Test IDs Oncogenic Drivers in Lung Cancers

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Test IDs Oncogenic Drivers in Lung Cancers
Test IDs Oncogenic Drivers in Lung Cancers

(HealthDay News) -- Nearly two-thirds of lung cancers have actionable genetic drivers detectable with multiplexed testing, according to a study published in the May 21 issue of the Journal of the American Medical Association.

Mark G. Kris, MD, from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues determined the frequency of 10 oncogenic drivers in patients with lung adenocarcinomas and used the data to select treatments targeting the identified driver(s). Survival was measured.

RELATED: Lung Cancer Resource Center

The researchers found that, from 2009 through 2012, 1,007 patients had their tumors tested for at least one gene and 733 were tested for 10 genes (patients with full genotyping). Just under two-thirds (64%) of those with full genotyping were found to have an oncogenic driver (25% KRAS; 17% sensitizing EGFR; 8% ALK rearrangements; 4% other EGFR; 3% two or more genes; 3% ERBB2 [formerly HER2]; and 2% BRAF). 

In just over one-quarter of patients (28%), results were used to select a targeted therapy or trial. For the 260 patients with an oncogenic driver and genotype-directed therapy, the median survival was 3.5 years, compared with 2.4 years for the 318 patients with any oncogenic driver(s) who did not receive genotype-directed therapy (propensity score-adjusted hazard ratio, 0.69; P=0.006).

"Multiplexed testing aided physicians in selecting therapies," the researchers wrote. "Although individuals with drivers receiving a matched targeted agent lived longer, randomized trials are required to determine if targeting therapy based on oncogenic drivers improves survival."

In an accompanying editorial, Boris Pasche, MD, from Wake Forest University and associate editor of JAMA, and Stefan C. Grant, MD, JD, MBA, from the University of Alabama at Birmingham, commented on the study's conclusions and the potential clinical implications of the researchers' findings.

"After decades of small, albeit significant, improvements in the care of patients with lung cancer, the advent of genetic testing of tumors, identification of driver mutations, and development of drugs able to specifically target these mutations, have produced substantial improvements in survival for patients with targetable driver mutations," they wrote.

"Although much remains to be done, the incorporation of genomic medicine into the study and treatment of lung cancer represents, at the very least, the end of the beginning for the care of these and other patients with cancer."

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Kris MG, Johnson BE, Berry LD, et al. Using Multiplexed Assays of Oncogenic Drivers in Lung Cancers to Select Targeted Drugs. JAMA. 2014;311(19):1998-2006.
  2. Pasche B, Grant SC. Non–Small Cell Lung Cancer and Precision Medicine: A Model for the Incorporation of Genomic Features Into Clinical Trial Design. JAMA. 2014;311(19):1975-1976.

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