personalized treatment of advanced nsclc a coordinated multidisciplinary approach

Personalized Treatment of Advanced NSCLC

A Coordinated Multidisciplinary Approach

Program Goals

Treatment of Advanced NSCLC

Impact of NSCLC-NOS on Treatment Selection in Advanced

NSCLC

Impact of NSCLC-NOS on Treatment Selection in Advanced

NSCLC (cont)

IPASS: Study Design

IPASS: PFS in Patients Positive and Negative for EGFR Mutation

EGFR TKI Therapy vs Chemotherapy for Patients With EGFR-Mutated Disease

Results From Randomized Clinical Trials

Crizotinib in Patients With ALK-Positive Advanced NSCLC

Crizotinib vs ChemotherapyPhase 3 Study Design

Crizotinib vs ChemotherapyPFS by Independent Radiologic Review

Case Study 1: 54-Year-Old Woman With Right-Sided Chest Pain and

Cough

Advanced NSCLC-Biopsy Specimens

Transthoracic Core Needle Biopsy in

BATTLE Lung Trial

Case Study 1: 54-Year-Old Woman With Right-Sided Chest Pain and

Cough (cont)

Stepwise Approach to Classification of NSCLC

Light Microscopy: NSCLC, Adenocarcinoma Subtype

Light Microscopy: NSCLC, Squamous Cell Carcinoma Subtype

Light Microscopy: NSCLC, Subtype Not Identified

IHC Staining in NSCLCThe Basics

Histologic Subtyping in NSCLCIHC Staining Arsenal

Napsin-A Cytoplasmic Staining in NSCLC, Adenocarcinoma Subtype

p40 Nuclear Staining in NSCLC, Squamous Cell Carcinoma

Using Clinical Criteria To Select Treatment

Molecular Testing GuidelineWho Should Be Tested for EGFR and ALK?

Molecular Testing GuidelineWhen Should EGFR and ALK Testing Be Done?

Molecular Testing GuidelinePrioritize EGFR and ALK Testing Over Other

Molecular Predictive Tests

Molecular Testing in Advanced NSCLCKey Principles

Case Study 1: 54-Year-Old Woman With Right-Sided Chest Pain and

Cough (cont)

SATURN

Pemetrexed + Erlotinib vs Pemetrexed or Erlotinib Alone

Phase 2 Trial of Second-Line Treatment

IHC as a Screening Tool for ALK Detection

Rebiopsy

Case Study 2: 41-year-old Woman With Dry Cough

Case Study 2: 41-year-old Woman With Dry Cough (cont)

Case Study 2: 41-year-old Woman With Dry Cough (cont)

Case Study 2: 41-year-old Woman With Dry Cough (cont)

Rapid Onsite Evaluation (ROSE)

Cytologic Specimens for Histologic Subtyping and Genotyping

EBUS-TBNA

Use of Cytologic Material for Molecular Testing in NSCLC

How Much Cytologic Material Is Needed for Molecular Testing?

Molecular Testing GuidelinePrimary vs Metastatic Site

Coordinating Care for Patients With NSCLC

Multidisciplinary Tumor Boards

Summary

Abbreviations

Abbreviations (cont)

Abbreviations (cont)

References

References (cont)

References (cont)

References (cont)

References (cont)

References (cont)

References (cont)