With the development of precision medicine, genetic testing has become a "standard" in lung cancer treatment. However, the low awareness and detection rate of some rare targets and the irregular selection of treatment plans are becoming a major clinical challenge.
On February 18, Pfizer's "ROS1 Target Grip Every Minute Possible" expert media salon meeting was held in Guangzhou, China. The meeting focused on the challenging issues of lung cancer rare target diagnosis and treatment, experience of lung cancer rare target treatment, and ways to improve the diagnosis and treatment level, aiming to raise the attention of clinicians and the public on rare target diagnosis and treatment.
Expert on-site discussion
Rare target for lung cancer diagnosis and treatment faces serious challenges
Lung cancer is the leading cause of cancer-related deaths worldwide, with a global 5-year survival rate of 17.8%, which is much lower than that of other major cancers and is a long-term threat to human life and health. Although the incidence of individual tumor-driven mutations is less than 5%, the overall number of rare targets is large, accounting for about 15% of all lung cancers, and thus about 1 in 7 lung cancer patients are positive for rare targets.
Prof. Dickey Yang
Currently, rare targets commonly found in domestic lung cancer patients include ROS1 rearrangement, BRAF mutation, Met amplification, etc. Prof. Yang Geji from the Oncology Center of Guangdong Provincial People's Hospital pointed out that "after years of exploration and accumulation of clinical experience, the diagnosis and treatment of ROS1 has been developed to a certain extent, and patients have gained more hope for survival. However, the overall knowledge of rare targets in lung cancer is still low compared with common targets, facing problems such as low clinical delivery rate, irregular selection of treatment plans and limited treatment options.
A Chinese questionnaire showed that the genetic testing rate of ROS1 fusion targets was less than 30%. the low genetic testing rate of ROS1 targets also brings the problem of low acceptance of targeted therapy in the first line. A large global online survey study showed that only 28% of ROS1+ lung cancer patients received targeted therapy in the first line.
Prof. Kejing Tang
"The biggest challenge facing the diagnosis and treatment of rare targets in lung cancer is how to use all the power to detect them accurately." Professor Tang Kejing from the First Hospital of Sun Yat-sen University mentioned when sharing his experience in rare target diagnosis and treatment, "The reason why the diagnosis and treatment of rare targets such as ROS1 has achieved a relatively large breakthrough lies more in the improvement of target detection awareness and standardization of detection in the clinic, which has increased the proportion of first-line targeted therapy, and thus some patients have been able to realize the hope of long survival. As clinicians, we have the responsibility and ability to further improve and refine the rare target diagnosis and treatment mechanism, to recommend personalized treatment plans according to different patients' tests, and to help more patients get the optimal treatment."
Several hospitals open "Targeted Clinic for Rare Mutations in Lung Cancer"
According to Prof. Dicky Yang, lung cancer's move toward chronicity depends firstly on the identification of rare driver genes including ROS1, HER2, RET, etc. through genetic testing technology. Secondly, at present, both targeted drugs, chemotherapeutic drugs and immunotherapy will encounter the problem of drug resistance. After drug resistance, tissue biopsy and liquid biopsy are still needed to analyze the resistance mechanism to adjust the subsequent treatment plan. In addition, even if no detailed resistance mechanism is found, the clinic will still provide the corresponding treatment strategy according to the pattern of tumor progression, which is the concept of the whole management of lung cancer treatment.
The demand for rare target diagnosis and treatment of lung cancer has been pushed to the forefront, and many hospitals have opened "lung cancer rare mutation target clinic" one after another to provide consultation, multidisciplinary consultation (MDT), follow-up treatment and clinical trial enrollment recommendation for people who have discovered rare targets of lung cancer, and at the same time accelerate the popularization of rare target diagnosis and treatment knowledge to raise the attention of related patients and primary doctors to rare targets.
Prof. Haihong Yang
Prof. Yang Haihong, chief physician of the First Hospital of Guangzhou Medical University, mentioned that "non-small cell lung cancer is highly heterogeneous and has a complex treatment model, and the clinical exploration of personalized, precise, multidisciplinary and integrated treatment for lung cancer patients has never stopped. As a typical ROS1 target that promotes the development of rare target diagnosis and treatment, we have accumulated certain diagnosis and treatment experience, and will continue to help patients get scientific guidance, efficient and precise diagnosis and treatment services through the improvement of specialized outpatient clinics and multidisciplinary diagnosis and treatment models, and promote its application to other rare target diagnosis and treatment models."
[Reporter] Yan Huifang
[Author] Huifang Yan
Healthy Living Circle
Source: South+ - Creating more value