Lung Cancer Biomarker Testing: IHC, Tissue Genomics, Digital Pathology, and ctDNA

Area of Science:

• Oncology
• Genomics
• Pathology

Background:

• Lung cancer biomarker testing has advanced significantly.
• Current methods include immunohistochemistry, tissue-based next-generation sequencing (NGS), and liquid biopsy.
• These techniques are crucial for personalized medicine in lung cancer.

Purpose of the Study:

• To provide an overview of current lung cancer biomarker testing modalities.
• To highlight the roles of NGS, liquid biopsy, and immunohistochemistry.
• To discuss workflow optimization and future directions in personalized lung cancer oncology.

Main Methods:

• Tissue-based next-generation sequencing (NGS) for comprehensive genomic profiling.
• RNA-based assays for enhanced fusion detection.
• Liquid biopsy utilizing circulating tumor DNA (ctDNA) for non-invasive genotyping and monitoring.
• Immunohistochemistry for PD-L1 and other therapeutic targets.
• Integration of digital pathology and artificial intelligence (AI).

Main Results:

• Tissue-based NGS is foundational for identifying actionable mutations and guiding personalized therapies.
• RNA assays improve the detection of gene fusions.
• Liquid biopsy offers a minimally invasive option for genotyping and disease monitoring, with ongoing sensitivity challenges in early stages.
• Immunohistochemistry expands therapeutic options, including for antibody-drug conjugates.
• Workflow optimizations like molecular tumor boards and reflex testing are key to reducing turnaround times.

Conclusions:

• The integration of diverse biomarker testing methods is transforming lung cancer personalized oncology.
• Advances in technology, including AI and digital pathology, are paving the way for novel biomarker discovery and improved treatment strategies.
• Efficient workflows and comprehensive profiling are essential for accurate interpretation and effective personalized treatment in lung cancer.