Improving Molecular Testing and Personalized Medicine in Non-Small-Cell Lung Cancer in Ontario

Lim, Charles Henry; Sekhon, Harman S.; Cutz, Jean Claude; Hwang, David; Kamel‐Reid, Suzanne; Carter, R.F.; Santos, Gilda da Cunha; Waddell, Thomas K.; Binnie, Matthew; Patel, Milan; Paul, Narinder; Chung, Taebong; Brade, Anthony; El-Maraghi, Robert H.; Sit, Christina; Tsao, Ming‐Sound; Leighl, Natasha B.

doi:10.3747/co.24.3495

Cited by 33 publications

(33 citation statements)

References 58 publications

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“…Other issue being debated is whether the biomarkers should be reflex tested (by the pathologist at diagnosis) or in response to the clinical request. Ideally, this should be done as reflex testing so the pathologist can prioritise the sample, avoid the need to review preparations when the molecular tests are requested, and minimise response time, although this is not always possible [91,92]. The whole concept of sample prioritization and multidisciplinary coordination should be organized through a molecular tumour board [93].…”

Section: How To Prioritise the Use Of Biological Specimens For An Accmentioning

confidence: 99%

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

et al. 2019

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In 2011 the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) started a joint project to establish guidelines on biomarker testing in patients with advanced non-small-cell lung cancer (NSCLC) based on current evidence. As this field is constantly evolving, these guidelines have been updated, previously in 2012 and 2015 and now in 2019. Current evidence suggests that the mandatory tests to conduct in all patients with advanced NSCLC are for EGFR and BRAF mutations, ALK and ROS1 rearrangements and PD-L1 expression. The growing need to study other emerging biomarkers has promoted the routine use of massive sequencing (next-generation sequencing, NGS). The coordination of every professional involved and the prioritisation of the most suitable tests and technologies for each case remains a challenge.

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Section: How To Prioritise the Use Of Biological Specimens For An Accmentioning

confidence: 99%

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

et al. 2019

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“…(21) In the United Kingdom, LC is the second most common cancer type in men and women, patients are diagnosed at stages III and IV in 87% of cases, and approximately 35% of cases are diagnosed after an emergency department visit. (22) Further revisions to the TNM staging system (11) and histological classifications (17) and the implementation and greater availability of new technologies for the diagnosis of metastatic lesions, as well as the increase in the number of cancer treatment centers in recent years, are possibly the main factors related to the increased proportion of LC cases diagnosed at an advanced stage in Brazil. The Expand project, developed by the Brazilian National Ministry of Health in conjunction with the INCA, has created 24 new oncology centers since 2000.…”

Section: Discussionmentioning

confidence: 99%

“…(7,8) Knowledge of the distribution of the clinical stages of LC is essential to optimizing smoking cessation programs, as well as cancer screening, diagnosis, and treatment at the national level, whether in the public or private sector. (9)(10)(11)(12) Therefore, using data from hospital cancer registries, the present study aimed to characterize the clinical and histological profile, as well as treatment patterns, of patients with early-stage, locally advanced, or advanced/metastatic LC, diagnosed between 2000 and 2014, in Brazil.…”

Section: Introductionmentioning

confidence: 99%

Tumor-node-metastasis staging and treatment patterns of 73,167 patients with lung cancer in Brazil

Mello

Bergmann

Ferreira³

et al. 2020

J. bras. pneumol.

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Objective: To characterize the clinical and histological profile, as well as treatment patterns, of patients with early-stage, locally advanced (LA), or advanced/metastatic (AM) lung cancer, diagnosed between 2000 and 2014, in Brazil. Methods: This was an analytical cross-sectional epidemiological study employing data obtained for the 2000-2014 period from the hospital cancer registries of two institutions in Brazil: the José Alencar Gomes da Silva National Cancer Institute, in the city of Rio de Janeiro; and the São Paulo Cancer Center Foundation, in the city of São Paulo. Results: We reviewed the data related to 73,167 patients with lung cancer. The proportions of patients with early-stage, LA, and AM lung cancer were 13.3%, 33.2%, and 53.4%, respectively. The patients with early-stage lung cancer were older and were most likely to receive a histological diagnosis of adenocarcinoma; the proportion of patients with early-stage lung cancer remained stable throughout the study period. In those with LA lung cancer, squamous cell carcinoma predominated, and the proportion of patients with LA lung cancer decreased significantly over the period analyzed. Those with AM lung cancer were younger and were most likely to have adenocarcinoma; the proportion of patients with AM lung cancer increased significantly during the study period. Small cell carcinoma accounted for 9.2% of all cases. In our patient sample, the main treatment modality was chemotherapy. Conclusions: It is noteworthy that the frequency of AM lung cancer increased significantly during the study period, whereas that of LA lung cancer decreased significantly and that of early-stage lung cancer remained stable. Cancer treatment patterns, by stage, were in accordance with international guidelines.

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“…This would allow doctors to make better educated guesses on treatment plan when individualized genetic testing is not available/feasible 13 , 82 . Luckily, due to our realization of the importance of personalized medicine, endeavors to improve the precision and scope of personalized lung cancer treatment are plentiful 83 , 84 , 85 , 86 . As some patients may have mutations that confer a high degree of natural resistance to the drugs that their specific types of lung cancers require, perhaps a good future step is to develop derivatives of these drugs with tailored binding sites optimized to target the altered ATP-binding pockets.…”

Section: Discussionmentioning

confidence: 99%

Personalized medicine in non-small cell lung cancer: a review from a pharmacogenomics perspective

Jiang

Cai

et al. 2018

Acta Pharmaceutica Sinica B

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Non-small cell lung cancer is a prevalent and rapidly-expanding challenge to modern medicine. While generalized medicine with traditional chemotherapy yielded comparatively poor response rates and treatment results, the cornerstone of personalized medicine using genetic profiling to direct treatment has exalted the successes seen in the field and raised the standard for patient treatment in lung and other cancers. Here, we discuss the current state and advances in the field of personalized medicine for lung cancer, reviewing several of the mutation-targeting strategies that are approved for clinical use and how they are guided by patient genetic information. These classes include inhibitors of tyrosine kinase (TKI), anaplastic lymphoma kinase (ALK), and monoclonal antibodies. Selecting from these treatment plans and determining the optimal dosage requires in-depth genetic guidance with consideration towards not only the underlying target genes but also other factors such as individual metabolic capability and presence of resistance-conferring mutations both directly on the target gene and along its cascade(s). Finally, we provide our viewpoints on the future of personalized medicine in lung cancer, including target-based drug combination, mutation-guided drug design and the necessity for data of population genetics, to provide rough guidance on treating patients who are unable to get genetic testing.

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Improving Molecular Testing and Personalized Medicine in Non-Small-Cell Lung Cancer in Ontario

Abstract: Background Although molecular testing has become standard in managing advanced nonsquamous non-small-cell

Cited by 33 publications

References 58 publications

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

Tumor-node-metastasis staging and treatment patterns of 73,167 patients with lung cancer in Brazil

Personalized medicine in non-small cell lung cancer: a review from a pharmacogenomics perspective

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