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Updated: Apr 22, 2026
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Molecular alterations in non-small-cell lung cancer: perspective for targeted therapy and specimen management for the
Kasia Czarnecka-Kujawa1, Kazuhiro Yasufuku
1Division of Respirology; Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
Abstract:
Major advances have occurred over the past decade in our understanding of lung cancer pathobiology. Increasing knowledge of molecular aberrations in lung cancer, specifically the discovery of two driver genes in pharmacologically targetable tyrosine kinases involved in growth factor receptor signalling, epidermal growth factor receptor and anaplastic lymphoma kinase, has been of major therapeutic and prognostic importance. This discovery has allowed for new, personalized approach to the management of lung cancer. Recognizing the importance of molecular signatures of lung cancer, the College of American Pathologists, International Association for the Study of Lung Cancer and Association for Molecular Pathology released the first guidelines for molecular testing in lung cancer. The introduction of minimally invasive needle techniques for the evaluation of lung cancer patients, such as endobronchial ultrasound transbronchial needle aspiration and oesophageal ultrasound-fine-needle aspiration, has revolutionized the way lung cancer patients are assessed. Samples obtained using the minimally invasive needle approaches have been shown to be sufficient not only for routine molecular testing but also for multigenic analysis. This allows bronchoscopist to assume an increasingly important role in the diagnostic workup of patients with lung cancer at all stages of the disease and contribute to personalizing the care of lung cancer patients.
Insights
Advances in lung cancer pathobiology include identifying driver genes like epidermal growth factor receptor and anaplastic lymphoma kinase. Minimally invasive techniques now enable comprehensive molecular testing for personalized lung cancer treatment.
Area of Science:
- Oncology
- Molecular Pathology
- Pulmonology
Background:
- Significant progress in understanding lung cancer pathobiology over the last decade.
- Discovery of driver genes in tyrosine kinases (epidermal growth factor receptor, anaplastic lymphoma kinase) crucial for targeted therapy.
- Emergence of personalized medicine approaches in lung cancer management.
Purpose of the Study:
- To highlight recent advances in lung cancer pathobiology and molecular testing.
- To emphasize the role of minimally invasive techniques in patient assessment.
- To underscore the importance of molecular profiling for personalized lung cancer care.
Main Methods:
- Review of major advances in lung cancer molecular understanding.
- Discussion of guidelines for molecular testing in lung cancer.
- Evaluation of minimally invasive needle biopsy techniques (endobronchial ultrasound transbronchial needle aspiration, oesophageal ultrasound-fine-needle aspiration).
Main Results:
- Identification of key driver genes (EGFR, ALK) has transformed lung cancer therapy.
- Minimally invasive techniques yield sufficient samples for extensive molecular analysis.
- These advancements facilitate a personalized approach to lung cancer diagnosis and treatment.
Conclusions:
- Molecular profiling is essential for personalized lung cancer management.
- Minimally invasive bronchoscopic techniques are revolutionizing patient evaluation.
- Bronchoscopists play a critical role in the diagnostic workup and personalized care of lung cancer patients.
