INTRODUCTIONPersonalized/precision medicine requires the rapid, cost‐effective, and reliable tissue‐based assessment of clinically validated predictive biomarkers. In particular, modern thoracic oncology has deeply transformed the way in which we practice lung cytopathology. The initial perception that cytological samples were merely sufficient for a generic microscopic diagnosis of non‐small cell lung cancer (NSCLC) whereas molecular analysis could only be applied to formalin‐fixed paraffin‐embedded material now has been completely overcome. By coupling microscopy with biomarker characterization, cytology can guide targeted therapy for NSCLC. In individuals with locally advanced or metastatic disease, when patients are not surgical candidates, fine‐needle aspiration biopsy is an ideal minimally invasive approach to inform targeted lung cancer therapy decisions.The study by Guseva et al, published in this issue of Cancer Cytopathology, represents a step ahead to maximize the informativeness of cytological smears. Indeed, treatment paradigms for patients with advanced lung cancer are well established. If the epidermal growth factor receptor (EGFR) gene demonstrates an activating (sensitizing) mutation, the first‐generation tyrosine kinase inhibitors (TKIs) gefitinib (Iressa; AstraZeneca, Cambridge, United Kingdom) and erlotinib (Tarceva; Hoffmann‐La Roche, Basel, Switzerland) or the second‐generation TKI afatinib (Giotrif; Boehringer Ingelheim, Ingelheim, Germany) should be given as first‐line therapy. Similarly, the TKI crizotinib (Xalkori, Pfizer,
Cancer Cytopathology – Wiley
Published: Jan 1, 2018
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