Theresa Boyle, MD, PhD, molecular pathologist and assistant professor at Moffitt Cancer Center, discusses the current approach to biomarker testing in lung cancer.

Biomarker testing begins with staging to assess how comprehensive a test is needed, says Boyle. For example, a more targeted panel could be selected in a patient who requires rapid results, whereas a more comprehensive next-generation sequencing panel could be selected if the turnaround time can be longer, Boyle explains.

 G12C mutations have become druggable with investigational agents, such as sotorasib and adagrasib, in the clinical trial setting, says Boyle. Both agents have demonstrated efficacy in this subset of patients, explains Boyle. However, whether the presence of co-mutations, such as 

, limit the efficacy of immunotherapy in this patient population is yet to be determined, Boyle adds.

Notably, the field of targeted therapy for patients with lung cancer is rapidly evolving, so it is important to be in close communication with multidisciplinary experts to determine the optimal treatment for a patient, says Boyle. Additionally, biomarker testing should be supported so that tumor interrogation can be used to inform treatment selection, Boyle concludes.

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Theresa Boyle, MD, PhD, discusses the current approach to biomarker testing in lung cancer.  



Dr. Boyle on Approaching Biomarker Testing in Lung Cancer 

Theresa Boyle, MD, PhD, molecular pathologist and assistant professor at Moffitt Cancer Center, discusses the role of concurrent molecular testing in lung cancer.

The role of liquid biopsy has grown significantly in lung cancer and is often utilized before tissue-based testing, says Boyle. The results of plasma-based testing can be obtained quickly and inform targeted therapy options for patients, Boyle explains. Although similar molecular markers can be identified with liquid and tissue biopsies, tissue-based testing is often reserved for confirmation or to ensure a mutation was not missed with the liquid biopsy, Boyle says. 

For example, if a liquid biopsy does not reveal a driver mutation in a patient with lung adenocarcinoma who has never smoked, tissue testing is indicated to ensure nothing was missed, Boyle says. In some cases, patients may not have enough circulating tumor DNA for the liquid biopsy to identify an aberration, so tissue-based testing is often needed, concludes Boyle. 

Theresa Boyle, MD, PhD, discusses the role of concurrent molecular testing in lung cancer.  



Theresa Boyle, MD, PhD

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Dr. Boyle on Approaching Biomarker Testing in Lung Cancer

Dr. Boyle on the Role of Concurrent Molecular Testing in Lung Cancer