Genetic Mutations Are Similar in Most NSCLC Sites of Origin and Metastases

The majority of genetic mutations found in the original site of cancer remain the same in sites of spread (metastases) in non-small cell lung cancer (NSCLC). These results may be an important driver to establish treatment options in patients with recurrences. These results were recently published in the Journal of Clinical Oncology.

Therapeutic options for patients with cancer are changing to include individualized treatment based upon a cancer cells’ genetics. As such, it is important for physicians to obtain enough of a tissue specimen from a site of cancer to conduct laboratory tests for determining specific genetic components.

Often, the site of metastases, or spread of the cancer from where it originally started, does not contain adequate volume to run genetic tests. Furthermore, studies have found that genetic changes occur from the original site of cancer to the metastatic site.

Since drugs are targeted against specific mutations, it is important to understand exactly which sites of cancer contain which mutations.

Researchers from France and Foundation Medicine in Cambridge, Massachusetts recently conducted a clinical study to explore the potential differences of specific genetic mutations between original sites of cancer and metastases in non-small cell lung cancer.

The study included 15 patients with NSCLC. Tumor samples were collected from the original site and from metastatic sites. Laboratory tests were run on the tumor samples to determine specific genetic mutations and whether the mutations matched between the sites of origin and metastases.

94% of recurrent mutations at a metastatic site matched that of the site of cancer origin.
The researchers concluded that keeping information on genetic mutations from the original site of cancer in NSCLC can help guide treatment decisions if a recurrence occurs. Patients diagnosed with NSCLC may wish to speak with their healthcare provider regarding genetic testing on their cancer and archiving of that information.

Reference: Vignot S, Frampton G, Soria J-C, et al. Next-Generation Sequencing Reveals High Concordance of Recurrent Somatic Alterations Between Primary Tumor and Metastases From Patients With Non–Small-Cell Lung Cancer. Journal of Clinical Oncology. Published online before print April 29, 2013, doi:10.1200/JCO.2012.47.7737.