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Sandip Patel, MD

Articles by Sandip Patel, MD

Final Reflections: Key Takeaways and Future Opportunities With QCS and TROP2 NMR

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the introduction of quantitative cell scoring (QCS) for TROP2 as a significant artificial intelligence (AI)-driven advancement in oncology, emphasizing its ability to provide precise, quantitative biomarker assessment that complements molecular data like EGFR status. The panelists also highlight the importance of pathologists embracing digital pathology tools to enhance diagnostic accuracy and treatment planning while recognizing the technology’s early but promising role in expanding patient identification for targeted therapies and its potential broader impact on precision oncology.

Broader Implications and Future Impact of QCS and AI-Driven Digital Pathology in Precision Oncology

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the expanding potential of quantitative cell scoring (QCS) technology beyond TROP2, highlighting its ability to assess not only cell surface expression but also internalization critical for antibody-drug conjugate (ADC) efficacy. They also emphasize how artificial intelligence (AI)-driven pathology advancements promise to streamline lung cancer diagnostics, improve predictive accuracy, and reduce variability in biomarker testing, ultimately enabling more precise patient selection and better integration of complex biomarker data into clinical care.

Forward Perspectives on Integrating QCS and TROP2 NMR Into Future Treatment Approaches

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the strategic approach to implementing targeted therapies through advanced biomarker testing, emphasizing the importance of prioritizing next-generation sequencing (NGS) early in diagnostic workflows due to limited tissue availability, the growing role of liquid biopsies, and emerging technologies like multiplex immunohistochemistry (IHC) to maximize tissue use. The panelists also highlight the critical need for close collaboration and clear communication between oncologists and pathologists to streamline testing, reduce redundant procedures, and ensure timely, personalized treatment decisions.

Evolving Multidisciplinary Collaboration in NSCLC: Preparing for QCS and AI-Driven Pathology

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss how biomarker testing in oncology is evolving beyond genomic sequencing to include complex protein and RNA analyses, highlighting challenges such as limited biopsy tissue, the need for recent samples, and the importance of clear, standardized reporting; they emphasize that effective collaboration between oncologists and pathologists, along with the use of specialized send-out labs, will be critical to streamline workflows and ensure timely, actionable results for personalized patient care.

Looking Toward Potential Future Integration of TROP2 NMR and QCS: Changing Workflows and Anticipated Challenges

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the significant changes needed to integrate quantitative continuous scoring (QCS) and TROP2 normalized membrane ratio (NMR) assays into routine clinical practice, emphasizing the current limited adoption of digital pathology, the likely use of artificial intelligence (AI)-based assays as send-out tests initially, and the importance of expanding digital infrastructure and collaboration to enable precise, automated biomarker evaluation that can guide personalized oncology treatment.

Prospective Evaluation of TROP2 NMR in Ongoing Trials: Key Data on the Horizon and Remaining Questions

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss several ongoing clinical trials, including AVANZAR and TROPION-Lung10, that are investigating the predictive utility of TROP2 normalized membrane ratio (NMR) in guiding treatment with datopotamab deruxtecan combinations in lung cancer while highlighting advances in artificial intelligence (AI)-driven pathology to refine biomarker assessments and emphasizing the need for prospective validation to establish NMR’s role in clinical practice.

TROP2 NMR as a Predictive Biomarker Across Multiple Patient Cohorts: Insights From TR

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss how data from the TROPION-PanTumor01, TROPION-PanTumor02, and TROPION-Lung02 studies reinforce the predictive value of the TROP2 normalized membrane ratio (NMR) biomarker across diverse patient populations and treatment regimens, highlighting its reproducibility and ability to specifically identify patients likely to benefit from datopotamab deruxtecan–based therapies rather than serving as a general prognostic marker.

TROP2 NMR as a Predictive Biomarker for Dato-DXd: Clinical Insights From TROPION-LUNG01

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the TROPION-LUNG01 trial results, highlighting how datopotamab deruxtecan improved progression-free survival (PFS) in nonsquamous non–small cell lung cancer (NSCLC) and the role of the TROP2 normalized membrane ratio (NMR) as a predictive biomarker that helps identify patients most likely to benefit from the therapy.

Expert Perspectives on TROP2 NMR: Preclinical Evidence and Rationale

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss preclinical findings supporting TROP2 normalized membrane ratio (NMR) as a predictive biomarker for datopotamab deruxtecan, highlighting its ability to quantify functional membrane expression and internalization potential, refine patient selection beyond conventional immunohistochemistry (IHC), and drive broader adoption of artificial intelligence (AI)-powered digital pathology in precision oncology across multiple tumor types.

Defining and Understanding TROP2 Normalized Membrane Ratio (NMR)

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the limitations of conventional immunohistochemistry (IHC) in assessing TROP2 expression for targeted therapies in non–small cell lung cancer and highlight how advanced tools such as quantitative continuous scoring (QCS) and normalized membrane ratio (NMR) offer more precise, objective, and functional evaluations of protein expression and internalization, paving the way for improved patient stratification and personalized treatment with antibody-drug conjugates (ADCs).

Quantitative Continuous Scoring (QCS) Explained From a Pathologist’s Perspective

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the limitations of conventional immunohistochemistry (IHC) in assessing TROP2 expression for targeted therapies in non–small cell lung cancer and highlight how advanced tools such as quantitative continuous scoring (QCS) and normalized membrane ratio (NMR) offer more precise, objective, and functional evaluations of protein expression and internalization, paving the way for improved patient stratification and personalized treatment with antibody-drug conjugates (ADCs).

Advancing Biomarker Assessment for TROP2: Moving Beyond Conventional IHC

ByCharu Aggarwal, MD, MPH,Sandip Patel, MD,Anil Parwani, MD, PhD, MBA ,Jacob Sands, MD

Panelists discuss the evolving role of advanced biomarker tools like quantitative continuous scoring (QCS) and normalized membrane ratio (NMR) in non–small cell lung cancer (NSCLC), highlighting their potential to overcome limitations of traditional TROP2 assessment, improve prediction of antibody-drug conjugate (ADC) efficacy, and enhance patient selection through more precise and functional tumor profiling.

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