Evaluating the Role of Molecular Testing in Lung Cancer

Nathan A. Pennell, MD, PhD, director, Lung Cancer Medical Oncology Program, Taussig Cancer Institute, Cleveland Clinic, discusses the role of molecular testing when treating and managing patients withlung cancer.He shares his advice on what to do for patients who need therapy immediately, as well.

Molecular testing should be done upfront as quickly and efficiently as possible in all patients with nonsquamous non-small cell lung cancer. In the case that a physician is unable to get molecular testing done quickly and needs to initiate treatment early, Pennell recommends staying away from immunotherapy until the testing results are in.

There are 2 main consequences to not obtaining molecular testing results for patients with lung cancer, Pennell says. First, the patient may end up missing out on a very effective therapy based on their mutational status. Second, it is known that immunotherapy can cause significant toxicity in patients harboring an EGFRmutation, which is why Pennell advises against using immunotherapy prior to receiving molecular testing results.