Online ISSN: 2515-8260

The Role of Pharmacists in Optimizing Molecular Testing with Evolving Biomarkers and Treatment for Non-Small Cell Lung Cancer

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Ashique Ahmed, 2 Alakesh Bharali, 1 Arindam Dutta, 1 Abhinab Chetia, 1 Arzoo Newar,1 Bedanta Bhattacharjee, 1 Bhargab Deka * , 1 Bonti Sonowal, 1 Bharjil Bingari, 1 Dhunusmita Barman, 1 Dibyojyoti Sarmah, 1 Farida Pegu, 1 Farak Ali, 3 Gargi Das, 4 Himangshu Sarma,1 Nikita Dey, 2 Nayanika Neog, 1 Pinkan Sadhukan, 1 Rofiqul Islam, 1 Richa Sonowal, 1 Shahnaz Alom, 5 Shamima Nasreen Ahmed, 2 Taslima Akhter Rohman

Abstract

Molecular testing and the development of targeted therapies have revolutionized the treatment of non-small cell lung cancer (NSCLC). Despite the advantages of molecular testing in patients with NSCLC and guideline recommendations, there is no specific standard testing method, resulting in variable testing practices based on institution protocol and access. Pharmacists can help to improve coordination of care around appropriate testing as results are important in determining the most appropriate targeted treatment course. The majority of patients with NSCLC are tested for PD-L1, EGFR, ALK, ROS1, and BRAF mutations. These biomarkers and their corresponding targeted therapies are more understood than the remaining biomarkers, such as KRAS, RET, MET exon 14 (METex14), and NTRK. Multiple new and emerging therapies target these latter biomarkers, and this article will focus on these lesser-known biomarkers. As the treatment of NSCLC becomes increasingly biomarker-driven and more therapies are added to the armamentarium for the management of NSCLC, pharmacists will be called upon to assist the oncology care team to optimize NSCLC treatment to improve patient outcomes.

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