HER2-Mutant NSCLC: Tissue Adequacy and Repeat Biopsy

In this segment of the OncLive Peer Exchange®, Dr. Benjamin P. Levy, Dr. Julia Rotow, and Dr. Narjust Florez discuss challenges associated with tissue adequacy and repeat biopsy in non-small cell lung cancer (NSCLC), including HER2-mutant disease. The experts explain how increasing reliance on comprehensive biomarker profiling places greater demands on initial diagnostic samples and can complicate treatment planning when tissue is insufficient. They also explore the role of liquid biopsy in obtaining molecular results more quickly and the importance of reassessing tumor biology at disease progression. Dr. Florez describes how repeat biopsy can help identify molecular evolution, potential resistance mechanisms, and histologic transformation, which may influence subsequent treatment decisions. The panel considers practical barriers to rebiopsy, including the location of disease progression, with central nervous system-only progression presenting particular challenges. Dr. Levy also highlights the need to consider how repeat biopsy and treatment sequencing strategies can be implemented in community practice. The discussion emphasizes obtaining adequate molecular information to support individualized treatment decisions as NSCLC evolves.