GENOMIC TESTING

At the recent <em>20th Annual </em>International Lung Cancer Congress&reg; in Huntington Beach, California, a number of very prominent contributors to the lung cancer translational and clinical field provided updates regarding novel strategies to address unmet needs.

Multiple presentations at the 2019 ESMO Congress add to the evidence that blood-based biomarkers have predictive utility in advanced non-small cell lung cancer. Blood-based next-generation sequencing has also shown clinical utility in aiding treatment decisions for physicians treating this disease.

In an interview with&nbsp;<em>Targeted Oncology</em>, Gregory Gores, MD explained the role of molecular therapy and the use of genetic testing to guide treatment of iCCA.

Gulam A. Manji, MD, PhD, discusses the need to identify mutations that may be actionable in patients with colorectal cancer. The identification of such mutations can further impact patient survival and improve efficacy, says Manji, in both CRC and other gastrointestinal cancers.

In an interview with <em>Targeted Oncology</em>, Dean A. Fennell, MD, PhD, explained the need for the MIST trial and personalized treatment for patients with mesothelioma.

Advances in molecular profiling have driven development and use of personalized medicine approaches in oncology, enabling detection of biomarkers for predicting prognosis and treatment response and determining inheritable cancer risk.

Timothy F. Burns, MD, PhD, discusses the necessary role of next-generation sequencing testing in patients with lung adenocarcinoma. In order to incorporate this into clinical practice, there is still a lot more work to be done, Burns says. Around 20% to 25% of patients with adenocarcinoma have targetable alterations.

Treatment with selpercatinib induced responses in 68% of patients with&nbsp;<em>RET&nbsp;</em>fusion&ndash;positive non&ndash;small cell lung cancer, according to findings from the phase I/II LIBRETTO-001 trial.

In a recent analysis published in <em>JAMA</em>, data were evaluated from a collection of clinical trials and analyzed for important takeaways in the testing and treatment of patients with non&ndash;small cell lung cancer. The authors stress the importance of molecular testing in patients with NSCLC as more targeted therapies become available.&nbsp;<br /> &nbsp;

In an interview with <em>Targeted Oncology,</em> Carol Mangione, MD, MSPH, a co-author on the USPSTF Recommendation Statement, gave insight&nbsp;into the specifics of the recommendations and how the Task Force hopes these suggestions will impact patient outcomes.<br /> &nbsp;

During the <em>20th Annual </em>International Lung Cancer Congress, <em>Targeted Oncology</em> spoke with another Lung-MAP investigator, Fred R. Hirsch, MD, PhD, about the status and importance of the trial and new recommendations for molecular testing and liquid biopsies working their way into practice in the lung cancer field.

The FDA has approved entrectinib for the treatment of adult patients with <em>ROS1</em>-positive metastatic non&ndash;small cell lung cancer. An accelerated approval was also granted to entrectinib for the treatment of adult and adolescent patients with solid tumors harboring an <em>NTRK </em>gene fusion and who have no alternative, effective therapies available.

In the largest genomic study of Merkel cell carcinoma tumors to date, investigators identified 2 distinct molecular subgroups, an ultraviolet light&ndash;driven subtype and a viral-driven subtype, which matched with tumor mutational burden classifications.&nbsp;

Fred R. Hirsch, MD, PhD, shares a message with oncologists regarding molecular testing in patients with lung cancer. He says the most important message is that molecular characterization of the patient&rsquo;s tumor must be done in order to best treat the patient.

During an interview with <em>Targeted Oncology</em>, Charu Agarwal, MD, reviewed the findings of a prospective study of pembrolizumab monotherapy in patients with advanced NSCLC.

Tissue-based microsatellite instability testing showed high concordance for detection of cell-free DNA, according to the results of a <em>Clinical Cancer Research</em> analysis.

Next-generation sequencing has increasingly become more valuable to physicians treating cancer at academic medical centers, but these tests also need to be incorporated more into community oncology practices. A recent study, presented at the 2019 ASCO Annual Meeting, demonstrated that the use of these tests has increased in the community setting as the technology, and the use and approval of matched therapies, continues to develop.

In an interview with&nbsp;Targeted Oncology, Rodabe N. Amaria, MD, discussed the guidelines and recommendations outlined by the INMC. She also highlighted the importance of genomic testing in the neoadjuvant setting of melanoma.&nbsp;

In a data set of 292&nbsp;oncologists who responded to questions about current awareness and incorporation of molecular testing in the treatment of cancer, almost 69% incorrectly matched the molecular alteration with the appropriate targeted therapy.

Charu Aggarwal, MD, MPH, the Leslye M. Heisler Assistant Professor for Lung Cancer Excellence at Perelman School of Medicine, University of Pennsylvania, and other researchers conducted a prospective study using next-generation sequencing as a biomarker to predict response and progression-free survival rates in patients with non&ndash;small cell lung cancer &nbsp;receiving pembrolizumab monotherapy. The data were presented during the 2019 ASCO Annual Meeting.

In an interview with&nbsp;<em>Targeted Oncology</em>, Susan Branford, PhD discussed the current role of NGS testing in hematologic malignancies. Following her presentation at the 2019 EHA Congress, she addressed how NGS can be incorporated more into the community practice and what challenges must be overcome in order to make this happen.

Jurgen Wolf, MD, discusses the importance of broad genomic testing to identify alterations in patients with advanced non&ndash;small cell lung cancer (NSCLC). By identifying molecular alterations and driver mutations early on, patients can receive matched targeted therapies at a time in the course of disease when the treatments would have the greatest impact.

A study aimed at exploring genomic diversity and defining its associations with clinical outcomes in metastatic castration-resistant prostate cancer found that alterations in&nbsp;RB1&nbsp;were a potent predictor of poor survival and that other common aberrations may serve as prognostic indicators of treatment response, according to recent work published in the&nbsp;Proceedings of the National Academy of Sciences.

<em>FLT3</em> mutation analysis in laboratories has brought on reimbursement barriers in clinical oncology. Jordan Clark, chief commercial officer, Diaceutics, a diagnostic development and commercialization company, spoke to <em>Targeted Oncology</em> about the cause of reimbursement issues and how the problem affects all parties involved.

A new study shows comparability between liquid biopsy and tissue biopsy in both diagnostics and monitoring of non&ndash;small cell lung cancer (NSCLC). However, based on the results, liquid biopsies may be preferable to help oncologists make swifter decisions that help manage the disease.<br /> &nbsp;