Pathology and personalized medicine in lung cancer

Abstract

SUMMARY Personalized medicine for patients with non-small-cell lung cancer is a reality now and its use will only increase in the future. Pathology is key in supporting this approach to treatment decision-making, by performing the most complete and accurate histological subtyping of tumors possible, supported by predictive immunohistochemistry and the assessment of relevant biomarkers. The need for these extra diagnostic steps emphasizes the importance of maximizing tissue yields from biopsy procedures. Although multiplex approaches may allow simultaneous assessment of several biomarkers, there will remain a need for different types of test (e.g., immunohistochemistry, as well as mutation testing). Next-generation technologies for DNA sequencing are a great hope for extensive genetic analysis of single samples, provided various technical and logistical problems can be solved. All such laboratory activity must be supported by high-quality internal procedures and external quality-assurance schemes.