Dr. Yung on a Paradigm Shift in Lung Cancer Treatment

Rex Chin-Wei Yung, MD, Assistant Professor of Medicine, Assistant Professor of Oncology, The Johns Hopkins Hospital, Sidney Kimmel Comprehensive Cancer Center, discusses the paradigm shift in lung cancer treatment from a very broad diagnosis from a few hundred cells to more complex molecular based panel.

In the early years of lung cancer a broad diagnosis was used because it was believed there was no difference in the subtypes of cancer. As further knowledge about the different subtypes was gained more adequate tissue staging was needed to ascertain response to medications. Some drugs are only effective in select subtypes of lung cancer; pemetrexed and bevacizumab, for example, do not perform well in squamous cell lung cancer.

Tissue-staging practices have advanced beyond diagnosing the cell type alone into completing biomarker panels in order to pair a predictive marker with an effective targeted therapy, such as tyrosine-kinase inhibitor (TKI) treatments that require a mutation in the epidermal growth factor receptor (EGFR).

Yung concludes by stating that lung cancer is shifting towards more thorough tissue staging. Enough tissue needs to be gathered to characterize not only the cell type but also for molecular panels. Possessing a fuller knowledge of the cancer will guide therapy and create a personalized approach that will create better outcomes for the patients.