Matthew Gubens, MD
The process of testing for EGFR/ALK/ROS1
as well as PD-L1 to identify molecular targets in patients with non–small cell lung cancer (NSCLC) is expected to transform over the next couple of years, as novel, next-generation biomarkers are currently being explored.
State of the Science Summit on Advanced Non–Small Cell Lung Cancer. In an interview, he shed more light on how far the field has come with molecular testing, the challenges still ahead, and what novel assays could be on the horizon.
OncLive: Please provide an overview of your lecture on biomarker testing.
Who do we need to look for targets in so we can give the right targeted therapy? Of course, that starts with the economical EGFR/ALK/ROS1
test and what the FDA tells us we can give, but also looking at some of the emerging targets, such as HER2, BRAF,
, where we have enough data in phase II trials to at least get us interested, if not putting a patient on trial and offering off-label drugs.
. We need to understand how tumors evolve and be smart about offering precision medicine, not just as a step 1, but steps 1, 2, 3, and 4.
Let’s say you get a patient with newly diagnosed NSCLC. Do you test them for PD-L1 expression and EGFR/ALK/ROS1 simultaneously, or does 1 molecular test come first?
This is a huge challenge right? Partly, you are dealing with a situation where, sometimes, there’s not that much tissue to go around, especially in lung cancer. Is that enough to answer all of the questions we just posed?
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