Optimizing Early-Stage NSCLC Management: A Multidisciplinary Perspective - Episode 14
Expert Insights in the Management of Early-Stage NSCLC With Limited Nodal or Oligometastatic Disease
Panelists discuss how advanced radiotherapy techniques, including stereotactic body radiation therapy (SBRT), combined with immunotherapy, have emerged as preferred treatment approaches for unresectable early-stage non–small cell lung cancer (NSCLC).
Video content above is prompted by the following:
Biomarker Testing for NSCLC
Medical professionals routinely perform the following biomarker tests:
Driver Mutations:
- EGFR mutations (exon 19 deletions, L858R, T790M, etc)
- ALK rearrangements
- ROS1 fusions
- BRAF V600E mutations
- NTRK fusions
- MET exon 14 skipping mutations
- RET fusions
- KRAS G12C mutations
Immunotherapy Biomarkers:
- PD-L1 expression (tumor proportion score)
- Tumor mutational burden
- Microsatellite instability status
Testing Methodology:
- Next-generation sequencing panels
- Immunohistochemistry for PD-L1 expression
- Fluorescence in situ hybridization for gene rearrangements
Timing:
- Recommended at diagnosis of advanced disease
- Increasingly recommended for early-stage disease to guide adjuvant therapy decisions
- Consider repeat testing at progression to identify resistance mechanisms
Biomarker results help determine eligibility for targeted therapies and immunotherapy, which may be considered in the adjuvant setting or upon disease progression after initial treatment.
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