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Challenges in molecular testing in non-small-cell lung cancer patients with advanced disease

Hiley, CT; Le Quesne, J; Santis, G; Sharpe, R; De Castro, DG; Middleton, G; Swanton, C; (2016) Challenges in molecular testing in non-small-cell lung cancer patients with advanced disease. The Lancet , 388 (10048) pp. 1002-1011. 10.1016/S0140-6736(16)31340-X. Green open access

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Abstract

Lung cancer diagnostics have progressed greatly in the previous decade. Development of molecular testing to identify an increasing number of potentially clinically actionable genetic variants, using smaller samples obtained via minimally invasive techniques, is a huge challenge. Tumour heterogeneity and cancer evolution in response to therapy means that repeat biopsies or circulating biomarkers are likely to be increasingly useful to adapt treatment as resistance develops. We highlight some of the current challenges faced in clinical practice for molecular testing of EGFR, ALK, and new biomarkers such as PDL1. Implementation of next generation sequencing platforms for molecular diagnostics in non-small-cell lung cancer is increasingly common, allowing testing of multiple genetic variants from a single sample. The use of next generation sequencing to recruit for molecularly stratified clinical trials is discussed in the context of the UK Stratified Medicine Programme and The UK National Lung Matrix Trial.

Type: Article
Title: Challenges in molecular testing in non-small-cell lung cancer patients with advanced disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S0140-6736(16)31340-X
Publisher version: https://doi.org/10.1016/S0140-6736(16)31340-X
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/10057928
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