Dr. Kris on Sequencing Challenges in Lung Cancer

Mark G. Kris, MD
Published: Thursday, Nov 17, 2016



Mark G. Kris, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses challenges associated with sequencing in the treatment of patients with lung cancer.

According to Kris, the marketplace and individual institution initiatives in this area of testing will advance the field quickly. The problem, however, is which option to choose and lack of availability. He says many insurance carriers have claimed that when a result is needed, they are agnostic as to the way in which that result is obtained. The carriers are only concerned with whether or not the result is achieved in a clean setting.

Kris also says that many of the cost barriers in this setting are virtually gone, and options are only going to get less expensive and more readily available.

A real issue with sequencing, says Kris, is whether to test blood or tissue samples. Some patients have blood-based tests for specific genes, while others use immunohistochemistry (IHC)-based tests. A benefit of the latter type of tests, according to Kris, is that they are part of the current flow of pathology departments, such that these tests are easy to conduct in any patient who may potentially have lung cancer. These departments are already administering other IHC tests, therefore, adding another is both an easy and quick approach.


Mark G. Kris, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses challenges associated with sequencing in the treatment of patients with lung cancer.

According to Kris, the marketplace and individual institution initiatives in this area of testing will advance the field quickly. The problem, however, is which option to choose and lack of availability. He says many insurance carriers have claimed that when a result is needed, they are agnostic as to the way in which that result is obtained. The carriers are only concerned with whether or not the result is achieved in a clean setting.

Kris also says that many of the cost barriers in this setting are virtually gone, and options are only going to get less expensive and more readily available.

A real issue with sequencing, says Kris, is whether to test blood or tissue samples. Some patients have blood-based tests for specific genes, while others use immunohistochemistry (IHC)-based tests. A benefit of the latter type of tests, according to Kris, is that they are part of the current flow of pathology departments, such that these tests are easy to conduct in any patient who may potentially have lung cancer. These departments are already administering other IHC tests, therefore, adding another is both an easy and quick approach.

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