The Value of Liquid Biopsies for Guiding Therapy Decisions in Non-small Cell Lung Cancer

Targeted therapies have allowed for an individualized treatment approach in non-small-cell lung cancer (NSCLC). The initial therapeutic decisions and success of targeted therapy depend on genetic identification of personal tumor profiles. Tissue biopsy is the gold standard for molecular analysis, but non-invasive or minimally invasive liquid biopsy methods are also now used in clinical practice, allowing for later monitoring and optimization of the cancer treatment. The inclusion of liquid biopsy in the management of NSCLC provides strong evidence on early treatment response, which becomes a basis for determining disease progression and the need for changes in treatment. Liquid biopsies can drive the decision making for treatment strategies to achieve better patient outcomes. Cell-free DNA and circulating tumor cells obtained from the blood are promising markers for determining patient status. They may improve cancer treatments, allow for better treatment control, enable early interventions, and change decision making from reactive actions toward more predictive early interventions. This review aimed to present current knowledge on and the usefulness of liquid biopsy studies in NSCLC from the perspective of how it has allowed individualized treatments according to gene profiling and how the method may alter the treatment decisions in the future

Farmaseutin etävastaanotto auttaa turvallisempaan lääkehoitoon

Vaasan keskussairaalan onkologian poliklinikalla farmaseutti selvittää ja arvioi potilaan lääkityksen puhelinvastaanotolla ennen ensimmäistä lääkärin vastaanottoa. Näin lääkärillä on käytettävissään ajantasainen lääkitystieto ja sen mahdollistamana sähköinen päätöksenteon tuki

Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer - A Systematic Review

Decision-making in cancer treatment is part of clinicians' everyday work, and it is especially challenging in non-small cell lung cancer (NSCLC) patients, for whom decisions are clearly dependent on gene alterations or the lack of them. The multimodality of treatments, involvement of gene alterations in defining systemic cancer therapies, and heterogeneous nature of tumors and their responsiveness provide extra challenges. This article reviews the existing literature to 2021 with extra effort to explore the role of genes and gene-driven therapies as part of decision-making. The process and elements in this decision-making participation are recognized and discussed comprehensively. Genetic health literacy aids are provided as a part of the review. Our systematic review, data extraction and analysis found that with current methods and broad gene panels, patients benefit from early molecular testing of liquid biopsy samples. An estimated 79% of liquid biopsy samples showed somatic mutations based on 8 original studies included in the systematic review. When both liquid biopsy samples and tissue samples are evaluated, the sensitivity to detect targetable mutations in NSCLC increases. We recommend early testing with liquid biopsy. Additional effort is needed for the logistics of obtaining and evaluating samples, and tissue samples should be saved and stored for tests that are not possible from liquid biopsy.</p

Farmaseutti onkologian poliklinikan hoitotiimiin - selvä työnjako parantaa lääkitysturvallisuutta ja tehostaa lääkehoitoprosessia

English summary.Peer reviewe

Farmaseutti onkologian poliklinikan hoitotiimiin - selvä työnjako parantaa lääkitysturvallisuutta ja tehostaa lääkehoitoprosessia

English summary.Peer reviewe

Farmaseutin etävastaanotto auttaa turvallisempaan lääkehoitoon

Vaasan keskussairaalan onkologian poliklinikalla farmaseutti selvittää ja arvioi potilaan lääkityksen puhelinvastaanotolla ennen ensimmäistä lääkärin vastaanottoa. Näin lääkärillä on käytettävissään ajantasainen lääkitystieto ja sen mahdollistamana sähköinen päätöksenteon tuki.</p

Current challenges in applying gene-driven therapies in clinical lung cancer practice

publishedVersionPeer reviewe

Current challenges in applying gene-driven therapies in clinical lung cancer practice

Over the last twenty years, with the development of gene-driven therapies, numerous new drugs have entered clinical use. Very few of these new drugs are suitable for a large number of patients, and all require molecular genetic testing. In lung cancer, gene-targeted therapy has evolved rapidly and has placed demands on the development of diagnostics and tissue sample preparation and logistics. Rapid diagnosis and prevalence assessment are necessary to determine the prognosis of a lung cancer patient based on the latest research findings. Therefore, the molecular-genetic diagnostic pathway must also be accelerated and matured to do the necessary analyses on small samples. Because lung cancer rebiopsy can be difficult, liquid biopsy techniques should be developed to cover more of the treatable mutations. There are obstacles related to tissue sampling, new genomic techniques and access to gene-driven cancer drugs, including their affordability. With this review and case study, we go into the obstacles faced by our clinic and discuss how to tackle these obstacles in lung cancer. We use lung cancer as an example due to its complexity, though these same obstacles are found in different cancers on a minor scale.</p

Pitkään tupakoineiden keuhkosyövän seulontaa tulisi Suomessa selvittää

Keuhkosyöpä aiheuttaa suurimman syöpäkuolleisuuden Suomessa, ja suomalaisten naisten kuollei­suuden keuhkosyöpään ennustetaan lisääntyvän. Keuhkosyöpä voi olla alkuvaiheessa täysin oireeton. Se todetaan usein vasta levinneessä vaiheessa, minkä vuoksi suurelle osalle potilaista leikkaushoito ei ole mahdollinen. Uusien kansainvälisten tutkimusten tulokset viittaavat siihen, että kuolleisuutta voitaisiin laskea seulomalla tupakoitsijoista suuren riskin henkilöitä pieniannoksisella tietokonetomografialla (TT). Eurooppalainen keuhkojärjestö (ERS) on suositellut, että jokaisessa Euroopan maassa perustettaisiin työryhmä, jonka tehtävänä on selvittää keuhkosyöpäseulonnan mahdollisuudet ja kustannustehokkuus