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New Guideline for Molecular Testing in Lung Cancer

Recommendations help guide targeted therapies (Apr. 3)

The emergence of molecular diagnostic testing in lung cancer offers new hope for patients with the number one cancer killer in the U.S. For the first time, after a decade of biomarker testing in lung cancer, a uniform approach to testing for the EGFR mutation and for ALK rearrangement, along with the availability of targeted therapies, offer lung cancer patients the chance for improved quality of life, according to a new guideline issued jointly by the College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP).

“The key recommendation of the guideline, and perhaps most important to lung cancer patients, is that all patients with advanced lung adenocarcinoma should be tested for EGFR and ALK abnormalities that would qualify them for tyrosine kinase inhibitor therapy, regardless of their clinical variables, such as smoking history, gender, or ethnicity,” said Marc Ladanyi, MD.

Similar to the testing done in breast cancer, matching a cancer patient’s molecular profile with the appropriate targeted therapy provides individualized treatment options. The guideline answers important clinical questions, including:

  • When should testing be performed?
  • How should testing be performed?
  • Should other genes be routinely tested in lung cancer?
  • How should molecular testing of lung cancer be implemented?

“In the U.S., up to 20% of patients with lung adenocarcinoma, the most common type of lung cancer, will test positive for one of the two biomarkers,” said Philip T. Cagle, MD, FCAP. “It is critical to identify these patients because they stand to benefit more from new targeted drugs than from conventional chemotherapy, and with fewer side effects.”

The new recommendations were published in the Archives of Pathology & Laboratory Medicine, the Journal of Thoracic Oncology, and the Journal of Molecular Diagnostics.

Sources: College of American Pathologists; April 3, 2013; and APLM; April 3, 2013.

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