The multidisciplinary team (MDT) management of non–small cell lung cancer (NSCLC) is an important part of a patient’s cancer journey. From early-stage disease to oligometastatic and oligoprogressive NSCLC scenarios, MDT discussions help guide personalized patient-centered care.

Oncology care is becoming increasingly complex, and we collaborate with our pathologists, surgeons, pulmonary medicine specialists, and radiation oncologists, along with other members of the team, from the start. Every one of us is actively and meaningfully involved in the care of our patients.

MDT care is essential at different points along a patient’s lung cancer journey and perhaps especially so up front at diagnosis. We rely on our surgeons or pulmonologists to obtain tissue samples for us and to confirm any diagnosis of NSCLC. Our pathologists perform histologic analyses of the tissue samples and play a crucial role in the molecular genomic testing that we do for all our patients with NSCLC, as well as immunohistochemistry testing (eg, for PD-L1, MET, and HER2).

MDT-based discussions during thoracic tumor board meetings often focus on complex cases in which multiple treatment options are being considered. In particular, the accurate staging of early-stage disease becomes key in determining whether the patient’s primary treatment should be surgical resection or definitive radiation, with or without chemotherapy. In this setting, the radiology team helps us interpret positron emission tomography scans and other imaging studies. Together, we develop a comprehensive treatment plan that we can then bring back to discuss with the patient with NSCLC.

MDT care also lends itself to another increasingly common scenario: consolidation treatment for metastatic disease. For patients with stage IV cancer who have a strong response to systemic therapy and are left with limited (ie, oligometastatic) disease, there is mounting evidence supporting the addition of local ablative therapies such as radiation or surgery. This strategy is gaining traction with modern targeted agents and immunotherapy and can lead to prolonged responses in select patients with NSCLC. These cases of measurable residual disease are regularly reviewed during our tumor board meetings to help us decide on optimal management.

Another scenario is oligoprogression, particularly in patients on targeted therapies. Such patients often maintain overall disease control, yet 1 or 2 sites may show progression. This is precisely the type of case that can be brought up at MDT meetings to determine whether local therapy, such as radiation, surgery, or ablation, would be appropriate.

Artificial intelligence (AI) is making inroads in medicine on multiple fronts, and a topic that sometimes arises is the impact of AI in MDT settings. In my view, there is definitely a place for AI as a facilitator (eg, in certain areas such as in literature reviews or in trying to determine if a question has been studied yet). However, most of the cases that are reviewed during MDT discussions are nuanced and do not have black-and-white answers. So, I see AI as a tool, not a replacement, for MDT care.

Throughout the entire disease course, social work and palliative care are also essential collaborators, helping us manage symptoms and address the psychosocial challenges that accompany a cancer diagnosis. Overall, strong MDT care clearly improves outcomes. Patients who receive MDT-guided treatment not only have better clinical results but also report higher levels of satisfaction, as the approach is inherently more patient centered. I think that patients value knowing that a group of specialists have reviewed their case together and have recommended the most appropriate personalized treatment options.