Personalized Medicine, Genetic Testing Could Shape the Future of Non-Small Cell Lung Cancer

While identifying new genetic targets and developing novel drugs is important for the future of non-small cell lung cancer (NSCLC), more emphasis should be put on improving patient access to existing targeted treatments, according to Dr. Nathan A. Pennell.

In an interview with OncLive®, CURE®’s sister publication, Pennell, an associate professor in the department of medicine and director of the lung cancer medical oncology program at the Taussig Cancer Institute of Cleveland Clinic, spoke about current and emerging treatment options in NSCLC, including immunotherapy combinations and personalized treatments involving T cells.

But when it comes to the future, Pennell said, identifying targetable genetic alterations in patients and treating them with existing drugs should be a key area of focus.

“Studies have shown that probably fewer than half of people with targetable genetic alterations in lung cancer are being identified and never receiving treatment for this,” Pennell said, “and I think before we move on to the next exciting drug or the next exciting marker, we should spend a little time making sure that every patient is identified and gets access to the treatments that we already have.”

Transcription:

We've made such tremendous progress over the last decade. And just it seems like every year, new targets are emerging and new drugs are getting approved. And so, the speed with which we're moving from discovery to actually treating people has been staggering, and I hope that continues.

There continue to be very promising emerging biomarkers including KRAS mutations, again, HER2 mutations. There certainly is lots of room for improving the efficacy of immunotherapy, which can be tremendously life changing and potentially even curative in patients with metastatic disease. But unfortunately, it's only really working in a minority of patients and so lots of room to be improved in that.

I think combinations of immunotherapy and perhaps even more personalized immunotherapy, using T-cells that recognize individual patients’ tumors, may be the future for this, or personalized tumor vaccines.

But honestly, instead of just focusing on discovering new treatments and new targets, I think we should focus more on applying what we already know. So, we have tremendous treatments for patients with specific subgroups of lung cancer, but studies have shown that probably fewer than half of people with targetable genetic alterations in lung cancer are being identified and never receiving treatment for this. And I think before we move on to the next exciting drug or the next exciting marker, we should spend a little time making sure that every patient is identified and gets access to the treatments that we already have.