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Mitsudomi T, Tan D, Yang JC, Ahn MJ, Batra U, Cho BC, Cornelio G, Lim T, Mok T, Prabhash K, Reungwetwattana T, Ren SX, Singh N, Toyooka S, Wu YL, Yang PC, Yatabe Y. Expert Consensus Recommendations on Biomarker Testing in Metastatic and Nonmetastatic NSCLC in Asia. J Thorac Oncol. 2023 Apr;18(4):436-446. doi: 10.1016/j.jtho.2022.10.021. Epub 2022 Nov 12. PMID: 36379356.
Most published guidelines for genomic biomarker testing in non-small cell lung cancer (NSCLC) reflect the disease epidemiology and treatments readily available in Europe and North America. However, 60% of annual global NSCLC cases occur in Asia, where patient characteristics, tumor molecular profiles, and treatments vary greatly from the Western world. For example, mutations in the epidermal growth factor receptor (EGFR) occur at a higher prevalence in Asia than in other world regions. Although medical associations such as IASLC, ESMO, and ASCO have described principles for tumor genomic biomarker testing in NSCLC, there is a need for recommendations specific for Asia. This report provides consensus recommendations for NSCLC biomarker testing from Asian lung cancer experts, for clinicians working in Asia to improve patient care. These recommendations are divided into non-metastatic and metastatic forms of adenocarcinoma and squamous cell carcinoma. Biomarker testing approaches for actionable genetic alterations in EGFR, ALK, ROS1 and others are discussed. Owing to the higher prevalence of EGFR mutations in Asia, the experts emphasized the need for EGFR testing to include not just common mutations (exon 19 deletions & L858R substitutions) but also other uncommon EGFR mutations. In addition to the assessment of biomarkers in tumor tissue, the role of assessing tumor biomarkers by liquid biopsy are also discussed.
大多数已发表的非小细胞肺癌基因组生物标志物检测指南反映的是欧洲和北美的流行病学和治疗方法，然而全球每年60%的NSCLC发生在亚洲，患者特征、肿瘤分子特征和治疗方法与西方差异很大。例如EGFR突变在亚洲的发生率高于世界其他地区。尽管IASLC、ESMO和ASCO等医学协会已经描述了NSCLC中肿瘤基因组生物标志物检测的原则，但仍需针对亚洲的建议。本文为亚洲肺癌专家提供的关于NSCLC生物标志物检测的共识建议，供亚洲临床工作者参考。这些建议分为非转移型和转移型腺癌和鳞状细胞癌，讨论了EGFR、ALK、ROS1和其他基因改变的生物标志物检测方法。由于亚洲EGFR突变的流行率较高，专家强调EGFR检测不仅需要包括常见突变（外显子19缺失和L858R替代），还需要包括其他不常见的EGFR突变。除了评估肿瘤组织中的生物标志物外，还讨论了通过液体活检评估肿瘤生物标志物的作用。
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