Completing YourEarly-Stage NSCLC Diagnosis
Biomarker Testing for Early-Stage NSCLC
If you’ve been diagnosed with early-stage NSCLC, you may have already had, or be preparing for, surgery. To help determine your appropriate treatment options after surgery, talk to your healthcare team about completing your diagnosis. Testing the tissue removed during surgery (either pre-surgical biopsy or surgery to remove your tumor) can help reveal if your cancer has certain biomarkers, which can provide information about what may be causing the cancer to grow and spread and what types of treatment may be most appropriate for your specific type of lung cancer.
Molecular testing, also known as biomarker testing, may help identify biomarkers and immune proteins that might be causing your cancer to grow and spread. Ask your doctor about biomarker testing and completing your lung cancer diagnosis.
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TALK
To Your Healthcare Team About Biomarker Testing
Biomarker testing is how your healthcare providers can detect possible driver mutations and/or protein inhibitors that may be causing your cancer to grow and spread. Obtaining more knowledge about your specific lung cancer diagnosis could help you and your healthcare team explore appropriate treatment options that may help keep your cancer from coming back after surgery.
TEST
As the Next Step in Your Treatment Plan
Biomarker testing on the lung cancer tissue removed during biopsy or surgery may help your doctors determine the most appropriate treatment plan for you. There are two groups of biomarkers in lung cancer:
- 1. PD-L1 Immune Proteins
- 2.Driver Mutations
PD-L1 is an immune protein that stops your immune system from killing cancer cells, allowing cancer cells to grow.
A driver mutation is a change in the cell’s DNA that causes it to become cancerous, enabling cancer cells to quickly duplicate, survive and spread in the body. Guidelines recommend testing for EGFR (epidermal growth factor receptor), which can cause lung cells to replicate quickly. Up to 1 in 5 patients with early-stage NSCLC test positive for an EGFR mutation.
Prevalence of EGFR Mutations in NSCLC Adenocarcinoma1-2*†
This bar graph shows the prevalence of EGFR Mutations in Adenocarcinoma in stages I-III. Adenocarcinoma is the most common type of NSCLC. The chart shows that stage I has a 20% prevalence whereas stages II and III have an 18% prevalence of EGFR mutations. These numbers indicate that EGFR mutations are 2% more prevalent in stage I than in stages II and III.
*Adenocarcinoma is the most common type of NSCLC.
†Prevalence of EGFR mutations in NSCLC adenocarcinoma was based on data from two references: Sholl et al (2015) performed mutation analysis on 1007 specimens with confirmed diagnosis of lung adenocarcinoma with EGFR sensitizing mutations (exon 19 deletions, EGFR L858R mutations, EGFR G719X mutations, EGFR L861Q mutations) and other EGFR mutations (any one or more mutations in EGFR other than exon 19 deletions, L858R mutations, G719X mutations, or L861Q mutations); D’Angelo et al (2012) analyzed tumor specimens from a cohort of 1118 patients with stage I-III surgically resected lung adenocarcinomas with EGFR exon 19 deletions and L858R mutations only.1-3
TREAT
To Determine Your Appropriate Treatment Plan, First Complete Your Diagnosis
Biomarker testing can reveal specific information about your NSCLC, which can help your healthcare team determine which treatment options may help to prevent your cancer from returning after surgery.
References
- 1Sholl LM, Aisner DL, Varella-Garcia M, et al. LCMC Investigators. Multi-institutional oncogenic driver mutation analysis in lung adenocarcinoma: The Lung Cancer Mutation Consortium experience. J Thorac Oncol. 2015;10(5):768-777. [Article and Supplementary Appendix]
- 2D’Angelo SP, Janjigian YY, Ahye N, et al. Distinct clinical course of EGFR-mutant resected lung cancers: results of testing of 1118 surgical specimens and effects of adjuvant gefitinib and erlotinib. J Thorac Oncol. 2012;7(12):1815-1822.
- 3Kris MG, Johnson BE, Berry LD, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs. JAMA. 2014;311(19):1998-2006.