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Driver Mutations and Therapy Selection for Lung Adenocarcinoma

Posted: Friday, August 11, 2017

For many patients with advanced adenocarcinoma of the lung, discovering targetable driver mutations plays a key role in selecting therapeutic options for this disease. Thus, molecular testing has become essential to ensure proper medical management. Eric H. Bernicker, MD, and colleagues at the Houston Methodist Hospital, reviewed many of the recent advances in diagnosis and targeted therapies for oncogene-addicted advanced nonsquamous non–small cell lung cancer in a recent issue of the Journal of Oncology Practice.

After reviewing the current recommendations regarding molecular testing for this type of lung cancer, the authors focus on a host of activating mutations, including EGFR, ALK, ROS1, BRAF, MET, and RET, as well as selected approved and emerging therapies for each. However, to fully benefit from these therapies, the authors emphasize the importance of molecular testing.

Several issues remain about improving outcomes with the use of tyrosine kinase inhibitors in prolonging control of disease and a good quality of life for these patients with advanced disease. Among them are a better understanding of the mechanisms that lead to acquired resistance as well as additional studies on less invasive procedures such as liquid biopsies (cell-free DNA and circulating tumor cells).