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The Evolving Role of Molecular Diagnostics in Australia: A Retrospective Cohort Study on Lung Cancer
Thesis   Open access

The Evolving Role of Molecular Diagnostics in Australia: A Retrospective Cohort Study on Lung Cancer

Thys Matthews
University of the Sunshine Coast, Queensland
Master of Science, University of the Sunshine Coast
2020
DOI:
https://doi.org/10.25907/00371
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Abstract

diagnostics lung cancer ALK EGFR
The landscape of lung cancer treatment has advanced significantly since the introduction of targeted molecular therapies. Clinicians are now often able to define specific oncogenic driver mutations associated with lung cancer and treat their patients with drugs that specifically target them. With these pharmaceutical developments, the focus has shifted towards molecular diagnostics to identify driver mutations earlier and develop more specific treatment options for patients harbouring them. The spectrum of molecular changes in lung cancer patients is strongly related to demographics and smoking behaviour. For example, mutations in both the epithelial growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genes are statistically more likely in young non-smokers and mutations in the Kirsten Rat Sarcoma (KRAS) gene are more frequently associated with a strong smoking history in older patients (1-3). There are also significant differences in the rate of EGFR and ALK mutations in lung cancer patients reported in the literature, which are linked to differences in the demographics of target populations. EGFR mutations are reported in 30%-46% of lung cancer patients in Asia (4, 5) and 5%-7% in Western countries (1, 6). ALK mutations are shown in 2.3% of Asian and 5%-8.5% of Western Non-Small Cell Lung Cancer (NSCLC) patients (3, 7). K-RAS mutations are more prevalent in western countries (18%-25%) than Asian countries (5.5%-10%) (1-3).

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