Journal
JOURNAL OF THORACIC ONCOLOGY
Volume 10, Issue 3, Pages 531-534Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JTO.0000000000000391
Keywords
Lung adenocarcinoma; Adrenal metastasis; Cytology; Multigene profile; Targeted therapy
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Funding
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN
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Somatic serine/threonine kinase 11 (STK11) also known as liver kinase B1 (LKB1) is a tumor suppressor gene and ranks as the third most frequently mutated gene in lung adenocarcinoma. However, current molecular testing guidelines recommend evaluating for epidermal growth factor receptor mutations and ALK fusions to guide therapy in all patients with advanced stage adenocarcinoma, regardless of gender, race, or smoking history. Identifying alternative driver mutations and using actionable targeted pharmacotherapy is a key approach to providing effective individualized medical care. The analytical sensitivity and parallel multigene approach of targeted next-generation sequencing is an attractive methodology for use for cytology specimens. The presented lung adenocarcinoma study revealed that STK11 mutations alone and concomitant KRAS/STK11 mutations were identified in 18.2% and 4.5% of solitary adrenal metastases, respectively. Molecular profiling of epidermal growth factor receptor tyrosine kinase inhibitor resistant tumors may help to identify patients who would most benefit from alternative single or dual pathway inhibition potentially leading to a revision in current molecular testing guidelines.
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