Talking Tumors: Turning to Liquid Biopsies and Immunotherapy in Lung Cancer

We recently traveled to Austin, Texas, for a State of the Science Summit^™ on Lung Cancer. Immunotherapy, whether alone or in combination with chemotherapy, has become a frontline standard of care in advanced non—small cell lung cancer. While PD-L1 expression and the presence of molecular markers such as ALK and EGFR can help determine whether such an approach is recommended, results from PD-L1 testing and next-generation sequencing can take several weeks to return. In the context of a symptomatic patient who cannot wait for the results to return before beginning treatment, what is the optimal treatment, and can a liquid biopsy hasten the process? Additionally, in a patient with brain metastases who has been treated with targeted therapy and local therapy, should immunotherapy be used as the next line of therapy?

This week, we sat down with Kathryn E. Hudson, MD, and Jeff Yorio, MD, both of Texas Oncology, to discuss when it is appropriate to wait for testing before starting therapy, the accuracy of tumor and liquid biopsies, as well as optimal sequencing strategies when managing patients with brain metastases.

First, we hear from Dr. Hudson, hematologist and oncologist, and director of Survivorship for Texas Oncology. Dr. Hudson presents a case of a 52-year-old female who has a large lung mass and metastases in the bilateral lungs. Her biopsy reveals adenocarcinoma, and her PD-L1 and next-generation sequencing panels are pending. Listen on to hear the complete case presentation and the recommended route of treatment.

Next, Dr. Yorio, a hematologist and oncologist at Texas Oncology, presents a case of a 64-year-old female who was originally diagnosed with a stage IIb lung adenocarcinoma. The patient underwent neoadjuvant chemotherapy followed by a right middle lobe lobectomy and was found to have mediastinal lymphadenopathy at that time. Listen on to hear the complete case presentation and the recommended course of therapy.

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