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In recent years, the scientific community has witnessed remarkable advances in knowledge about the basic biology of diseases and technological developments, so crucial in the field of oncology that many specialists describe the current situation as a true paradigm shift in the diagnosis and treatment of these diseases. "Five to ten years ago, the specialist attended the patient according to a fixed diagnosis that indicated a specific clinical protocol and, nowadays, the diagnosis and treatment of cancer is based on objective results from the Pathology Laboratory", explains the Dr. Juan Fernando Garcia, chief of the Pathology Department at MD Anderson Cancer Center Madrid and coordinator, together with Dr. Joseph Khoury, of the Department of Hematopathology in the Division of Pathology and Medicine Laboratory at MD Anderson Cancer Center Houston, of the II Meeting Advances in the Diagnosis of Molecular Pathology, which held these days (from Wednesday, October 3 to Friday, October 5) at the Rafael del Pino Auditorium, in Madrid.

The challenge now is that "the percentage of patients who heal also grows exponentially," explains Dr. Garcia, who with the organization of this congress seeks to combine experiences and debate around the importance of the diagnosis and molecular approach to the tumors "It is very important to understand the new advances in knowledge and technologies in a more transverse way and not just by organ of origin or medical specialties", states Dr. Garcia, who gives the case of HER2 + as an example.

This molecular alteration, which is so important and very well known in breast cancer, has proved to also play a very important role in many other types of tumor such as gastric, colon, pancreatic, head and neck or uterus neck cancers. This, which opens doors to new therapeutic options for patients, also progressively increases the complexity of cancer diagnosis procedures, so that there is a growing trend towards greater specialization in Molecular Pathology, which leads to an increased need for economic and training resources.

"These advances are tremendously rapid and, in many cases, go even faster than the authorities and medical societies can understand and learn," says this specialist, who firmly believes in the importance of integrating new techniques such as, for example, next generation sequencing (NGS), in the daily routine of hospitals. "They should not be an added luxury, but an added value and a routine tool, which will significantly increase efficiency," he finishes.

Immunotherapy in lung cancer

After increasing cure rates in metastatic melanoma dramatically, immunotherapy is now being developed as a treatment option in a large number of tumors, among which is lung cancer, where it seems that it could also be an effective tool in some subtypes. Therefore, biomarkers that may be useful will be discussed at the conference, in addition to the expression of PDL-1, and that could be much more predictive, such as the mutational load of the tumor, revealed as a prognostic biomarker with greater validity in several prospective clinical studies. "This biomarker must be included in the daily routine even though it is something technically complex, with different possible bioinformatics solutions and this has been discussed in this meeting," says Dr. Garcia.

Likewise, the results of the latest scientific studies that show long-term results (between five and ten years of follow-up) on the validity in clinical trials of the different platforms for response prediction to treatments in patients with different subtypes of breast cancer will also be discussed. "These results allow us to confirm the usefulness of these platforms, which is very important from the clinical point of view, but also from the economic point of view and the optimization of resources", stresses Dr. Garcia.

A whole series of advances focused on improving the quality of life of cancer patients that, as Dr. Khoury points out, "can only be achieved by sharing knowledge and forging high level collaborations". In his opinion, "congresses like this, sponsored by MD Anderson Cancer Center network, allow the creation of a place where opinions can be exchanged, which is absolutely vital for the propagation of good practices at the healthcare level and for the creation of opportunities for collaboration". In addition, Dr. Khoury points out that the participation of speakers and attendees from the five continents "speaks of the confidence and excellence that MD Anderson as a brand generates around the world”.