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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 alteration...

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Autores principales: Saarenheimo, Jatta, Andersen, Heidi, Eigeliene, Natalja, Jekunen, Antti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546351/
https://www.ncbi.nlm.nih.gov/pubmed/34712614
http://dx.doi.org/10.3389/fonc.2021.754427
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author Saarenheimo, Jatta
Andersen, Heidi
Eigeliene, Natalja
Jekunen, Antti
author_facet Saarenheimo, Jatta
Andersen, Heidi
Eigeliene, Natalja
Jekunen, Antti
author_sort Saarenheimo, Jatta
collection PubMed
description 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.
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spelling pubmed-85463512021-10-27 Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review Saarenheimo, Jatta Andersen, Heidi Eigeliene, Natalja Jekunen, Antti Front Oncol Oncology 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. Frontiers Media S.A. 2021-10-12 /pmc/articles/PMC8546351/ /pubmed/34712614 http://dx.doi.org/10.3389/fonc.2021.754427 Text en Copyright © 2021 Saarenheimo, Andersen, Eigeliene and Jekunen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Saarenheimo, Jatta
Andersen, Heidi
Eigeliene, Natalja
Jekunen, Antti
Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title_full Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title_fullStr Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title_full_unstemmed Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title_short Gene-Guided Treatment Decision-Making in Non-Small Cell Lung Cancer – A Systematic Review
title_sort gene-guided treatment decision-making in non-small cell lung cancer – a systematic review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546351/
https://www.ncbi.nlm.nih.gov/pubmed/34712614
http://dx.doi.org/10.3389/fonc.2021.754427
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