Episode 363: Lung Cancer Treatment Considerations for Nurses

“A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it’s just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to lung cancer treatments.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episode: Episode 359: Lung Cancer Screening, Early Detection, and Disparities
• ONS Voice articles:
• Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship
• Oncology Drug Reference Sheet: Amivantamab-Vmjw
• Oncology Drug Reference Sheet: Cisplatin
• Oncology Drug Reference Sheet: Lazertinib
• Oncology Drug Reference Sheet: Nivolumab and Hyaluronidase-Nvhy
• Oncology Drug Reference Sheet: Fam-Trastuzumab Deruxtecan-Nxki
• Optimize Your Testing Strategy and Improve Patient Outcomes With NeoGenomics’ Neo Comprehensive™–Solid Tumor Assay
• Clinical Journal of Oncology Nursing article: Oncogenic-Directed Therapy for Advanced Non-Small Cell Lung Cancer: Implications for the Advanced Practice Nurse
• ONS Biomarker Database
• ONS video: What is the role of the KRAS biomarker in NSCLC?
• Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool
• ONS Huddle Cards:
• Checkpoint inhibitors
• External beam radiation
• Monoclonal antibodies
• Proton therapy

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

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To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“Unfortunately, because lung cancer is pretty aggressive, we’ll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they’re locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that’s stage I and II, where we can do surgical approaches.” TS 2:53

“The majority of radiation that you’re going to see is for patients with stage III disease that’s inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51

“Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there’s good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00

“It’s important for nurses to know that there’s a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It’s good that the patients understand that there’s a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05