ESMO E-Learning: The Importance of Molecular Aspects to Make Therapeutic Decisions in Lung Cancer

Learning Objectives

  • To evaluate the heterogeneity of NSCLC and the relationship between molecular features of the tumour and clinical course of the disease
  • To interpret the results of molecular testing to guide treatment selection for patients with NSCLC
  • To appreciate currently available molecular techniques and match them correctly when testing of specific oncogenic alteration(s) in NSCLC patients is needed
Title Duration Content CME Points CME Test
The Importance of Molecular Aspects to Make Therapeutic Decisions in Lung Cancer 28 min. 36 slides 1 Take Test
Tony Mok
Tony Mok
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Non-small cell lung cancer (NSCLC) is an aggressive disease and challenging to treat. The past decade has witnessed a major shift in the treatment of advanced NSCLC.Histological subtype is clearly an important factor in selecting among standard cytotoxic chemotherapies, but the genetic subtype — the presence (or absence) of key oncogenic alterations such as activating mutations and chromosomal rearrangements — is now also crucial. This was first established with the discovery of sensitising epidermal growth factor receptor (EGFR) mutations in a subset of patients with NSCLC, and has now been further validated by the successful development of a targeted agent for a different NSCLC subset defined by anaplastic lymphoma kinase (ALK) Gene rearrangements.

New therapeutic options have emerged that focus on specific molecular targets. However, it is important to identify which patients are most likely to respond to these treatments. Treatment guidelines now recommend EGFR mutational analysis as a diagnostic tool if EGFR tyrosine kinase inhibitors are being considered as treatment, although it is unclear how widely this is being implemented. In addition crizotinib has been recently approved in USA for the treatment of patients with locally advanced or metastatic NSCLC that is ALK-positive, as detected by an FDA-approved test.

The goal of this E-Learning module is to provide a perspective on the importance of molecular testing for therapeutic decisions on new and emerging molecular treatments in NSCLC. It provides a rationale for identifying patients most likely to respond to a certain targeted therapy. In addition it discusses current methods of identifying tumours positive for oncogenic alterations, and the interpretation of the results of molecular testing to guide treatment choice.

Last update: 24 February 2012

Prof. Mok has reported to be the advisor for AstraZeneca, Roche, Eli Lilly, Merck Serono, Eisai, BMS, BeiGene, AVEO, Pfizer, Taiho and Boehringer Ingelheim. He is also a member of the speakers’ bureau for AstraZeneca, Roche, Eli Lilly, Boehringer Ingelheim and Merck Serono. He is currently conducting research sponsored by AstraZeneca.