Non-Small Cell Lung Cancer Diagnosis & Testing

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How Is Non-Small Cell Lung Cancer (NSCLC) Diagnosed?

Diagnosing non-small cell lung cancer (NSCLC) begins with a physical exam and an evaluation of symptoms. Diagnostic tools—including imaging scans, biopsies, and molecular testing—confirm the presence of NSCLC and help identify its specific subtype.

Key Questions for Newly Diagnosed Lung Cancer Patients to Ask

Diagnosed with Lung Cancer? Why You Should Seek a Second Opinion

Non-Small Cell Lung Cancer Staging and Subtypes

NSCLC Staging

Stage I: The cancer is located only in the lungs and has not spread to lymph nodes. NSCLC is divided into two sub-stages—IA and IB—based on tumor size.
Stage II: The cancer may or may not have spread to nearby lymph nodes. NSCLC is divided into stages IIA and IIB, based on tumor size and location.
Stage III: The cancer is present in the lungs and lymph nodes in the center of the chest. It may be classified as stage IIIA, IIIB, or IIIC, depending on the tumor’s size, location, and extent of spread.
Stage IV: The cancer has spread beyond the lungs to other parts of the body.

NSCLC Subtypes

The three main subtypes of NSCLC are:

Adenocarcinoma: A common form of NSCLC typically found in the outer regions of the lungs. It develops in epithelial cells that line body surfaces and form glands. form glands.
Squamous cell carcinoma: Usually located in the central part of the lung, near a bronchus (airway).
Large cell carcinoma: A less common NSCLC type that can occur in any part of the lung. It tends to grow and spread more quickly than the other subtypes.

Essential Non-Small Cell Lung Cancer Testing

Testing is essential for identifying the NSCLC subtype, assessing the stage, detecting genetic mutations, guiding treatment decisions, and monitoring treatment response.

Testing Methods in NSCLC

Imaging Tests: X-rays, CT scans, PET scans, and MRIs to detect tumors and assess spread.
Biopsy: Tissue sample collection through bronchoscopy, needle biopsy, or surgical biopsy to confirm NSCLC diagnosis.
Cytology Tests: Examination of sputum or fluid from the lungs to detect cancer cells.
Molecular and Biomarker Testing: Identifies specific genetic mutations and protein expressions to personalize treatment.

When Should Lung Cancer Patients Receive Biomarker Testing?

What Essential Testing Reveals About Your Non-Small Cell Lung Cancer

NSCLC Biomarkers and Mutations

Biomarkers and mutations can determine whether a particular targeted therapy may be effective. Common driver mutations include:

EGFR (Epidermal Growth Factor Receptor) Mutation: Found in 10–15% of NSCLC cases, especially among non-smokers. These mutations often respond well to targeted treatments like tyrosine kinase inhibitors (TKIs).
ALK (Anaplastic Lymphoma Kinase) Rearrangement: Present in about 5% of NSCLC cases. Tumors with this mutation often respond well to ALK inhibitors.
NTRK (Neurotrophic Tyrosine Receptor Kinase) Fusion: A rare but important mutation found in a small percentage of NSCLC cases, NTRK fusions can be targeted with TRK inhibitors.
PD-L1 (Programmed Death-Ligand 1) Expression: High PD-L1 levels indicate a better response to immunotherapy, such as checkpoint inhibitors, which help the immune system attack cancer cells.
HER2 (Human Epidermal Growth Factor Receptor 2) Mutation: Though rare in NSCLC, HER2 mutations can be targeted with specific HER2 inhibitors.
KRAS (Kirsten Rat Sarcoma Virus) Mutation: The most common NSCLC mutation, found in approximately 25-30% of cases. Recent advances have led to targeted therapies for KRAS mutations, particularly the KRAS G12C variant.
BRAF (B-Raf Proto-Oncogene) Mutation: Found in about 1-3% of NSCLC cases, with BRAF V600E being the most common subtype. BRAF mutations respond to targeted therapies, often in combination with MEK inhibitors.
TP53 (Tumor Protein 53) Mutation: The most frequently mutated gene in human cancers, TP53 mutations are common in NSCLC and can influence prognosis and treatment resistance.
MET (Mesenchymal-Epithelial Transition) Alteration: MET amplifications and exon 14 skipping mutations occur in a subset of NSCLC cases and can be treated with MET inhibitors.
ROS1 (c-ros Oncogene 1) Rearrangement: Found in 1–2% of NSCLC cases. These tumors often respond well to targeted ROS1 inhibitors.

What Biomarkers Affect Lung Cancer Care and Treatment?

How Can Specific Biomarkers Impact Lung Cancer Progression?

Non-Small Cell Lung Cancer Diagnosis & Testing Programs

These programs help you understand your diagnosis, and how testing can identify the stage of disease and predict how well treatment may work for you.

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Tools to help you feel activated and connect with resources to overcome barriers to accessing care.

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Advice for People Newly Diagnosed with Non-Small Cell Lung Cancer
Non-Small Cell Lung Cancer Treatment and Clinical Trials
Accessing Non-Small Cell Lung Cancer Care
Non-Small Cell Lung Cancer Patient Profiles
[ACT]IVATED Non-Small Cell Lung Cancer Resources
Non-Small Cell Lung Cancer Biomarkers
Non-Small Cell Lung Cancer Veterans

Best Care

Empowers NSCLC patients and families by addressing factors like age, ethnicity, and insurance that impact outcomes. Gain confidence in your healthcare decisions, no matter where you live.

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Non-Small Cell Lung Cancer Patient Self-Advocacy Profiles
Accessing the Best Non-Small Cell Lung Cancer Care
Understanding Non-Small Cell Lung Cancer Testing
Non-Small Cell Lung Cancer Treatment Overview

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Provides lung cancer patients with key information to help them understand their role, empowering them to engage in their care and treatment decisions

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