Due to the high prevalence of the disease, lung cancer is one of the most studied fields in the world of biology and medicine/ShutterStock
About 2700 Israelis are diagnosed with lung cancer every year.
According to the cancer registrar at the Ministry of Health, lung cancer is the second most common among men, and the third among women.
Most lung cancer cases are caused by smoking, but some are not related to tobacco consumption at all.
This cancer is also considered one of the main causes of death because it is often discovered in an advanced or metastatic stage.
Against the background of the high prevalence of the disease, lung cancer is one of the most researched areas in the world of biology and medicine, where new means are constantly being developed for the early detection of the disease, and many efforts are invested in the development of targeted drugs and immunotherapy in order to delay the disease and improve patient survival.
"In most cases, lung cancer is discovered in relatively late stages, because the lung is an internal organ, and the mass does not cause pain, cough or shortness of breath in the early stages. Usually, when symptoms appear, the disease is in an advanced stage and then usually the treatment given to patients is systemic," says D Dr. Mor Moshkowitz, Director of the Lung Tumor Service at the Davidoff Cancer Center at Beilinson Hospital.
"Naturally, smoking is the main risk factor"/ShutterStock
Does lung cancer have a defined risk population?
"Naturally, smoking is the main risk factor, but at the same time 20 percent of patients do not smoke. In general, lung cancer is more characteristic of older patients over the age of 70, but there are also young people who are diagnosed with the disease, usually as a result of certain genetic mutations that appear in the tumor," she adds .
Dr. Moshkowitz explains that thanks to the progress in cancer research, in some cases when certain mutations are discovered in the tumor, it is possible to adjust a target-oriented treatment, thereby delaying the progression of the disease and enabling a significant extension of life for patients. " she says. "In order to detect the existence of those mutations, a genomic test is performed that is taken from the patient's tumor tissue.
In some cases, there is not enough material for the test or the tumor sample by biopsy is difficult or dangerous for the patient, since it is an invasive test, and then we perform a liquid biopsy (from a blood sample) using different methods,
such as the "Guardant 360" test. In the laboratory, a process is carried out In it, the free DNA in the bloodstream is separated from the other components and it goes through a scanning process to locate mutations related to driving the cancer tumor and are targets for treatment."
About 2,700 Israelis are diagnosed with lung cancer every year/ShutterStock
What are the advantages of the liquid biopsy over the usual biopsy?
"First, in a liquid biopsy it is a blood sample, a non-invasive test so it is much easier to perform and does not require a tissue mass," explains Dr. Moshkowitz. "Secondly, using this advanced test, we can relatively quickly locate the mutations, if they exist , and match them with targeted treatment that may significantly prolong the patients' lives.
The blood test better covers the mutation profile of all tumor sites, in contrast to a biopsy, in which only the genetic changes in the specific tumor cells sampled can be diagnosed." The
"Guardant 360" test is offered not only to patients who need to adjust their treatment after the diagnosis of their disease, but also to patients who are already being treated with targeted drugs, but are at a stage where the tumor has developed resistance to the treatment they are receiving, and their disease is progressing. "Guardant 360" test in order to find out whether another mutation has developed that causes the disease to flourish, and sometimes we can adjust another goal-oriented treatment."
The "Guardant 360" liquid biopsy can help patients with different types of tumors to find customized therapeutic alternatives for them.
The test identifies mutations in free DNA segments of the tumor that are even at a very low frequency. The test is considered particularly sensitive. Studies have shown that this test has high reliability, with the ability to identify mutations with an efficiency of 99.99%
when a positive finding of the presence of a mutation is obtained in the "Guardant 360" test. The result is sufficient to start a targeted treatment or to join a clinical study according to the criteria, usually without the need to confirm the finding with a tissue-based test. If the patient does not have enough material to perform a molecular profile, the use of the "Guardant 360" test saves the patient from having to undergo another invasive biopsy, which sometimes involves risks, Discomfort or delay in the beginning of treatment.
Dr. Moshkovitz tells about a lung cancer patient who, thanks to the test, discovered the expression of a mutation in his tumor and even targeted treatment was adapted to him.
"The patient had an expression of an EFGR type mutation, so he received targeted treatment for several years," explains Dr. Moskovitz. "Later, the tumor developed resistance and he had to undergo chemotherapy treatment that helped him for a few months until the disease showed progress and grew," she adds. "At this point he performed another 'Guardant 360' test which indicated an overexpression type mutation of the MET gene for which we have a dedicated treatment.
The patient entered a clinical study of a drug that inhibits the protein produced by this gene, and to our delight his disease was significantly reduced.
He has been responding positively to treatment for several months.
So it can be seen that even after developing resistance to targeted treatments, mutations can be found that explain the mechanism of resistance and there is a treatment against them."
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