Since surgical biopsies are too dangerous for patients with late-stage lung cancer, less invasive approaches, such as fine needle aspiration and core needle biopsies, are often used. Unfortunately, lead author of a study published in The Journal of Thoracic and Cardiovascular Surgery, David T. Cooke, MD, said these procedures may not collect enough cells for molecular testing.
According to the study, insufficient tumor tissue is available for molecular analysis, which is a common problem in advanced lung cancer treatment. This tumor tissue is needed before doctors can prescribe targeted therapy.
Cooke and colleagues discussed the cases of 25 patients with known or suspected stage IV lung cancer at a multidisciplinary thoracic oncology conference or clinic. They examined their records, and all patients underwent surgical biopsies, with a majority being video-assisted thoracic surgery.
For 19 of the 25 patients, potentially targetable molecular information was identified. Ten patients were also eligible to enroll in a therapeutic targeted clinical trial. In addition, five patients experienced complications, in which three were minor, during surgery.
Cooke said that patients whose less invasive biopsies were deemed unsuccessful and whose cases were reviewed in a multidisciplinary manner could be candidates for surgical biopsies.
The multidisciplinary team, according to Cooke, should include a pulmonologist, radiologist, surgeon, and medical oncologist.
Researchers at University of California, Davis have determined that surgical biopsies can be safely performed on select patients with late-stage non-small cell lung cancer, which should enhance their access to drugs that target specific genetic mutations such as epidermal growth factor receptor (EGFR).
The findings, to be published in the July issue of The Journal of Thoracic and Cardiovascular Surgery, address a common problem in treatment for advanced lung cancer: insufficient tumor tissue available for molecular analysis, which is required before prescribing targeted therapy.