A Commentary on High PD-L1 Expression in NSCLC

EP: 1.Biomarkers and Biomarker Testing in NSCLC

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EP: 2.A Commentary on High PD-L1 Expression in NSCLC

EP: 3.Broad Molecular Testing Use in Adenocarcinoma versus Squamous Cell Carcinoma

EP: 4.Reflex Testing of Next Generation Sequencing (NGS)-Based Panels in NSCLC

EP: 5.Common Biomarker Testing Methodologies Utilized in NSCLC

EP: 6.Case 1: Metastatic NSCLC with an EGFR Exon 20 Insertion

EP: 7.A Pathologist Outlines Typical Tumor Tissue Processing Steps after Biopsy in NSCLC

EP: 8.First- and Second-Line Treatment Options for Patients with mNSCLC and an EGFR Exon 20 Mutation

EP: 9.Considerations for First-Line Treatment Selection for Patients with mNSCLC and Brain Metastases

EP: 10.Repeat Liquid and Tissue Biopsy Practices in mNSCLC

EP: 11.Targeted Therapy Options for EGFR Exon 20-Mutated mNSCLC

EP: 12.Mobocertinib Safety and Efficacy Data in Patients with mNSCLC and an EGFR Exon 20 Mutation

EP: 13.CHRYSALIS Data on Amivantamab and a Comparative Efficacy Analysis of Mobocertinib vs Amivantamab

EP: 14.A Pathologist’s Commentary on The Heterogeneity of EGFR Exon 20 Insertions Found in NSCLC and Considerations for Results Reporting

EP: 15.Molecular Results Interpretation and Subsequent Treatment Selection for EGFR Exon 20 Mutation-Positive mNSCLC

EP: 16.Management of Adverse Events Following Mobocertinib and Strategies for Treatment Modification

EP: 17.Mobocertinib Treatment-Emergent EGFR Mutations and Subsequent Therapy Selection

EP: 18.RET Fusion-Positive mNSCLC: Case 2 Presentation and Molecular Testing Strategies

EP: 19.Selpercatinib and Pralsetinib for RET Fusion-Positive mNSCLC and Supporting Efficacy Data

EP: 20.Occurrence and Management of Selpercatinib- and Pralsetinib-Related AEs in Patients with RET Fusion-Positive mNSCLC

EP: 21.Potential Immunotherapy Use in Patients with mNSCLC and RET Alterations

EP: 22.Looking Towards the Future of Molecular Testing and Additional Treatment Options for Patients with mNSCLC

Joel Neal, MD, PhD: One of the other tests that's often highlighted, and we find that early on in immunohistochemistry tests part of non-small cell lung cancer, is PD-L1. Lauren, I was wondering if you see patients early on in the diagnosis and have been involved in the care of patients who have a diagnosis of non-small cell lung cancer, a very high PD-L1, but none of the molecular data back; and there's this eagerness to act on that?

Lauren Welch, MSN, NP-C, AOCNP: Absolutely, I feel like this happens almost every week. We've focused so much on trying to get the patient into clinic as quickly as possible that sometimes by the time that they're seeing us for their initial medical oncology evaluation we don't have all the results back. The patient's so eager – or anxious may be a better word – to describe how many of them are feeling, to know more about their cancer, to know more about the treatment. It can be a really challenging conversation to have to say, actually, we need to pause, put the brakes on until we get the rest of your testing back. A lot of what I do is making sure that all the testing has actually been ordered. That in between from biopsy to initial evaluation, PD-L1 is often reflexively performed and then I find depending on who's done the biopsy or where the patient may have had their initial biopsy done, sometimes limited panels are still ordered or there isn't always routine reflexing to next generation sequencing. That's always a difficult and lengthy conversation that we have to have with the patient.

Joel Neal, MD, PhD: Absolutely. I do want to make the point that PD-L1 is different. It's a protein marker on the outside of tumor cells and depending on where we sample the cancer and what point in time and what prior treatments there have been, PD-L1 is a lot more variable. Most of the other molecular diagnostic markers we talk about are root biomarkers. They really happen in the trunk of the branch of cancer tumorigenesis and as such they're in almost every single tumor cell probably as well as a host of other mutations that we don't talk about that may sometimes contribute to tumorigenesis or the incidental that we find.