Case 2, Treatment Burden in a Patient Living Alone

Estelamari Rodriguez, MD, MPH, of Sylvester Comprehensive Cancer Center presents a 74-year-old woman with epidermal growth factor receptor (EGFR)-mutated advanced non–small cell lung cancer (NSCLC), no central nervous system involvement, limited mobility, osteoporosis and rheumatoid arthritis, who lives alone an hour from the cancer center and depends on others for transportation. Matthew Gumbleton, MD, PhD, of Huntsman Cancer Institute says he still considers lung cancer high risk and would favor an intensified regimen for this patient, and would want one for himself or a family member at that age. He describes meeting the patient where she is, which in his experience still usually means intensified therapy, and notes that monthly dosing is easier than every 3 weeks and that infusion visits become an all-day commitment. Dr Rodriguez cautions that even subcutaneous dosing is not a 5-minute visit once travel and laboratory work are counted.