What, when, and how of biomarker testing in non–small cell lung cancer

GL Riely - Journal of the National Comprehensive Cancer …, 2017 - jnccn.org
GL Riely
Journal of the National Comprehensive Cancer Network, 2017jnccn.org
Biomarker testing is recommended for all patients diagnosed with non–small cell lung
cancer. At a minimum, testing should include the mutations/fusions EGFR, ALK, ROS1, and
the protein programmed death ligand-1 (PD-L1), because FDA-approved therapies are
available for these alterations. Other actionable molecular findings include RET
rearrangements, BRAF V600E mutations, and MET exon 14 alterations. If adequate testing
was not performed at treatment initiation, molecular testing should be performed before …
Biomarker testing is recommended for all patients diagnosed with non–small cell lung cancer. At a minimum, testing should include the mutations/fusions EGFR, ALK, ROS1 , and the protein programmed death ligand-1 (PD-L1), because FDA-approved therapies are available for these alterations. Other actionable molecular findings include RET rearrangements, BRAF V600E mutations, and MET exon 14 alterations. If adequate testing was not performed at treatment initiation, molecular testing should be performed before administration of subsequent lines of therapy. In patients with EGFR -mutant lung cancer, when resistance develops, physicians should seek to identify the T790M mutation using plasma and tissue assays, because osimertinib therapy is available for this mutation.
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