Description

Cheng et al listed 2 algorithms for molecular testing of a lung adenocarcinoma. These can help to select an appropriate regimen utilizing a targeted agent. The authors are from Indiana University, Case Western Reserve University, Polytechnic University of the Marche Region (Ancona, Italy) and Cordoba University (Cordoba, Spain).


 

Patient selection: lung adenocarcinoma

 

About 75% of lung adenocarcinomas show a wild-type EGFR, which does not have an EGFR mutation and so is resistant to EGFR tyrosine kinase inhibitors (TKI).

 

An adenocarcinoma with a mutated EGFR showing a responsive mutation profile has a 91% chance of responding to EGFR TKI. An adenocarcinoma with a mutated EGFR showing a resistant mutation profile has a 9% chance of responding to EGFR TKI. An ad

 

About 3% of lung adenocarcinomas show an EML4-ALK rearrangement. About half of these will respond to ALK-targeted therapy. A patient negative for the EML4-ALK rearrangment will not respond to ALK-targeted therapy.

 

Testing panel may include:

(1) test for the presence of an EGFR mutation

(2) mutation profile for EGFR (if present)

(3) FISH test for EML4-ALK rearrangement

EGFR Mutation

EGFR Mutation Profile

EML4-ALK Rearrangement

Therapy

present

responsive

NA

EGFR TKI

present

resistant

NA

other

negative

NA

present

ALK TKI

negative

NA

negative

other

 


To read more or access our algorithms and calculators, please log in or register.