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Molecular testing in stage I–III non-small cell lung cancer: Approaches and challenges

2021Journal article Open access
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dc.contributor.authorAggarwal, C
dc.contributor.authorBubendorf, L
dc.contributor.authorCooper, WA
dc.contributor.authorIllei, P
dc.contributor.authorBorralho Nunes, P
dc.contributor.authorOng, BH
dc.contributor.authorTsao, MS
dc.contributor.authorYatabe, Y
dc.contributor.authorKerr, KM
dc.date.accessioned2023-02-05T17:42:27Z
dc.date.available2023-02-05T17:42:27Z
dc.date.issued2021
dc.description.abstractPrecision medicine in non-small cell lung cancer (NSCLC) is a rapidly evolving area, with the development of targeted therapies for advanced disease and concomitant molecular testing to inform clinical decision-making. In contrast, routine molecular testing in stage I-III disease has not been required, where standard of care comprises surgery with or without adjuvant or neoadjuvant chemotherapy, or concurrent chemoradiotherapy for unresectable stage III disease, without the integration of targeted therapy. However, the phase 3 ADAURA trial has recently shown that the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), osimertinib, reduces the risk of disease recurrence by 80% versus placebo in the adjuvant setting for patients with stage IB-IIIA EGFR mutation-positive NSCLC following complete tumor resection with or without adjuvant chemotherapy, according to physician and patient choice. Treatment with adjuvant osimertinib requires selection of patients based on the presence of an EGFR-TKI sensitizing mutation. Other targeted agents are currently being evaluated in the adjuvant and neoadjuvant settings. Approval of at least some of these other agents is highly likely in the coming years, bringing with it in parallel, a requirement for comprehensive molecular testing for stage I-III disease. In this review, we consider the implications of integrating molecular testing into practice when managing patients with stage I-III non-squamous NSCLC. We discuss best practices, approaches and challenges from pathology, surgical and oncology perspectives.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLung Cancer . 2021 Dec;162:42-53.pt_PT
dc.identifier.doi10.1016/j.lungcan.2021.09.003pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/43628
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectNeoplasia do Pulmãopt_PT
dc.subjectCarcinoma Pulmonar de Células não Pequenaspt_PT
dc.subjectTécnicas de Diagnóstico Molecularpt_PT
dc.subjectCarcinoma, Non-Small-Cell Lungpt_PT
dc.subjectLung Neoplasmspt_PT
dc.subjectMolecular Diagnostic Techniquespt_PT
dc.titleMolecular testing in stage I–III non-small cell lung cancer: Approaches and challengespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage53pt_PT
oaire.citation.startPage42pt_PT
oaire.citation.titleLung Cancerpt_PT
oaire.citation.volume162pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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