Precision Medicine in Oncology®

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.

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

After nearly two decades of successfully developing therapies directed at molecular aberrations in non–small cell lung cancer, investigators are exploring a new generation of novel targets, including some not specifically associated with driver mutations.

Sonam Puri, MD, discusses the rationale to evaluate the real-world multiomic characterization of small cell lung cancer subtypes.

Hirva Mamdani, MD, discusses the rationale to evaluate the immunogenicity of STK11 and TP53 co-mutations in non–small cell lung cancer.

Abdul Rafeh Naqash, MD, discusses the results of a tumor profiling study in STK11 and TP53 co-mutated non–small cell lung cancer.

Osimertinib has emerged as the standard of care for patients with EGFR-mutated non–small cell lung cancer, but the need for novel agents is underscored as disease progression on the agent is inevitable.

Sukhmani K. Padda, MD, discusses strategies to overcome EGFR resistance in patients with non–small cell lung cancer.

Bispecific antibodies have become an interesting new class of agents in the lung cancer pipeline, most recently with the developments of amivantamab-vmjw, zenocutuzumab, and tarlatamab.

Multicancer early detection tests yielded high specificity and accuracy in predicting cancer signal origin and identified cancer signals in multiple tumor types.

The FDA has approved the FoundationOne Liquid CDx for use as a companion diagnostic to assist in the identification of patients with metastatic non–small cell lung cancer whose tumors harbor MET exon 14 skipping mutations and who could derive benefit from treatment with capmatinib.

The lead novel candidate, the WEE1 inhibitor adavosertib, has been tested in more than 50 completed or ongoing clinical studies but has yet to proceed to a phase 3 trial despite showing promising safety and efficacy as monotherapy and in combination with a range of other cancer therapies.

During the past decade, a growing number of PD-1/PD-L1 inhibitors gained FDA approval to treat a wide range of cancer types. Their stimulatory counterparts also emerged as sought-after anticancer targets but have proved much more challenging to manipulate therapeutically.

The FDA has approved FoundationOne CDx for use as a companion diagnostic for brigatinib, which was approved for the treatment of adult patients with ALK-positive, metastatic non–small cell lung cancer.

NRG1 fusions, which are often first detected by RNA-based sequencing, confer a more molecularly, pathologically, and clinically diverse subtype of lung cancer compared with historical hypotheses.

Next-generation sequencing plays a critical role in the diagnosis of patients with myeloid malignancies, but it also plays a necessary role in the identification of passenger mutations and subclonal events that go beyond founding drivers.

Streamlined processes afforded by in-house genomic testing have the potential to provide clinical, collaborative, and financial benefits.

Alison Schram, MD, discusses the results of the phase 1/2 eNRGy trial, which were presented during the 2021 ASCO Annual Meeting, in NRG1 fusion–positive solid tumors.

Several distinct subgroups have been identified within the myelodysplastic syndrome genomic landscape and have notable clinical features and discrete evolution patterns that provide proof of concept for next-generation disease classification and prognosis.

Dual blockade of the RAF/MEK and FAK pathways presents an opportunity for investigators to enhance and expand the number of patients with recurrent low-grade serous ovarian cancer who can benefit from targeted therapies.