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LUNG CANCER PROFILES
UNDERSTANDING
LUNG CANCER
How molecular profiles are changing the way we
look at the disease...and what it means for YOU
224,390
An estimated
new cases of lung cancer
are expected to be diagnosed in the U.S. in 20161
That’s enough to fill over
3
professional football stadiums*
*Based on average stadium capacity of 70,0002
LUNG CANCER CAN AFFECT ANYONE
It’s estimated that of new
lung cancer cases:
Most cases of lung cancer
occur in men and women
ages 60-80
52%
are male
48%
are female
1
≈10%
of people with lung cancer 3
NEVER SMOKED
but up to 10%
are diagnosed in patients
less than 55 years of age4
Our understanding of lung cancer has
evolved considerably. Doctors used to think
lung cancer was one singular disease.5,6
Today, we know that isn’t true. Doctors
understand that there are two major
types of lung cancer, the most common
being non-small cell lung cancer
(NSCLC). In NSCLC classified as
adenocarcinoma, researchers have
now identified more than 15 genetic
mutations that may cause cells to become
cancerous — redefining the disease.7,8
Lung Cancer
PIK3CA2
NRAS
MET
MEK1
ROS1
RET
PTEN
AKT
Unknown
ALK
BRAF
DDR2
KRAS
EGFR
HER2
FGFR1
In fact,
MORE THAN HALF
of adenocarcinoma cases have an
identifiable molecular driver
causing the cancer to grow.6,7,8
Now doctors may be able to test the molecular makeup of some
patients’ tumors in hopes of identifying the molecular profiles driving them.
Tumor tissue is tested from a biopsy or surgery. While there are many factors
to consider and molecular testing may not be appropriate for everyone,
knowing the molecular driver of the cancer can help guide treatment
decisions. Three professional organizations, CAP, IASLC and AMP,
have developed a guideline to establish recommendations supporting
standard molecular testing for the ALK and EGFR biomarkers in
advanced adenocarcinoma patients.9
doctor
assessment
biopsy
performed
lab
testing
doctor & patient discuss
treatment guidance
While treatments are not
available for every molecular driver,
NEW DISCOVERIES are continually
being made to help improve our
understanding of the disease.10-26
KRAS
DDR2
PTRF/
cavin-1
AKT1
ROS1
MET
NRAS
EGFR
1981
1984
PIK3
CA
ALK
HER2
MIF
FGFR1
RET
PTEN
BRAF
1996
2002 2004 2005 2007 2008 2010 2011 2012
MEK1
In the past decade, the number of
clinical trials exploring treatments in
different molecular profiles of lung
cancer has grown significantly.
Currently, there are
MORE THAN 500 TRIALS27
examining the role of molecular
profiles in lung cancer tumors.
SO WHAT DOES THIS MEAN FOR YOU?
4 QUESTIONS
about molecular testing to ask when diagnosed with lung cancer
1. What type of lung cancer do I have? Previously thought of as one disease, doctors now
understand that there are different types of lung cancer, which can be driven by
different molecular profiles. Molecular testing, which is usually determined by
testing tumor tissue samples, can help doctors tailor treatment plans for certain
individuals based on the molecular makeup of their tumors. In fact, three
professional organizations joined together to publish an evidence-based guideline
recommending all advanced adenocarcinoma patients get tested for ALK and
EGFR biomarkers in order to help better diagnose and treat patients.
2. Can I get a molecular test to determine my tumor type?
Molecular testing is available via doctors’ offices and cancer centers of all sizes.
Talk to your doctor to see if it’s right for you.
3. Based on my tumor type, what treatments may be appropriate for me? Some drugs have
been developed to treat specific types of lung cancer based on the tumor’s
molecular profile. Some are approved by the U.S. Food and Drug Administration,
while others are being studied in clinical trials. Both the presence and absence
of specific molecular drivers may be taken into consideration when determining
an appropriate treatment plan, including participation in a clinical trial.
4. When is the best time to test my tumor for genetic mutations? Testing for clinically relevant
biomarkers during treatment planning is important to patients with metastatic
NSCLC. According to the 2013 CAP-ISALC-AMP guideline, doctors should order
EGFR mutation and ALK rearrangement testing at the time of adenocarcinoma
diagnosis for patients who present with metastatic NSCLC, regardless of their
clinical history. However, your doctor may decide to order molecular testing at
any time during your treatment journey. If you have not been tested, talk to your
doctor to see if molecular testing may be right for you.
UNITED WE TEST QUEST
In the past few years, there has been an evolution in
the molecular understanding of non-small cell lung cancer.
#UWTQ
United We Test Quest
is a national mapping project that
calls on lung cancer survivors,
their families, friends, advocates
and health care professionals to
amplify awareness around the
importance of molecular testing.
Visit
LungCancerProfiles.com
to place a pin on the
United We Test Quest map.
If you or someone you know has lung cancer,
ASK YOUR DOCTOR ABOUT MOLECULAR TESTING.
For more information, visit:
www.LungCancerProfiles.com
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American Cancer Society. Cancer Facts & Figures 2016. Atlanta: American Cancer Society; 2016.
Stadiums of Pro Football. NFL Stadium Comparisons. http://www.stadiumsofprofootball.com/comparisons.htm. Accessed July 24, 2012.
Subramanian J, Govindan R. Lung Cancer in Never Smokers: A Review. J Clin Oncol. 2007;561:1-3.
Ramalingam S, Pawlish K, Gadgeel S, Demers R, Kalemkerian GP. Lung Cancer in Young Patients: Analysis of a Surveillance, Epidemiology, and End Results Database. J Clin Oncol. 1998;651-657.
Janssen-Heijnen MLG, Coebergh JWW. The changing epidemiology of lung cancer in Europe. Lung Cancer. 2003;41:245-258.
Paik PK, Johnson ML, D’Angelo SP, et al. Driver Mutations Determine Survival in Smokers and Never-Smokers With Stage IIIB/IV Lung Adenocarcinomas. Cancer. 2012. 10.1002/cncr.27637.
Kris MG, Johnson BE, Kwiatkowski DJ, et al. Identification of driver mutations in tumor specimens from 1000 patients with lung adenocarcinoma: The NCI’s Lung Cancer Mutation Consortium
(LCMC). J Clin Oncol. 2011. 29(suppl; abstr CRA7506). Page 10. http://meetinglibrary.asco.org/content/81670-102. Accessed October 24, 2014.
Takeuchi K, Soda M, Togashi Y, et al. RET, ROS1 and ALK fusions in lung cancer. Nat Med. 2012;18(3):378-381. Doi:10.1038/nm.2558.
Wigle DA, Jurisica I, Radulovich N, et al. Molecular profiling of non-small cell lung cancer and correlation with disease-free survival. Cancer Res. 2002;62:3005-3008.
Mendelsohn J. Targeting the Epidermal Growth Factor Receptor for Cancer Therapy. J Clin Oncol. 2002;20(18 Suppl):1S-13S.
Santos E, Martin-Zanca D, Reddy EP, et al. Malignant activation of a K-ras oncogene in lung carcinoma but not in normal tissue of the same patient. Science. 1984;223(4637):661-664.
Yuasa Y, Gol RA, Chang A. Mechanism of activation of an N-ras oncogene of SW-1271 human lung carcinoma cells. Proc Natl Acad Sci U S A. 1984;81(12):3670-3674.
Davies H, Bignell G, Cox C, et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417:949-954.
Samuels Y, Wang Z, Bardelli A, et al. High Frequency of Mutations of the PIK3CA Gene in Human Cancers. Science. 2004;304:554.
Tengs T, Lee J, Guillermo P, et al. A transforming MET mutation discovered in non-small cell lung cancer using microarray-based resequencing. Cancer Letters. 2006;239:227-233.
Shigematsu H, Gazdar A. Somatic mutations of epidermal growth factor receptor signaling pathway in lung cancers. Int J Cancer. 2006;118:257-262.
Soda M, Choi YL, Enomoto M, et al. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nat Med. 2012;18(3):382-384.
Marks J, Gong Y, Chitale D, et al. Novel MEK1 Mutation Identified by Mutational Analysis of Epidermal Growth Factor Receptor Signaling Pathway Genes in Lung Adenocarcinoma.
AACR.2008; 68:14. Cancer Res. 2008;68:5524-5528.
Bergethon K, Shaw AT, Ou SHI, et al. ROS Rearrangements Define a Unique Molecular Class of Lung Cancers. J Clin Oncol. 2012;30(8):863-870.
Lipson D, Capelletti M, Janne PA, et al. Identification of new ALK and RET gene fusions from colorectal and lung cancer biopsies. Nat Med. 2012;18(3):382-384.
Gamez-Pozo A, Sanchez-Navarro I, Calvo E, et al. PTRF/Cavin-1 and MIF Proteins Are Identified as Non-Small Cell Lung Cancer Biomarkers by Label-Free Proteomics. PLOS ONE. 2012.
Lovly C, Horn L, Pao W. 2013. AKT1 Mutations in Non-Small Cell Lung Cancer (NSCLC). My Cancer Genome. http://www.mycancergenome.org/content/disease/lung-cancer/akt1/. Updated
September 9. Accessed October 20, 2014.
Paik P. 2013. DDR2 Mutations in NSCLC. My Cancer Genome http://www.mycancergenome.org/content/disease/lung-cancer/ddr2/ (Updated June 24). Accessed October 20, 2014.
Sos M, Thomas R. 2012. FGFR1 Mutations in NSCLC. My Cancer Genome. http://www.mycancergenome.org/content/disease/lung-cancer/fgfr1/. Updated June 1. Accessed October 20, 2014.
Lovly C, Horn L, Pao W. 2013. NRAS Mutations in Non-Small Cell Lung Cancer (NSCLC). My Cancer Genome. http://www.mycancergenome.org/content/disease/lung-cancer/nras/. Updated
April 4. Accessed October 20, 2014.
Lovly C, Horn L, Pao W. 2012. PTEN Mutations in Non-Small Cell Lung Cancer (NSCLC). My Cancer Genome. http://www.mycancergenome.org/content/disease/lung-cancer/pten/. Updated
July 31. Accessed October 20, 2014.
ClinicalTrials.gov. 525 studies found for: KRAS OR EGFR OR ALK OR PIK3CA OR HER2 OR BRAF OR ROS OR RET OR NRAS OR MET | lung cancer.
https://clinicaltrials.gov/ct2/results?term=KRAS+OR+EGFR+OR+ALK+OR+PIK3CA+OR+HER2+OR+BRAF+OR+ROS+OR+RET+OR+NRAS+OR+MET&recr=Open&rslt=&type=&cond=lung+cancer
&intr=&titles=&outc=&spons=&lead=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&rcv_s=&rcv_e=&lup_s=&lup_e=. Accessed February 8, 2016.
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February 2016.