Doctors need additional training for personalized lung cancer therapy
In 2009, an oral treatment with the targeted drug gefitinib that was shown to lengthen progression-free survival was approved only for treating patients whose tumors carried a certain mutation. The treatment worked for patients with advanced non-small cell lung cancer (NSCLC) who had mutations in their tumors that activate the cell surface molecule epidermal growth factor receptor (EGFR). However, doctors must perform a molecular analysis of tumor material from biopsies to clearly demonstrate the presence of the mutation, explained Robert Pirker, a professor at the Medical University of Vienna.
“This will benefit patients, but it changes the whole diagnostic workup and requires some change in thinking of oncologists, including closer cooperation between the various disciplines: interventional pulmonologists, pathologist, biologists, oncologists,” said Pirker.
Pirker revealed that while tissue sampling to allow for mutation testing will eventually become standard in Europe, current obstacles prevent it from becoming more widespread.
“The obstacles include the fact that too few doctors are trained in invasive tumor sampling, that mutation analysis not yet readily available, and that there are reimbursement issues which might vary from country to country,” Pirker said. “If these obstacles can be overcome, and more doctors are trained in taking lung cancer biopsies, more patients will be able to be treated with oral gefitinib, and the discovery of other new therapeutic targets will be accelerated.”