Scientific Background
The ForeSENTIA Lung (NSCLC) panel analyses single nucleotide variants, insertions, deletions, copy number alterations, and rearrangements in 36 genes associated with non-small cell lung cancer (NSCLC). It can help identify mutations that can be responsible for cancer development and therapy resistance in solid tumors.
According to World Health Organisation, lung cancer is the second most common type of cancer worldwide with more than 2 million cases in 2020. Non-small cell lung cancer (NSCLC) is a type of lung cancer that accounts for 80-85% of all lung cancer cases. There are three types of NSCLC, adenocarcinomas, squamous cell carcinoma, and large cell carcinoma which can start from different types of lung cells depending on the type. Different risk factors, such as hereditary and environmental, can contribute to NSCLC development. In addition, mutations in driver genes, including EGFR, ALK, and ROS1 among others, can lead to cancer initiation and progression. Detecting the genetic alterations that contribute to NSCLC can help in identifying FDA/EMA-approved targeted therapies and might contribute to improving the overall survival of cancer patients.
Microsatellite instability (MSI) immunotherapy biomarker can optionally be tested in this panel. FDA-approved immunotherapy drug pembrolizumab is also available for patients with MSI-high status.
Recommendations by professional bodies:
ESMO recommends MSI testing via NGS in NSCLC patients (Luchini et al., 2019)
“ESMO recommends the use of tumour multigene NGS in NSCLC” (Mosele et al., 2020)
References and more information:
• Information obtained from American Cancer Society, World cancer Research Fund international and World Health Organisation
• Luchini C, Bibeau F, Ligtenberg MJL, Singh N, Nottegar A, Bosse T, Miller R, Riaz N, Douillard JY, Andre F, Scarpa A. ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: a systematic review-based approach. Ann Oncol. 2019 Aug 1;30(8):1232-1243. doi: 10.1093/annonc/mdz116. PMID: 31056702.
• Mosele F, Remon J, Mateo J, Westphalen CB, Barlesi F, Lolkema MP, Normanno N, Scarpa A, Robson M, Meric-Bernstam F, Wagle N, Stenzinger A, Bonastre J, Bayle A, Michiels S, Bièche I, Rouleau E, Jezdic S, Douillard JY, Reis-Filho JS, Dienstmann R, André F. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group. Ann Oncol. 2020 Nov;31(11):1491-1505. doi: 10.1016/j.annonc.2020.07.014. Epub 2020 Aug 24. PMID: 32853681.
