Optimizing Early-Stage NSCLC Management: A Multidisciplinary Perspective - Episode 1
Comprehensive Molecular Testing in Early-Stage NSCLC: Best Practices and Multidisciplinary Strategies
Panelists discuss how medical professionals currently approach molecular testing in early-stage non–small cell lung cancer (NSCLC) through comprehensive biomarker analysis, including targeted next-generation sequencing (NGS), to identify actionable mutations that guide adjuvant therapy decisions and improve patient outcomes.
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Current Approach to Molecular Testing in Early-Stage NSCLC
Early-stage NSCLC patients increasingly benefit from molecular testing, though implementation varies across practice settings. The current landscape includes.
- Most centers perform biomarker testing after surgical resection rather than at diagnosis
- Testing primarily focuses on identifying targetable alterations, particularly EGFR mutations
- Molecular profiling is expanding beyond EGFR to include ALK, ROS1, BRAF, MET, RET, and NTRK
- NGS panel testing is becoming more common but isn’t universally implemented
- Testing rates remain suboptimal with significant disparities across health care settings
- Guidelines generally recommend biomarker testing for patients with stage IB-IIIA disease, particularly those with nonsquamous histology
- Results increasingly guide adjuvant targeted therapy decisions, especially following FDA approval of osimertinib for EGFR-positive patients
- Barriers include tissue availability, turnaround time, and lack of standardization
- Liquid biopsy adoption is increasing as a complementary approach but hasn’t replaced tissue-based testing
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