A presentation on lung cancer therapy and molecular targets was given by Gary Jean, PharmD, BCOP, Clements University Hospital in Dallas, TX, and Christine M. Walko, PharmD, BCOP, DeBartolo Family Personalized Medicine Institute at the Moffitt Cancer Center in Tampa, FL, at this year’s ASHP meeting.
In 2016, it was estimated that there will be more than 220,000 new cases of non–small-cell lung cancer (NSCLC); it is the second most common cancer among men and women.1 NSCLC is the leading cause of cancer-related death, and approximately 50% of patients present with metastatic disease.1 Treatment for NSCLC often is driven by histology and testing for driver mutations. Dr. Jean highlighted one study that found that in more than 1000 patients with metastatic adenocarcinoma lung cancer, approximately 64% were identified to have oncogenic driver mutations. In 28% of those patients, these results were used to select a targeted therapy or clinical trial.2
Mutations are common in NSCLC, and the emergence of targeted therapy in the early 2000s has changed the treatment landscape for NSCLC and the emergence of numerous new therapies. Dr. Jean stated that although targeted therapy has shown great improvement in patients through the years, oftentimes the reliability of the response is not always certain.
Dr. Walko focused on how the mutation landscape often changes for a patient over time and the need for NSCLC treatment to evolve, especially through the practice of precision medicine. The goal of precision medicine is to determine the optimal treatment or sequence of treatments for a patient. Through the course of highlighting patient cases, Dr. Walko emphasized the importance of precision medicine not only in selecting therapy but by testing a tumor’s genome and how you can potentially predict the response to a particular therapy as well as other diagnostic and prognostic data.
Lastly, Dr. Walko closed by highlighting the importance of translating the data you receive from a tumor genome test into viable clinical recommendations by ensuring that all available data are included; the interactions of all the mutations present and the unique patient characteristics are all considered when making a clinical decision. She also highlighted the importance of clinical trial opportunities and eventually being able to translate these insights to the average oncologist to improve care for patients overall.
Jean G, Walko CM. Clinical session presentation at ASHP Midyear Clinical Meeting. Las Vegas, NV; December 2016.
- American Cancer Society. Cancer Facts & Figures 2016. Atlanta, GA: American Cancer Society; 2016.
- Kris MG, et al. JAMA. 2014;311:1998-2006.