Levy Benjamin P, Chioda Marc D, Herndon Dana, Longshore John W, Mohamed Mohamed, Ou Sai-Hong Ignatius, Reynolds Craig, Singh Jaspal, Wistuba Ignacio I, Bunn Paul A, Hirsch Fred R
Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA
Mount Sinai Health Systems, New York, New York, USA; Pfizer Oncology, New York, New York, USA; Cone Health Cancer Center, Greensboro, North Carolina, USA; Carolinas Pathology Group, Carolinas HealthCare System, Charlotte, North Carolina, USA; Chao Family Comprehensive Cancer Center, University of California at Irvine School of Medicine, Orange, California, USA; US Oncology Research, Ocala, Florida, USA; Carolinas HealthCare System, Charlotte, North Carolina, USA; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; University of Colorado Cancer Center, Aurora, Colorado, USA.
Oncologist. 2015 Oct;20(10):1175-81. doi: 10.1634/theoncologist.2015-0114. Epub 2015 Sep 1.
The recent discovery of relevant biomarkers has reshaped our approach to therapy selection for patients with non-small cell lung cancer. The unprecedented outcomes demonstrated with tyrosine kinase inhibitors in molecularly defined cohorts of patients has underscored the importance of genetic profiling in this disease. Despite published guidelines on biomarker testing, successful tumor genotyping faces significant hurdles at both academic and community-based practices. Oncologists are now faced with interpreting large-scale genomic data from multiple tumor types, possibly making it difficult to stay current with practice standards in lung cancer. In addition, physicians' lack of time, resources, and face-to-face opportunities can interfere with the multidisciplinary approach that is essential to delivery of care. Finally, several challenges exist in optimizing the amount and quality of tissue for molecular testing. Recognizing the importance of biomarker testing, a series of advisory boards were recently convened to address these hurdles and clarify best practices. We reviewed these challenges and established recommendations to help optimize tissue acquisition, processing, and testing within the framework of a multidisciplinary approach.
近期相关生物标志物的发现重塑了我们对非小细胞肺癌患者治疗方案选择的方法。酪氨酸激酶抑制剂在分子定义的患者队列中展现出的前所未有的疗效凸显了基因检测在该疾病中的重要性。尽管已有关于生物标志物检测的指南，但在学术和社区实践中，成功的肿瘤基因分型仍面临重大障碍。肿瘤学家现在面临着解读来自多种肿瘤类型的大规模基因组数据的任务，这可能使他们难以紧跟肺癌的实践标准。此外，医生缺乏时间、资源和面对面交流的机会，可能会干扰对提供护理至关重要的多学科方法。最后，在优化用于分子检测的组织数量和质量方面存在若干挑战。认识到生物标志物检测的重要性，最近召开了一系列咨询委员会会议来应对这些障碍并阐明最佳实践。我们回顾了这些挑战并制定了建议，以帮助在多学科方法的框架内优化组织获取、处理和检测。
