Anne S. Tsao, MD of MD Anderson Cancer Center discusses profiling standards for NSCLC blood & tissue especially for oncogenic mutations. Profiling patients, especially for non-small cell lung cancer disease is very important. Dr. Tsao uses both blood-based and tumor tissue profiling, especially for patients who are suspected to have oncogenic driver mutations. Although oncogenic driver mutated patients may respond well to their targeted therapy, but they may not gain much benefit from immunotherapy. So, its important to profile them in order to get information that will help in the design of the overall treatment plan.
The blood-based testing is very important, specifically on the testing for T790M for patients who are currently or previously on first generation EGFR TKI. T790 is a resistance mechanism and Osimertinib will target it. However, it is also important to know additional drugs down the pipeline that will also target T790. Testing is also important in order to know what type of EGFR mutation the patient has in order to target it with specific treatment plan. Above all, it is very important to know the biology of the patients disease in order to be prepared and give them what they really need in terms of salvage therapy.