Non-Small Cell Lung Cancer (NSCLC) is not a standardized type of cancer; it is a diverse disease that differs genetically from one patient to another. This is why the current treatment strategies are not based solely on conventional treatment approaches. Rather, they concentrate on the genetic signature of the tumor. In this regard, genetic testing becomes an important component of the process as it allows doctors to understand more about the nature of the cancer and thus make more personalized decisions.
What Is Genetic Testing in NSCLC?
Genetic testing in non-small cell lung cancer refers to the analysis of the cancerous tumor’s DNA to discover specific mutations that cause cancer development and metastases. It should be noted that genetic testing does not relate to genetic tests for inherited mutations. In non-small cell lung cancer, testing is performed for acquired mutations. The procedure can be conducted by:
- Tumor tissue biopsy.
- Liquid biopsy by using a blood sample.
These procedures are used to reveal significant genetic changes.
Why Is Genetic Testing Important?
The process of genetic testing is vital because it is an important guide when making treatment plans. Patients would have taken treatment options that are not necessarily effective in their case without this process. Importance of genetic testing in cancer is:
- Matching patients to targeted treatments.
- Improving the chances of successful treatment.
- Avoiding the administration of inappropriate treatments and suffering from side effects.
- Control over disease development and increase in survival rates.
What are the common biomarkers tested in NSCLC?
There are some essential biomarkers that need to be checked in patients diagnosed with NSCLC. The biomarkers are:
- EGFR (Epidermal Growth Factor Receptor)
- ALK (Anaplastic Lymphoma Kinase)
- ROS1 gene rearrangement
- BRAF mutation
- KRAS mutation
- PD-L1 expression
Each of these biomarkers provides information regarding the response of the patient to different treatments.
When Should NSCLC Patients Be Tested?
Genetic testing is supposed to take place upon initial diagnosis, particularly at the advanced stage of NSCLC. It can also be recommended for:
- Recurrent cancer after undergoing treatment.
- Non-response of the cancer to existing treatment.
- Initiation of targeted and immunotherapy.
Early genetic testing will allow healthcare providers to make treatment decisions promptly and accurately.
How Many Types of Genetic Testing Used in NSCLC?
Genetic testing of NSCLC is conducted by various techniques:
1. Tumor Tissue Biopsy Testing: Most commonly used testing technique when testing of tumor tissue is performed in the laboratory.
2. Liquid Biopsy Testing: Testing method which consists in analyzing the presence of DNA in the blood circulation.
3. Next-Generation Sequencing (NGS): Technique of testing several genes at one time giving a full genetic picture.
Every technique has its advantages and is selected depending on the state of the patient.
Conclusion
Genetic Testing has been established as an important milestone in the treatment of Non-Small Cell Lung Cancer. It helps to switch the treatment from a general approach to one that is customized based on the patient’s genetic mutation. With the help of identification of important biomarkers, the process of genetic testing not only helps in improving treatment results but also in improving the quality of life of the patients. Genetic testing will continue to play an important role in cancer treatment in the future.
FAQs
1. Are all NSCLC patients genetically mutated?
Not all patients carry targetable mutations, but most do. This is why testing is necessary as it determines if targeting therapy will work.
2. Can genetic testing be performed repeatedly?
Yes, if the disease progresses or becomes resistant to any kind of treatment, it may be recommended by the doctor to perform genetic testing again.
References
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- Ehrhart, N. (1998). Principles of tumor biopsy. Clinical Techniques in Small Animal Practice, 13(1), 10-16. https://www.sciencedirect.com/science/article/abs/pii/S1096286798800212
- Burke, W. (2002). Genetic testing. New England Journal of Medicine, 347(23), 1867-1875. https://www.nejm.org/doi/full/10.1056/NEJMoa012113?__cf_chl_f_tk=fQlXGeluQDUFgpEVnwTWbdZy8iqI5NdckwfqoUebeEw-1782904866-1.0.1.1-DubQdCeRMTyQcDH1eDNE51N3x_OctF4gNJdarAn4U50
- Villalobos, P., & Wistuba, I. I. (2017). Lung cancer biomarkers. Hematology/oncology clinics of North America, 31(1), 13. https://pubmed.ncbi.nlm.nih.gov/27912828/
- Castro-Giner, F., Gkountela, S., Donato, C., Alborelli, I., Quagliata, L., Ng, C. K., … & Aceto, N. (2018). Cancer diagnosis using a liquid biopsy: challenges and expectations. Diagnostics, 8(2), 31. https://www.mdpi.com/2075-4418/8/2/31
