Volume 1 · August 2026
From Biopsy to Biomarker: How Pathology Guides Precision Treatment in Lung Cancer — Scientific Feature
Dr. Rukmini Bezbaruah · Associate Professor, Oncopathology · Dr. B. Borooah Cancer Institute, Guwahati, Assam
Lung cancer pathology has moved beyond establishing malignancy to providing the biological information that directly supports treatment selection. A small biopsy must increasingly answer several questions: What is the tumour? What is its histological subtype? Are there actionable molecular alterations? Could the patient benefit from immunotherapy? Molecular profiling may identify actionable alterations such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK and ERBB2, creating opportunities for targeted therapy. PD-L1 assessment provides complementary information for immunotherapy decisions. The pathologist has a pivotal role in converting a limited tissue sample into clinically actionable information.
The Diagnostic Starting Point
Every lung cancer case begins with morphology. Histopathology establishes malignancy and classifies the tumour, broadly distinguishing small cell lung cancer from non-small cell lung cancer (NSCLC). Within NSCLC, recognition of adenocarcinoma and squamous cell carcinoma guides subsequent testing and management.
The challenge is that diagnostic material is often limited. Bronchoscopic biopsies, needle biopsies and cytological specimens may contain only a small number of tumour cells. A carefully selected immunohistochemical panel, including markers such as TTF-1 and p40, can establish lineage without unnecessarily exhausting the specimen.
This is available in the Annual Subscription.
Subscribe to the Online Edition to read every article, or get the Print Edition delivered to your doorstep.
Subscribe Now