. To optimise tumour tissue management increasing the diagnostic yield in histologic subtyping and predictive molecular determinations.
3. To understand the correct information to relate to the oncologist as the first line of treatment.

Role of the oncologist: personalising the treatment
S. Novello, M. L. Reale; Orbassano/IT
Learning Objectives

1. To learn about the meaning of personalised treatment and the evolution of lung cancer therapies in the last 10 years.
2. To understand the role of the newer targeted therapies.
3. To become familiar with the needs of the oncologist to optimise lung cancer treatment.


Lung cancer treatment has become a paradigmatic example of personalised medicine. Therapeutic management takes into consideration histology, molecular pathology, staging, patients’ characteristics. The identification of oncogenic driver alterations (EGFR activating mutations, ALK/ROS1 translocations) allowed the development of targeted therapies based on molecular profiling, enriching the previous ‘histology-directed treatment’ paradigm. These drugs, counteracting the deregulated pathways, improved outcomes substantially, quality of life and toxicity in molecular selected populations and represent today the standard of care in the oncogene-addicted advanced disease. Nevertheless, acquired resistance arises. Newer agents, overcoming cancer escape, showed remarkable outcomes. Unfortunately, the best sequence of the available treatments, in most cases, is not defined. The landscape is evolving, and other oncogenes are emerging as potential targets implementing personalised medicine algorithms. In the case of non-oncogene addiction and permissive comorbidities, immunotherapy demonstrated successful results in different settings. PDL-1 is the current biomarker to identify patients who may benefit from frontline immune checkpoint inhibitors. However, because of its high variability and dynamic expression, complementary predictive factors are exploring to maximise patients’ selection. In this scenario, tissue availability, after histologic definition, is necessary; non-invasive methods are emerging to overcome the potential limits of biopsies or aspirates. Lung cancer is an increasingly complex and heterogeneous disease. Understanding how to best sequence and combine therapies could represent another important step in treatment personalisation. Cooperation and multidisciplinary approaches are the keys for the shared vision of a precision medicine aimed to offer the best treatment to every single lung cancer patient.

What the surgeon needs to know
U. Pastorino; Milan/IT
Learning Objectives

1. To learn about the advances in the surgical approach for lung cancer treatment.
2. To understand how the clinical staging may affect surgical results in lung cancer.
3. To become familiar with the needs of the surgeon to define the appropriate surgical approach.

Multidisciplinary case presentation and discussion
A. R. Larici; Rome/IT
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