Worried About Lung Cancer Treatment? Molecular Testing Explained
Targeted Therapy for Lung Cancer A diagnosis of lung cancer no longer means a one size fits all treatment plan. Targeted therapies guided by molecular diagnostics have become the standard of care, achieving significantly better outcomes than conventional chemotherapy for patients with the right mutation profile. Key Biomarkers EGFR Mutations Epidermal growth factor receptor EGFR mutations are the most common actionable driver mutation in lung adenocarcinoma, particularly in: Asian populations up to 50% of adenocarcinomas Women Never smokers or light smokers Patients with sensitising EGFR mutations respond well to EGFR tyrosine kinase inhibitors TKIs such as erlotinib, gefitinib, and osimertinib. ALK Rearrangements Anaplastic lymphoma kinase ALK gene rearrangements occur in approximately 3–5% of non small cell lung cancers NSCLC and predict response to ALK inhibitors such as crizotinib and alectinib. PD L1 Expression Programmed death ligand 1 PD L1 expression by IHC predicts response to checkpoint immunotherapy pembrolizumab, nivolumab . High PD L1 expression ≥50% may indicate immunotherapy as first line treatment. Who Should Be Tested? Current guidelines recommend molecular testing for: All patients with non squamous NSCLC adenocarcinoma or adenocarcinoma component Young patients, females, never smokers, or those with small biopsies regardless of histology Patients with multiple tumours to distinguish metastasis from synchronous primaries How TSL Performs Molecular Testing | Test | Method | Turnaround | | | | | | Histology report | Standard H&E | 5 working days | | EGFR mut