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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, February 10, 2025
The use of next-generation sequencing–based comprehensive genomic profiling in patients with non–small cell lung cancer (NSCLC) may be a useful strategy to help guide clinical management, according to a study published in Frontiers in Oncology. Particularly, patients with NSCLC harboring STK11 or KEAP1 mutations should be offered novel agents from clinical trials specifically targeting genomic mechanisms that may improve their clinical outcomes, suggested Sandip Pravin Patel, MD, of Moores Cancer Center, San Diego, and colleagues.
Despite KRAS-mutated NSCLC being the most common subtype of lung cancer, no established first-line therapy has been recommended. Currently, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend chemoimmunotherapy as a therapeutic option. Many patients with KRAS-mutated NSCLC also have other cancer-associated genetic mutations, commonly in the tumor suppressor genes KEAP1 and STK11. With these concurrent mutations, patients often have worse clinical outcomes after treatment with chemotherapy, immunotherapy, or chemoimmunotherapy. Therefore, there is an increased need for an effective treatment strategy in this patient population.
Identifying patients with KEAP1 or STK11 mutations earlier may help to guide the choice of treatment regimen. Implementing biomarker testing for these specific mutations may be useful in this patient population, the authors noted. Next-generation sequencing–based comprehensive genomic profiling already includes these biomarkers in most standard panels and could easily be integrated into clinical practice. Identifying these patients earlier would allow for therapeutic intervention in the limited window of time available before significant clinical deterioration. Furthermore, clinicians may observe patterns in affected patients that may illuminate the heterogeneous nature of the tumor and change the standard therapeutic approach, the authors stated.
Disclosure: The study authors reported no conflicts of interest.
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