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Actionable mutations are present in 30% of patients with metastatic non-squamous (mNSq) non-small cell lung cancer (NSCLC) where administration of targeted therapy is associated with an overall survival benefit. Guidelines now recommend broad genomic profiling for newly diagnosed mNSq NSCLC patients, however several studies suggest that this is not routinely performed. Penn has successfully implemented “reflex” tissue-based next-generation sequencing (NGS) for mNSq NSCLC at the Hospital of the University of Pennsylvania (HUP). In a recent study, Dr. Aggarwal and colleagues demonstrated that the addition of plasma NGS to tissue NGS testing nearly doubled the rate of detection for actionable mutations. Dr. Aggarwal will describe a new project which seeks to build on this work by fully integrating plasma-based NGS into clinical pathways at HUP and at community oncology practice sites across the University of Pennsylvania Health System. Since the majority of lung cancer patients are treated in the community, it is critical to develop systems that work at both academic as well as community cancer programs.

Dr. Charu Aggarwal, MD, MPH specializes in the management of patients with lung cancer, with a specific and clinical research focus on the development of novel immunotherapeutic approaches, and the discovery and application of biomarkers to guide therapy and monitor treatment. She serves as the local and national principal investigator for multiple clinical trials focusing on the development of “targeted” immunotherapeutic approaches including cellular therapy and CAR-T for solid tumors. Dr. Aggarwal has led trials evaluating the role of plasma-based next generation sequencing in the management of patients with metastatic lung cancer. Dr. Aggarwal performs patient-centered, scientifically relevant novel immunotherapy clinical trials that will make a tangible impact and advance our understanding of immunotherapy in patients with lung cancer.