What does it mean if my lung cancer does not have a ALK or EGFR mutation? Are there other mutations as well?
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Expert Answers
This is a very exciting time to be a lung cancer researcher, as the understanding of the molecular causes of lung cancer is growing very quickly. We now know that about 10% of non-small cell lung cancer (NSCLC) cases contain a mutation in the epidermal growth factor receptor (EGFR) gene, while another 4% or so contain an altered gene called EML4-ALK. These are commonly tested for because there are now drugs that work very well, better than traditional chemotherapy, in patients whose tumors contain these targets.
However, 85% of NSCLC patients will not have either of these targets and are usually treated with standard combination chemotherapy. Of course, EGFR and ALK are simply the first 2 genetic targets that have approved drugs, not the only potential targets out there. A recent study presented at the American Society of Clinical Oncology (ASCO) annual meeting showed that about 60% of NSCLC patients actually have a specific genetic change that might be treatable with a specific targeted drug, and clinical trials are underway to develop more targeted drugs for these patients. Ultimately, most patients will eventually be treated with personalized therapy based upon the genetic vulnerabilities of their cancer. In 2013 the best option, in my opinion, is to try and enroll on a clinical trial if one is available near the patient's home and specific for their type of lung cancer. Only through research studies will true personalized treatment become a reality.
However, 85% of NSCLC patients will not have either of these targets and are usually treated with standard combination chemotherapy. Of course, EGFR and ALK are simply the first 2 genetic targets that have approved drugs, not the only potential targets out there. A recent study presented at the American Society of Clinical Oncology (ASCO) annual meeting showed that about 60% of NSCLC patients actually have a specific genetic change that might be treatable with a specific targeted drug, and clinical trials are underway to develop more targeted drugs for these patients. Ultimately, most patients will eventually be treated with personalized therapy based upon the genetic vulnerabilities of their cancer. In 2013 the best option, in my opinion, is to try and enroll on a clinical trial if one is available near the patient's home and specific for their type of lung cancer. Only through research studies will true personalized treatment become a reality.
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