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Appointment dossier — Lung Adenocarcinoma

Bring this to your appointment. It summarizes what published studies report — it is not medical advice and does not say anything works. Decisions are yours and your care team’s.

Compounds studied in Lung Adenocarcinoma

“Positive” means a study reported a positive result — most are early lab/animal work that may not translate to people.

Guideline-backed standard of care

Anatomic resection (lobectomy/segmentectomy) with systematic nodal dissection when operable, Sublobar resection considered for small peripheral lesions or limited reserve, VATS/robotic approaches common, For oligometastatic disease responding to systemic therapy, consider metastasectomy case-by-case, SBRT for medically inoperable early-stage disease (curative intent), Post-op or definitive chemoradiation for positive margins/unresectable disease, SRS for brain metastases, Palliative RT for symptomatic bone, chest wall, airway, or CNS lesions, Driver-positive: matched TKI first-line (EGFR, ALK, ROS1, RET, METex14, BRAF V600E, NTRK, HER2), Driver-negative: PD-L1 ≥50% → single-agent PD-1/PD-L1, Pemetrexed-based regimens favored in non-squamous NSCLC, Later lines guided by resistance profile (e, Platinum + Pemetrexed (± Pembrolizumab) (first-line driver-negative non-squamous), Platinum + Taxane (± Pembrolizumab/Bevacizumab) (first-line non-squamous alternative), Single-agent Pemetrexed Maintenance (post-induction), Docetaxel (± Ramucirumab) (subsequent line), Gemcitabine/Vinorelbine/Other Doublets (selected cases), EGFR, ALK, ROS1, RET, METex14, BRAF V600E, NTRK, HER2: prioritize matched TKIs with CNS-active options where possible, KRAS G12C: G12C inhibitors active, PD-L1 high driver-negative disease: consider IO monotherapy, Avoid initiating IO just before TKIs with high pneumonitis/hepatitis overlap, Re-biopsy/ctDNA at progression to reveal on-target mutations (e, Combinations to overcome resistance (TKI + MET/MEK/other) best pursued on trials.

The established options for Lung Adenocarcinoma — ask which apply to your case. Investigational options appear in the compounds list above.

Open recruiting trials (18)

Most-relevant first: trials that name Lung Adenocarcinoma, then broader trials you may still qualify for. 303 recruiting trials name this cancer on ClinicalTrials.gov. Eligibility is decided by each trial's team — bring these NCT numbers to your appointment.

Interactions & safety to discuss

Not a complete check — a drug not listed here is not therefore safe. Show your pharmacist your full list.

Financial help to look into

For each medicine above, search manufacturer and nonprofit programs at medicineassistancetool.org.

Questions to ask your oncologist

  1. Has my tumor been tested for EGFR activating mutations (ex19 del, L858R; uncommon: G719X, L861Q, S768I), and would the result open up targeted treatments or trials?
  2. Has my tumor been tested for ALK fusions (e.g., EML4-ALK), and would the result open up targeted treatments or trials?
  3. Has my tumor been tested for ROS1 fusions, and would the result open up targeted treatments or trials?
  4. I've read that Etoposide has been studied in people for Lung Adenocarcinoma — what's the evidence, and is it an option or available in a trial for me?
  5. I've read that Carboplatin has been studied in people for Lung Adenocarcinoma — what's the evidence, and is it an option or available in a trial for me?
  6. I've read that Durvalumab has been studied in people for Lung Adenocarcinoma — what's the evidence, and is it an option or available in a trial for me?
  7. Of the open trials I found (for example NCT06467786), am I eligible for any — here or at a larger cancer center?
  8. Do I have a targetable driver (EGFR, ALK, ROS1, RET, METex14, BRAF V600E, NTRK, HER2, KRAS G12C)?
  9. If no driver, what is my PD-L1 and best IO±chemo plan?
  10. Is surgery or SBRT an option for my stage? Could oligomet sites be consolidated after response?
  11. What is our plan if first-line therapy stops working—when and how will we test for resistance?
  12. Do my co-mutations (STK11/KEAP1/TP53) affect treatment choice?
  13. How will we monitor and manage IO irAEs and TKI toxicities?
  14. Would I benefit from pulmonary rehab, nutrition support, or prehab before treatment?
  15. Am I eligible for clinical trials now or at progression?
  16. What is the plan for brain surveillance and treatment if needed?
  17. How will we coordinate supplements/OTC meds to avoid interactions?
  18. What is my exact diagnosis — the type, subtype, stage, and grade?
  19. Has my tumor had molecular or genomic testing (e.g. next-generation sequencing), and what did it find?
  20. Should I have inherited (germline) genetic testing, and could it affect my treatment or my family?
  21. What is the goal of treatment for me — cure, long-term control, or comfort?
  22. What are all of my standard treatment options, and what does each one involve?