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Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Next Generation Sequencing Analysis and its Benefit for Targeted Therapy of Lung Adenocarcinoma
Vlastimil Kulda1, Jiri Polivka2,3, Martin Svaton4
1Department of Medical Chemistry and Biochemistry, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
Background/Aim:
Targeted therapy has become increasingly important in treating lung adenocarcinoma, the most common subtype of lung cancer. Next-generation sequencing (NGS) enables precise identification of specific genetic alterations in individual tumor tissues, thereby guiding targeted therapy selection. This study aimed to analyze mutations present in adenocarcinoma tissues using NGS, assess the benefit of targeted therapy and evaluate the progress in availability of targeted therapies over last five years.
Patients And Methods:
The study included 237 lung adenocarcinoma patients treated between 2018-2020. The Archer FusionPlex CTL panel was used for NGS analysis.
Results:
Gene variants covered by the panel were detected in 57% patients and fusion genes in 5.9% patients. At the time of the study, 34 patients (14.3% of patients) were identified with a targetable variant. Twenty-five patients with EGFR variants, 8 patients with EML4-ALK fusion and one patient with CD74-ROS1 fusion received targeted therapy. Prognosis of patients at advanced stages with EGFR variants treated by tyrosine kinase inhibitors and patients with EML4-ALK fusion treated by alectinib was significantly favorable compared to patients without any targetable variant treated by chemotherapy (p=0.0172, p=0.0096, respectively). Based on treatment guidelines applicable in May 2023, the number of patients who could profit from targeted therapy would be 64 (27.0% of patients), this is an increase by 88% in comparison to recommendations valid in 2018-2020.
Conclusion:
As lung adenocarcinoma patients significantly benefit from targeted therapy, the assessment of mutational profiles using NGS could become a crucial approach in the routine management of oncological patients.
Insights
Next-generation sequencing (NGS) identifies targetable mutations in lung adenocarcinoma, significantly improving patient outcomes with targeted therapies. The availability of these advanced treatments has notably increased over five years.
Area of Science:
- Oncology
- Genomics
- Personalized Medicine
Background:
- Lung adenocarcinoma is the most common lung cancer subtype.
- Targeted therapy selection is guided by genetic alterations identified through next-generation sequencing (NGS).
Purpose of the Study:
- To analyze mutations in lung adenocarcinoma tissues using NGS.
- To assess the benefits of targeted therapy for patients.
- To evaluate the evolving availability of targeted therapies over five years.
Main Methods:
- NGS analysis using the Archer FusionPlex CTL panel.
- Study cohort comprised 237 lung adenocarcinoma patients treated between 2018-2020.
Main Results:
- Gene variants detected in 57% of patients; fusion genes in 5.9%.
- 34 patients (14.3%) had targetable variants, receiving specific therapies (EGFR, EML4-ALK, CD74-ROS1).
- Targeted therapy significantly improved prognosis compared to chemotherapy for advanced-stage patients with EGFR or EML4-ALK alterations.
- Potential beneficiaries of targeted therapy increased by 88% by May 2023.
Conclusions:
- Lung adenocarcinoma patients demonstrate significant benefit from targeted therapy.
- NGS-based mutational profiling is crucial for routine oncological patient management.
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