Exploring the Importance of Finding a Molecular Target in Lung Cancer

Brendon Stiles, MD, a thoracic surgeon at NewYork-Presbyterian Hospital and an associate professor of cardiothoracic surgery at Weill Cornell Medicine, discusses the current landscape for treating patients with metastatic lung cancer.

Stiles states that there is an amazing number treatment options available in the metastatic setting. Understanding the molecular subtype of cancer in patients with metastatic disease is important for their treatment. There are targets such as EGFR, ALK, ROS, BRAF, NTRK, MET, and RET. There are multiple options when targeting rare alterations in this population. He says it gets to that principle of having to look for mutations to know if they are there.

Aside from targeted therapy, some patients are eligible for immunotherapy, which is a completely different paradigm based on PD-L1 expression and combination therapy, according to Stiles.

Stiles sees many patients in the late stages of their disease as part of the initial diagnosis phase or sometimes to perform a diagnostic procedure to uncover metastatic disease. There was a time when there wasn’t good prognosis for patients with lung cancer. Now that oncologists have figured out the appropriate therapy for each type of patient, Stiles explains that he would like to see these treatments move into the early-stage setting. This is slowly starting to happen, he says, but it’s critical to know the histologic and molecular subtype of a patient with stage IV disease.