Interactive Case Studies - Overview

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Treatment of a Patient With Stage IV Non–Small-Cell Lung Cancer With Bone Metastases

Release Date: February 27, 2009
Expiration Date: February 27, 2010

Interactive Case Study Overview

Most patients with non–small-cell lung cancer (NSCLC) are diagnosed at an advanced stage of the disease. Standard first-line treatment for advanced NSCLC includes platinum-based chemotherapy regimens with or without an antibody to vascular endothelial growth factor. Several agents have been approved as single agents for use as therapy in previously treated disease, including taxanes, antifolates, and tyrosine kinase inhibitors targeting epidermal growth factor receptor. Like many other solid tumors, advanced NSCLC is often associated with bone metastases. It is estimated that approximately 30%-40% of patients with lung cancer will develop bone metastases, and the median overall survival for these patients is < 6 months. Hypercalcemia of malignancy, pathologic fractures, spinal cord compression, and bone pain are some of the skeletal-related events (SREs) caused by bone metastases. These adverse events can lead to reduced quality of life, increased morbidity, and a higher rate of mortality for patients. Current therapeutic approaches to the treatment of skeletal complications include radiation therapy, surgery, and treatment with bisphosphonates. In advanced lung cancer with bone metastases, a bisphosphonate has shown efficacy in reducing the rate of SREs and delaying the onset of first SRE.

The purpose of this activity is to update physicians on treatment options in advanced NSCLC and to discuss strategies to manage bone metastases.

Target Audience

This educational activity is intended for medical oncologists involved in the care of patients with NSCLC. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Appraise the efficacy and safety of treatment options for patients with advanced NSCLC
  • Assess the efficacy of therapy with bisphosphonates for patients with NSCLC with bone involvement
  • Evaluate the safety of bisphosphonates in patients with NSCLC with bone involvement

Instructions for Participation

  1. Read the following information before entering the educational activity.
  2. Complete the Pretest.
  3. Study the educational activity.
  4. Complete the Posttest.
  5. Answer the evaluation questions.
  6. After completion of the Pretest and successful completion of the Posttest and evaluation, you will receive your certificate online.

Successful completion is determined by a score of 65% or greater.

Read all of the conditions in the Activity Terms box below. You must accept the Activity Terms in order to continue:

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Allan Lipton, MD
Research Funding – Monogram Biosciences, Novartis Pharmaceuticals Corporation, Oncogene Science
Speaker’s Bureau – Amgen, GlaxoSmithKline, Novartis Pharmaceuticals Corporation
Other Remuneration – Novartis Pharmaceuticals Corporation

PER Editorial Staff
No relevant relationships to disclose

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All correspondence should be directed to:
Editor, Interactive Case Study, Treatment of a Patient With Stage IV Non–Small-Cell Lung Cancer With Bone Metastases
Physicians’ Education Resource
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Suite 700
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Phone: (214) 367-3400
Fax: (214) 367-3304
E-mail: editor@cancerlearning.com

Educational Grants

An educational grant for this activity was provided by:


  1. Novartis Oncology

Allan Lipton, MD
Professor of Medicine and Oncology
Milton S. Hershey Medical Center
Hershey, PA