Precision Medicine in Oncology®

Dr. Gordan discusses the advantages of in-house genomic testing, the transition from external to internal sequencing, and the anticipated effects of the move.

Patritumab deruxtecan, a novel antibody-drug conjugate, is emerging as a promising HER3-directed therapy in patients with non–small cell lung cancer and perhaps other solid malignancies.

Investigators have expanded the scientific understanding of cancer in the adolescent young adult patient population over the past decade. However, unmet needs remain in establishing treatment standards, addressing unique survivorship challenges, and providing a framework for patients to reference as they navigate their cancer journey.

The sustainability of next-generation sequencing will be dependent on the implementation of thorough informatics and infrastructure that can support the integration of genomic results into electronic medical records.

Dr. Patel discusses the role of biomarker testing in lung cancer, the FDA approvals of amivantamab and mobocertinib in EGFR exon 20 insertion–positive NSCLC, and future research directions in this subset of lung cancer.

Dr. Scott and Dr. Torres-Roca discuss their research of a pooled retrospective analysis exploring genomic-adjusted radiation dose–based radiation therapy in solid tumors and what using genomics to guide radiation dosing decisions could mean for oncology practices.

Andre H. Goy, MD, discusses the importance of refined decision making with precision medicine.

John L. Marshall, MD, discusses the importance of molecular profiling when utilizing precision medicine.

Benjamin P. Levy, MD, discusses potential strategies to overcome resistance to osimertinib in EGFR-mutant non–small cell lung cancer. 

Clinical limit of detection may be a reasonable metric for evaluating cell-free DNA for multi-cancer early detection.

Current approaches to precision medicine in oncology have been fruitful, but require better integration and utilization of available resources to inform sustainable and effective drug development and clinical care, according to Andre Goy, MD.

Dr. Neel discusses the momentum of molecularly-driven research and treatment strategies in oncology, the continuation of current research trends, and potential future directions throughout the field.

The FDA has granted premarket approval to the Oncomine Dx Target Test for use as a companion diagnostic to identify patients with non–small cell lung cancer whose tumors harbor EGFR exon 20 insertion mutations who may be eligible to receive the newly approved small molecule TKI mobocertinib.

Mobocertinib plus ado-trastuzumab emtansine demonstrated inhibitory effects in HER2 exon 20 insertion–mutated lung cancer cell lines.

The European Association of Neuro-Oncology and ESMO have released clinical practice guidelines, which provide management recommendations for the diagnosis, treatment, and follow-up of patients with solid tumor brain metastases.

Genomic-adjusted radiation dose demonstrated a significant association with time to first recurrence and overall survival in patients with certain solid tumors who had been treated with radiation therapy, indicating that genomics should be used to guide radiation dosing decisions.

Javier Torres-Roca, MD, discusses optimizing radiation therapy with genomic-adjusted radiation dose–based radiotherapy dosing in oncology.

Jacob G. Scott, MD, DPhil, discusses the incorporation of genomic-adjusted radiation dose–based radiotherapy dosing in oncology.

The rapid development of novel agents directed at anaplastic lymphoma kinase gene fusions has emerged as one of the success stories of the targeted therapy era in non–small cell lung cancer

Jacob G. Scott, MD, DPhil, discusses the rationale to evaluate genomic-adjusted radiation dose–based radiotherapy dosing in oncology.

Overall survival was significantly improved at 18.6 months in patients with non–small cell lung cancer who received targeted therapy compared with those who did not receive targeted therapy at 11.4 months, according to a pooled analysis of patients who received National Comprehensive Cancer Network-guided therapies in accordance with their biomarkers.

The FDA has approved the VENTANA MMR RxDx panel as the first companion diagnostic test to assist in identifying patients with solid tumors that are DNA mismatch repair deficient who may be eligible to receive the anti–PD-1 therapy dostarlimab-gxly, which was recently granted an accelerated approval by the agency.

Circulating tumor DNA, tumor mutational burden, and homologous recombination deficiency are 3 emerging biomarkers for tailoring therapy need further clinical and technical clarity to support robust use in daily practice.

Drs. Brown and Kurzrock discuss the current and future applications of next-generation sequencing in breast cancer, the role of tissue-based testing in light of the growing role for liquid-based testing, and some of the emerging technologies that could overcome current barriers to biomarker testing.

Understanding the oncogenic drivers behind a cancer is taking on increasing importance as more effective agents targeting specific gene aberrations continue to emerge.