WHAT IS STAGING AND WHY IS IT IMPORTANT?
Staging a tumor involves determining how far a cancer has spread. This is useful for several reasons:
- It allows physicians to have a common “language” in describing a patient’s tumor. Thus, when a surgeon tells an oncologist that a patient has Stage IIIA disease, the oncologist immediately has some idea as to the extent of the patient’s disease.
- It is an important prognostic indicator. Patients with Stage I disease, for example, typically do much better than do patients with Stage IV disease.
- It is very useful for determining therapy. The type of treatment that is recommended – surgery, radio therapy, chemotherapy or any combination of these – will depend upon the extent of the disease and how far it has spread.
WHAT TO KNOW: The CAP/IASLC/AMP Molecular Testing Guideline for the selection of lung cancer patients for EGFR mutation and ALK rearrangement
The new frontier of precision medicine offers patients the opportunity for molecular testing, leading to optimal, targeted individualized treatment based on their genetic profile. To help pathologists and oncologists provide the best possible patient care, the College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) have developed an evidence-based guideline to provide recommendations for the test selection for EGFR mutation and ALK rearrangement in lung cancer. The implementation of the guideline will identify patients who could benefit more from new targeted drugs than from conventional chemotherapy, while experiencing fewer side effects. Below is a link to the guideline:
Molecular Testing Guideline for the Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors
- Physicians should order EGFR mutation and ALK rearrangement testing at the time of diagnosis for patients with advanced-stage lung adenocarcinoma, regardless of their clinical history.
- In the United States, up to 20% of patients with lung adenocarcinoma, the most common type of lung cancer, will test positive for one of the two biomarkers, EGFR and ALK, and will benefit from targeted drugs matched to these biomarkers.
- Patients with advanced-stage lung adenocarcinoma should ask to be tested for EGFR and ALK and should also ask if their testing is being performed in an accredited laboratory.
- The molecular changes, if present, are only in the cancer cells, not in normal cells and are not inherited. Therefore, there are no concerns for patients’ family members.
- The molecular testing will identify patients for oral therapy. Standard therapies will be used as well.
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