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Combining radiotherapy with targeted therapies in non-small cell lung cancer: focus on anti-EGFR, anti-ALK and anti-angiogenic agents - PubMed

Combining radiotherapy with targeted therapies in non-small cell lung cancer: focus on anti-EGFR, anti-ALK and anti-angiogenic agents - PubMed

Source :

https://pubmed.ncbi.nlm.nih.gov/34012812/

The combination of radiotherapy (RT) with targeted agents in non-small cell lung cancer (NSCLC) has been expected to improve the therapeutic ratio and tumor control. The EGFR blockade enhances the antitumor effect of RT. The ALK inhibition elicits anti-proliferative, pro-apoptotic and antiangiogenic ...

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    Key Points
    • In the current study, researchers assessed endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the analysis of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and programmed death-ligand 1 (PD-L1) status.
    • EBUS-TBNA is a minimally invasive method for diagnosing and staging lung cancer. Rapid on-site cytologic evaluation (ROSE) is a complementary test to gauge the adequacy of the collected samples. ROSE identifies malignant cells, as well as sometimes diagnosing during the procedure.
    • “ROSE represents an important tool, since it can not only provide information about the quality of the tissue obtained, but also shorten the time of the EBUS-TBNA procedure, by reducing the number of punctures per lymph node. It also lowers the necessity for additional procedures in order to reach a diagnosis,” the authors wrote.
    • According to the authors, ROSE can be used for screening because it exhibited a high sensitivity (92.18%) and positive predictive value (93.65%) for NSCLC diagnosis, as well as a moderate specificity (75%) and negative predictive value (70.58%).
    • The authors concluded, “ROSE proved to have a moderate prediction of the final diagnosis in NSCLC. Molecular analysis of EGFR, ALK and PD-L1 can be successfully accomplished on EBUS-TBNA small tissue samples.”
    • Limitations of the current study include the small sample size tested for molecular alterations. Furthermore, tumor heterogeneity could have resulted in non-representative samples of the lung tumor. Another limitation is that the study was performed in Romania where PET-CT is only performed in select patients.