pathology-surgical-pathology-2018-posters

15 / 15

Page 41
allied
academies
Journal of Pathology and Disease Biology | Volume 2
September 06-07, 2018 | Edinburgh, Scotland
Pathology and Surgical Pathology
International Conference on
Recent advances in the molecular testing for treatment selection in lung cancer
Mulazim Hussain Bukhari
University of Lahore, Pakistan
Lung cancer is still a biggest dilemma in developing
countries where is no rules and regulations of smoking and
control of other palliative agents. Biomakers have recently
become a part of standard-of-care treatment for cell lung
cancer with the recent FDA approval of different drugs in the
second-line setting for patients with advanced disease. The
concept of chemotherapy and radiation is rapidly changing
in advanced countries due the invention of biomarkers.
Lung cancer is a leading cause of malignancy associated
human deaths, which is evident from its high mortality rate
of 1.6 million (19.4% of total) cancer deaths Worldwide.
It is more common in male and elderly group risk factors
include smoking, pollution, certain metals (chromium,
cadmium), some organic chemicals and radiation. The risk
of genetic susceptibility can contribute especially in young.
Thyroid transcription factor 1 (TTF1) is expressed by both
neuroendocrine and non-neuroendocrine carcinomas of
lung but the frequency of expression varies markedly among
various histologic types.
Sensitivity is highest among adenocarcinomas & non-mucinous
bronchoalveolar carcinomas where it is over 90%. Lowest
expression is seen inmucinousadenocarcinomasandSquamous
cell carcinomas. TTF1 expression is also seen albeit focal in a
subset of ovarian & colorectal carcinomas. Striking differences
in sensitivity are seen among neuroendocrine tumors of lung,
varying from 90% in Small cell carcinoma, 50% in large cell
neuroendocrine carcinoma and < 50% in carcinoid tumors.
Napsin A is a very sensitive marker for detecting pulmonary
adenocarcinomas with a level of sensitivity from 80% to over
90%. The specificity of coexpression of TTF1 and Napsin A is
extremely high for pulmonary adenocarcinomas. However
Napsin A can be identified in a subset of RCC (most frequently
Papillary, up to 80%). Also in a minority of endometrial
adenocarcinomas and PTC & Clear cell carcinoma of ovary.
EGFR are the most frequent mutations in Pakistani lung
adenocarcinoma patients and around 29% of the patients were
found eligible for erlotinib therapy.
Several other immunotherapeutics are currently under
investigation for the treatment of NSCLC, including those that
inhibit PD-1 and PD-L1
Conclusion: This is an extremely exciting time in the
field of thoracic oncology due to the development of
immunotherapeutic drugs targeting to different biomarkers
responsibleformutationandinthedevelopmentoflungcancer.
Key areas of ongoing investigation are elucidating a predictive
biomarker, determining the most appropriate line of therapy
to use these drugs, and defining whether combination with
other agents (including chemotherapy, targeted therapy,
or other immunotherapies) can provide additional benefit.
e:
Notes: