Detection of genes in all patients with lung adenocarcinoma

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In April 3rd, College of American Pathologists, reviews International Association for study of lung cancer, and the American Association for

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In April 3rd, College of American Pathologists, reviews International Association for study of lung cancer, and the American Association for molecular pathology three authoritative academic institutions issued a lung cancer molecular detection guidelines recommend that all patients with lung cancer undergoing genetic testing, in order to select targeted therapies, such as epidermal growth factor receptor (EGFR) inhibitors (such as erlotinib and Kyrgyzstan gefitinib) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (such as Kerry Tini). (Arch Pathol Med. Diagn. J Thorac JMol April 3, 2013 online edition) Lab (Oncol.)

Evidence based medicine suggests that the prognosis of patients with lung cancer can be significantly improved if the gene is detected and the appropriate target drug is selected. Therefore, it is recommended that all patients with lung adenocarcinoma, regardless of gender, race, smoking or other clinical risk factors, should be tested for genetic testing, in which EGFR mutation and ALK fusion is the preferred test. Guidelines emphasize that primary tumors and metastatic lesions are equally suitable for detecting EGFR and ALK status. Detection of EGFR and ALK is not suitable for patients with non-small cell lung cancer, including squamous cell carcinoma, small cell carcinoma and immunohistochemical detection of large cell lung cancer. The state of EGFR and ALK detection was: when the patients with advanced lung cancer were diagnosed at the time of treatment, and the patients who had earlier stage of lung cancer but did not receive the gene test were at the time of disease recurrence or progression.

The authors point out that the idea of community based hospitals tends to be a waste of smoking in patients with lung adenocarcinoma. In fact, this view is wrong, 5%~10% smoking in patients with lung adenocarcinoma gene detection positive, so it can benefit from targeted therapy.

James, a National Jewish Health Hospital in the United States, says the guidelines will improve the prognosis of a large number of patients with lung cancer. Lung adenocarcinoma is the most common type of lung cancer, accounting for 60%~70%. About 15% of patients with lung adenocarcinoma were EGFR mutations, with a mutation of ALK in 5%. Jett stressed that the guidelines are ideal for the treatment of lung cancer, a disease that can be treated but not cured". In the absence of treatment, the median survival of patients with advanced lung cancer is only 4~5 months, the standard chemotherapy can prolong the survival period to 9 months, while the EGFR inhibitor can prolong the survival period to 2 years. In addition, targeted therapies are usually oral drugs, which are less toxic than chemotherapy drugs, so the quality of life of patients receiving the drug is better. He believes that the routine detection of lung cancer patients will be realized in the near future. ReginaVidaver, executive director of the National Association for lung cancer in the United States, said the detection of genetic abnormalities is becoming part of the standard treatment for lung cancer.

 

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