Dr. Herbst on Selecting Patients for Molecular Testing

Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Director for Translational Research, Clinical Research Program Leader, Thoracic Oncology Program, Yale Cancer Center, discusses determining the eligibility of patients with non-small cell lung cancer (NSCLC) for molecular testing.

Overall, Herbst recommends molecular testing for all patients with NSCLC, regardless of whether they are smokers or nonsmokers. However, he adds, some mutations, such as EGFR, are known to be more common in nonsmokers, but they’re not unheard of in smokers. In general, the frequency of this mutation depends on how much someone smoked and when they stopped smoking.

Herbst believes it is important to test all patients with NSCLC for molecular aberrations because of the magnitude of benefit derived if an actionable mutation is found. In general, he notes, clinical characteristics are trumped by the molecular profile.