Monday, September 15, 2014

From Eric Bernicker: Biomarker Testing in Non–Small Cell Lung Cancer: A Clinician's Perspective

Eric BernickerMD
From Thoracic Medical Oncology, Houston Methodist Hospital, Houston, Texas.



"By now, it is no longer an active clinical question: multiple clinical trials have conclusively proven that, in the presence of an activating EGFR mutation, targeted agents are superior to cytotoxic chemotherapy.7–10 For that reason, unless the patient has clinical symptoms necessitating rapid  initiation of therapy, most clinicians will await the results of molecular testing before beginning treatment. It is expected that the turnaround time for such results should be 2 weeks at the most, the upper limit of time that a patient and their family can stand to wait for the information. It is certainly true that these mutation-directed therapies retain their ability to cause responses even if used after initial chemotherapy. However, their generally favorable toxicity profile leads most clinicians to prefer to select targeted therapy if the correct driver mutations are present, unless disease burden or severity necessitates a more urgent therapeutic start."

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