Emerging uses of biomarkers in lung cancer management
Over the past decade, non-small cell lung cancer (NSCLC) has witnessed unprecedented scientific advances that have translated into meaningful improvements in clinical outcomes. Much of these gains have been predicated on a better understanding of tumor biology including the identification of driver mutations that allow patients to receive novel, genotype-driven therapies. Multiple studies have now demonstrated improvements in outcomes in advanced stage patients EGFR mutations and ALK rearrangements treated with tyrosine kinase inhibitors (TKIs) when compared to chemotherapy. While the precision therapy paradigm was initially restricted to these aforementioned genotypes, a broader genomic characterization of lung cancer via next generation sequencing (NGS) approaches has identified BRAF, MET exon 14 skipping mutations as well as ROS-rearrangements as actionable mutations. Aiding this effort has been the development of novel diagnostic platforms like plasma genotyping (i.e., liquid biopsies) that can identify relevant, genetic alterations in blood when tissue is inadequate. These important diagnostic and therapeutic advances in lung cancer have converged to increase the number of patients eligible for targeted therapies and improved outcomes for these patients.