Keypoints:
• The significance of HER2 alterations in NSCLC and how they differ from breast and gastric cancers.
• The complexities of biomarker testing, including NGS, IHC, and FISH amplification.
• Patient characteristics and phenotypes associated with HER2-positive disease.
• The current testing workflows in clinical practice and the role of liquid biopsies.
• Insights into the treatment landscape for HER2-positive NSCLC, including recent FDA approvals and ongoing clinical trials.
In this episode of the Oncology Brothers podcast, we dived into the exciting and rapidly evolving field of HER2-positive non-small cell lung cancer (NSCLC). Drs. Rahul & Rohit Gosain were joined by esteemed guests Dr. Devika Das, a thoracic medical oncologist from the University of Florida Health, and Dr. Fernando Lopez-Rios, a pathologist from Madrid, Spain.
The discussion began by highlighting the significance of identifying HER2 alterations in lung cancer, a topic that has gained momentum following recent approvals of targeted therapies. Drs. Das and Lopez-Rios elaborated on the complexities of HER2 testing, including the differences between mutations, overexpression, and amplification, and how these factors influence treatment decisions.
Dr. Lopez-Rios emphasized the importance of immunohistochemistry (IHC) testing and the challenges associated with interpreting results, particularly in comparison to breast and gastric cancers. We also explored the role of next-generation sequencing (NGS) and the potential of liquid biopsies in identifying HER2 alterations when tissue samples are limited.
As we discussed patient characteristics, Dr. Das highlighted that HER2-positive NSCLC is more commonly found in younger patients, particularly those with adenocarcinoma, and often presents with a higher incidence of CNS metastases. This underscores the need for thorough testing and awareness of the disease's aggressive nature.
We touched on the current treatment landscape, including the use of Trastuzumab deruxtecan, and the promising results from clinical trials. The conversation wrapped up with a reminder of the importance of ongoing testing and the potential for increased incidence of HER2-positive cases as we continue to refine our diagnostic approaches.
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