What is the Value of Testing for Molecular Markers in Advanced NSCLC?

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Memorial Sloan-Kettering Cancer Center medical oncologist Dr. Greg Riely explains how testing for specific mutations in patients with advanced NSCLC can guide prognosis and treatment recommendations.

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When we’re evaluating a patient with lung cancer, the first question we start to ask is, what’s going on with this patient’s cancer? Where is the disease, so has it spread to other sites, and what does it look like under the microscope? So, what’s the tumor histology, is it an adenocarcinoma, squamous cell carcinoma. And then, importantly, molecular testing has become a critical part of our understanding of a patient with lung cancer.

Now, by doing molecular testing, we’re able to better refine the prognostic and predictive value of a variety of drugs and treatments that we have going forward, for designing an overall treatment plan for a patient. Some of the most common testing that should be done are EGFR and ALK — now, these are important because these both have FDA approved drugs that are indicated for abnormalities in EGFR and ALK. If you go beyond those two things, there are actually a long list of drugs that can target individual molecular aberrations and molecular abnormalities, but they’re uncommon, and we don’t have FDA approved drugs for those things, but I think if we go beyond those EGFR and ALK tests, we can learn a lot more and sometimes help patients a great deal.

 

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