Friday, September 6, 2013

From Phil Cagle and Randy Olsen: Verifying the Role of Surgical Pathologists in the Precision Medicine of Lung Cancer

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0659-ED


Verifying the Role of Surgical Pathologists in the Precision Medicine of Lung Cancer

Philip T. Cagle MDRandall J. Olsen MD, PhD
From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas, and the Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York.



The First Line Erbitux in Lung Cancer Phase III clinical trial recently reported that a portion of advanced non–small cell lung carcinoma (NSCLC) patients benefit from the addition of the anti–epidermal growth factor receptor (EGFR) antibody cetuximab (Erbitux, Bristol-Myers Squibb, New York, New York, and Eli Lilly and Company, Indianapolis, Indiana) to their conventional platinum-based therapy. Patients whose NSCLC expressed high levels of EGFR based on an immunohistochemistry (IHC) scoring system had improved survival when cetuximab was added to their therapy, in contrast to those with tumors with low levels of EGFR expression.13 This observation signifies an important new opportunity for pathologists to participate in predictive biomarker testing using the conventional light microscope, the familiar technique of IHC, and their traditional skills as pathologists. In this issue of theArchives, the article by Dr Rüschoff and his multinational group of collaborators systematically addresses the interobserver reproducibility of the EGFR IHC scoring system used in the First Line Erbitux in Lung Cancer clinical trial, further solidifying, in this context, the value of the surgical pathologist in the personalized health care of lung cancer patients.

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