A lung cancer diagnosis can bring many questions, especially when it comes to choosing the right treatment. Not every lung cancer behaves in the same way, and two patients with a similar diagnosis may respond differently to treatment. This is where molecular testing for lung cancer can play an important role. By checking cancer cells for specific gene changes and biomarkers, doctors can better understand the cancer and identify treatment options that may be more suitable for the patient.
But what exactly does molecular testing check? Who needs it, how is it performed, and can it really change the treatment plan? In this guide, we will explain these questions in simple language, including common lung cancer biomarkers, NGS testing, liquid biopsy, targeted therapy, and how test results can help doctors plan personalised cancer care.
What Is Molecular Testing for Lung Cancer?
Molecular testing for lung cancer is a group of laboratory tests used to examine cancer cells for specific gene changes, proteins, and other biomarkers. These changes can provide important information about how the cancer may behave and whether certain treatments may be suitable. Molecular testing is also called biomarker testing, tumor profiling, or molecular profiling.
What Does Molecular Testing Look For?
Lung cancer cells can have different genetic changes, and these changes are not the same in every patient. Lung cancer biomarker testing may look for alterations such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, and HER2/ERBB2, depending on the type and stage of cancer and the testing approach used. Some biomarkers can help doctors identify patients who may benefit from specific targeted therapies.
How Is Molecular Testing Done?
The test can be performed using a sample of tumor tissue, such as tissue obtained during a biopsy or surgery. In selected situations, doctors may also use a blood-based liquid biopsy to look for cancer-related DNA when obtaining enough tumor tissue is difficult or not feasible. The sample is sent to a laboratory, where methods such as PCR, immunohistochemistry, FISH, or next-generation sequencing (NGS) may be used.
Why Is Molecular Testing Important in Lung Cancer?
Molecular testing for lung cancer can help doctors understand the specific biological changes driving a patient’s cancer. This is especially important in non-small cell lung cancer (NSCLC), where certain genetic alterations can make cancer cells grow and survive. Finding these changes may help the oncology team identify actionable mutations and select a treatment that is more closely matched to the cancer. Indian consensus guidelines also recognise molecular and biomarker testing as an important part of treatment planning for NSCLC.
Helps Identify Actionable Mutations
Some lung cancers have changes in genes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, or HER2 (ERBB2). When a clinically actionable alteration is found, it may open the door to a targeted therapy designed to act on that specific cancer characteristic. This is one reason molecular profiling can be an important step before deciding on treatment for eligible patients.
Helps Personalise Lung Cancer Treatment
Traditional treatments such as chemotherapy remain important, but treatment is not the same for every patient. Lung cancer biomarker testing can provide additional information that helps doctors consider targeted therapy, immunotherapy, chemotherapy, or combinations based on the patient’s cancer characteristics. PD-L1 is another important biomarker that may help guide immunotherapy decisions in appropriate NSCLC patients.
Can Help When Lung Cancer Changes or Returns
Molecular testing can also be useful when cancer progresses after targeted treatment. In selected situations, repeat testing may identify changes linked to treatment resistance and help doctors consider the next treatment approach. Testing can sometimes use tissue or, when appropriate, circulating tumour DNA from a blood sample.
Why It Matters Before Starting Treatment
The key benefit is better information before making an important treatment decision. Molecular testing does not decide the treatment by itself; doctors also consider the cancer type and stage, overall health, previous treatments, and other biomarkers. A personalised treatment plan is created by bringing all of these factors together.
Who Should Get Molecular Testing for Lung Cancer?
Molecular testing for lung cancer is especially important for people diagnosed with non-small cell lung cancer (NSCLC), particularly when the disease is advanced or metastatic. Current ASCO guidance recommends that patients with NSCLC should have access to broad biomarker testing using tissue and/or blood-based methods, along with relevant protein biomarker testing such as PD-L1. The results can help doctors identify genetic changes that may make targeted treatment an option.
Patients With Non-Small Cell Lung Cancer (NSCLC)
Molecular testing is particularly relevant for people with NSCLC, especially adenocarcinoma and other non-squamous cancers. Testing can look for actionable changes in genes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, and HER2. Knowing whether one of these changes is present can help an oncologist choose a more personalised treatment plan.
Patients With Advanced or Metastatic Lung Cancer
People with advanced or stage 4 NSCLC are a key group for comprehensive molecular profiling because treatment decisions may depend on whether the tumour has an actionable driver alteration. Ideally, biomarker results should be available before starting first-line systemic treatment when the patient’s condition allows.
Patients With Limited or Difficult-to-Obtain Tissue
Sometimes a biopsy does not provide enough tissue for complete lung cancer biomarker testing. In selected situations, doctors may consider a blood-based test, often called a liquid biopsy, to look for tumour DNA. However, a negative blood test may not completely rule out a mutation, so tissue testing may still be needed when feasible.
Patients Whose Cancer Progresses After Targeted Treatment
Molecular testing may also be considered when lung cancer grows again or becomes resistant after targeted therapy. Repeat testing can sometimes identify new molecular changes that help explain treatment resistance and guide the next treatment decision.
How Is Molecular Testing for Lung Cancer Done?
Molecular testing for lung cancer is usually performed after a biopsy or other procedure provides a sample of the cancer. The sample is examined by a pathology laboratory to look for specific gene changes, mutations, fusions, or other biomarkers that may affect treatment. In non-small cell lung cancer (NSCLC), these results can help doctors identify patients who may benefit from targeted therapies or other personalised treatment approaches.
Step 1: A sample of the cancer is collected
The first step is usually obtaining a tumour tissue sample through a biopsy. Depending on the patient’s condition, the sample may come from the lung tumour, a lymph node, a metastatic site, or a surgical specimen. The pathologist checks whether the sample contains enough cancer cells and whether its quality is suitable for molecular testing.
Step 2: The cancer type is confirmed
Before molecular testing, the pathology team confirms the type of lung cancer. This is important because molecular testing is particularly relevant to treatment planning in non-small cell lung cancer, including lung adenocarcinoma. Other tests, such as immunohistochemistry (IHC), may also be used to help identify the cancer type and certain biomarkers.
Step 3: The sample is tested for important biomarkers
The laboratory then looks for specific lung cancer mutations and genetic alterations. Depending on the patient’s cancer type and treatment situation, testing may include biomarkers such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET and HER2/ERBB2. Testing may use methods such as PCR, FISH, IHC, or next-generation sequencing (NGS).
Step 4: NGS may be used for broader testing
Instead of testing one gene at a time, an NGS test for lung cancer can examine multiple genes in a single test. This broader approach can help identify uncommon but potentially actionable alterations while making better use of limited tumour tissue. The exact test or panel should be selected according to the patient’s diagnosis and clinical situation.
Step 5: Liquid biopsy may be considered when tissue is limited
In some situations, doctors may use a liquid biopsy, which involves analysing cancer-related DNA found in a blood sample. It can be useful when obtaining enough tumour tissue is difficult or when additional molecular information is needed. However, a negative blood-based result does not always rule out a mutation, so tissue testing may still be recommended when appropriate.
Step 6: The results are reviewed by the oncology team
The laboratory provides a report showing which biomarkers or genetic alterations were detected. The oncologist then considers these findings along with the cancer stage, cancer type, overall health, previous treatment, and other test results. The molecular report is therefore an important part of treatment planning, but it does not determine treatment by itself.
What Types of Samples Are Used for Molecular Testing?
Molecular testing for lung cancer can be performed using different types of samples, depending on the cancer, available tissue, and the test required. The most common sample is tumor tissue obtained through a biopsy or surgery, but cytology samples and blood-based liquid biopsy may also be used in selected situations. The sample must contain enough good-quality cancer material for the laboratory to obtain a reliable result.
Tumor Tissue From a Biopsy
A lung biopsy is one of the main ways doctors obtain tissue for molecular testing. A small piece of the tumor is collected and examined by a pathologist to confirm the cancer type. If enough suitable tissue is available, the same sample can then be tested for important lung cancer biomarkers and genetic mutations, such as EGFR, ALK, ROS1, and other actionable alterations. Doctors try to preserve enough tissue for all necessary tests.
Tissue From Surgery
If a patient undergoes lung cancer surgery, the removed tumor may provide a larger tissue sample for lung cancer molecular testing. This can give the laboratory enough material for broader biomarker testing when clinically appropriate. Both the primary tumor and, in suitable cases, a metastatic tumor can be used for molecular analysis.
Cytology Samples
Sometimes cancer cells are collected through procedures that provide a cytology sample rather than a traditional tissue biopsy. When there are enough cancer cells and the sample is properly preserved, cytology material can be suitable for molecular testing. This can be particularly useful when obtaining a larger tissue biopsy is difficult.
Blood Sample: Liquid Biopsy
A liquid biopsy uses a blood sample to look for cancer-related genetic material, such as circulating cell-free DNA. It may be considered when there is not enough tumor tissue for testing or when obtaining another biopsy may be difficult. However, a negative blood-based result does not always rule out a mutation, so tissue testing may still be needed when clinically appropriate.
What If There Is Not Enough Tissue?
Not having enough tissue does not automatically mean molecular testing is impossible. The oncology and pathology teams may consider a liquid biopsy or another appropriate sample, depending on the patient’s situation and the biomarker being investigated. The quality and amount of cancer material are important because they can affect whether the laboratory can produce a reliable lung cancer biomarker test result.
How Molecular Testing Helps Choose Lung Cancer Treatment
Molecular testing for lung cancer helps doctors look for specific genetic changes and other biomarkers in cancer cells. These results can show whether a patient’s cancer has a change that may respond to a particular treatment. This is an important part of personalised or precision cancer treatment, especially in many patients with non-small cell lung cancer (NSCLC).
Identifying mutations that may guide treatment
Some lung cancers have specific changes in genes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, or HER2. When a clinically actionable change is found, the oncologist may consider a targeted therapy designed to act on that particular cancer change. This can help doctors choose treatment based on the biology of the tumour rather than relying only on the cancer’s location or stage.
Helping decide between different treatment options
Molecular results are considered along with the cancer type, stage, overall health, pathology findings, and other biomarkers such as PD-L1. Depending on these factors, treatment may include targeted therapy, immunotherapy, chemotherapy, radiation therapy, surgery, or a combination of treatments. Molecular testing does not choose the treatment by itself; it gives the oncology team important information to make a more personalised treatment plan.
What if no actionable mutation is found?
A negative molecular test does not mean that treatment is not possible. It simply means that the test did not identify a currently actionable alteration. Doctors can then consider other suitable options based on the patient’s diagnosis and other test results. In some situations, broader testing such as next-generation sequencing (NGS) may help identify additional alterations that a limited single-gene test could miss.
Can testing be useful after treatment?
Yes. Lung cancer can sometimes develop changes that make it resistant to a treatment that previously worked. If the cancer progresses, the oncologist may consider repeat molecular testing or, in selected situations, a liquid biopsy to look for new changes that could influence the next treatment approach.
Molecular Testing and Targeted Therapy for Lung Cancer
Molecular testing for lung cancer can help doctors understand whether a tumour has specific genetic changes that may be driving its growth. This is especially important in non-small cell lung cancer (NSCLC), where certain biomarkers can guide the choice of targeted treatment. Tests may look for changes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, and HER2, depending on the patient’s cancer type and clinical situation.
What Is Targeted Therapy for Lung Cancer?
Targeted therapy uses medicines designed to act on specific proteins or molecular changes that help cancer cells grow, divide, or spread. Unlike treatments that affect cancer cells more broadly, targeted medicines are selected based on the characteristics of the patient’s tumour. This is why lung cancer biomarker testing is an important part of personalised or precision cancer treatment.
How Does Molecular Testing Help Choose Targeted Treatment?
The process can be understood simply:
Biopsy → Molecular testing → Biomarker identified → Treatment options reviewed → Personalised treatment plan
If testing finds an actionable genetic alteration, the oncologist may consider a targeted medicine designed for that particular change. For example, certain EGFR alterations can make a patient eligible for EGFR-targeted treatment, while ALK or ROS1 rearrangements may open the door to corresponding targeted therapies.
What If No Targetable Mutation Is Found?
A negative molecular test does not mean that lung cancer cannot be treated. If no suitable actionable alteration is identified, the oncologist considers other factors such as cancer stage, tumour type, overall health and other biomarkers. Depending on the situation, treatment may include immunotherapy, chemotherapy, radiation therapy, surgery, or a combination of treatments.
Can Molecular Testing Be Done Again?
Sometimes, yes. Lung cancer can develop resistance to a targeted medicine, and the molecular features of the tumour may change as the disease progresses. In selected situations, doctors may recommend repeat testing using a new tissue sample or liquid biopsy to look for changes that could influence the next treatment decision.
Molecular Testing and Immunotherapy for Lung Cancer
Immunotherapy helps the immune system recognise and attack cancer cells. In lung cancer, molecular testing for lung cancer and biomarker testing can provide important information before doctors decide whether immunotherapy may be suitable. One of the key biomarkers is PD-L1, a protein found on some cancer cells and immune cells. PD-L1 testing is commonly performed using immunohistochemistry (IHC) on a tumour sample and can help guide the use of certain immune checkpoint inhibitors in non-small cell lung cancer (NSCLC).
How Does PD-L1 Testing Help Choose Immunotherapy?
PD-L1 results are usually reported as a percentage or score showing how much PD-L1 is present. A higher level of PD-L1 may make immunotherapy an option in some treatment settings, but PD-L1 alone does not decide the complete treatment plan. Doctors also consider the cancer type and stage, overall health, previous treatments, and molecular alterations such as EGFR or ALK. Current lung-cancer treatment guidance continues to distinguish treatment approaches according to whether a patient has a driver alteration and other relevant biomarkers.
Do Patients Need Both Molecular and PD-L1 Testing?
Often, yes—particularly when evaluating advanced NSCLC for systemic treatment. Molecular testing looks for genetic changes that may make targeted therapy appropriate, while PD-L1 testing provides information that can help assess immunotherapy options. Using these results together gives the oncology team a more complete picture for personalised lung cancer treatment. Importantly, finding a targetable mutation may change the preferred treatment approach, so comprehensive biomarker testing should be considered before starting treatment when clinically appropriate.
What If PD-L1 Is Low or Negative?
A low or negative PD-L1 result does not automatically mean that immunotherapy or other cancer treatments cannot be used. Treatment decisions depend on the complete clinical picture and the specific treatment setting. Similarly, a high PD-L1 result does not mean that immunotherapy is automatically the best choice for every patient. An oncologist should interpret the PD-L1 result together with molecular testing, pathology and other clinical factors before recommending treatment.
What Happens If Molecular Testing Finds a Mutation?
Finding a mutation through molecular testing for lung cancer does not automatically mean that a particular medicine will be given. Instead, the result gives the oncologist important information about how the cancer is growing and whether a targeted treatment may be suitable. The doctor will consider the exact mutation, cancer type and stage, overall health, previous treatment, and other biomarkers before creating a treatment plan. Current ASCO guidance supports broad biomarker testing in NSCLC because actionable driver alterations can directly influence treatment choices.
Actionable Mutation
An actionable mutation is a genetic change for which there is a treatment option that may target that specific alteration. For example, changes involving EGFR, ALK, ROS1, BRAF, MET, RET, or NTRK can influence treatment decisions in appropriate patients. When an actionable alteration is found, the oncologist may consider targeted therapy for lung cancer instead of, or before, other treatment approaches, depending on the patient’s individual situation.
Mutation Found, but No Suitable Targeted Treatment
Sometimes molecular testing identifies a genetic change, but there may not be an approved or appropriate targeted treatment for that particular alteration. In such cases, the result is still recorded as part of the patient’s cancer profile, while the oncology team considers other options such as immunotherapy, chemotherapy, radiation therapy, or a combination of treatments, depending on the cancer and its stage.
What If No Actionable Mutation Is Found?
A negative result does not mean that lung cancer cannot be treated. If no actionable driver alteration is identified, doctors may use other information, including PD-L1 testing, cancer type, stage, and the patient’s overall health, to guide treatment. Immunotherapy-based treatment or chemotherapy-based approaches may be considered when appropriate.
Can the Test Be Repeated Later?
Yes. If lung cancer progresses after targeted therapy, the cancer may develop new genetic changes that cause treatment resistance. In selected situations, doctors may recommend repeat molecular testing using a new tissue sample and/or blood-based testing such as NGS to look for new alterations that could influence the next treatment.
Can Molecular Testing Detect Treatment Resistance?
Yes. Molecular testing for lung cancer can sometimes identify genetic changes that develop when cancer stops responding to a targeted treatment. This is known as acquired treatment resistance. When lung cancer progresses after targeted therapy, doctors may recommend repeat molecular testing to look for new mutations or other changes that could explain why the treatment is no longer working.
How Does Treatment Resistance Develop?
Cancer cells can change over time. Even when a targeted therapy initially controls the cancer, some cancer cells may develop new genetic changes that allow them to survive and grow. These changes can affect the original treatment target or activate another pathway that helps the cancer continue growing. Identifying these changes through lung cancer mutation testing may help the oncology team understand the reason for progression and consider the next treatment option.
When Is Repeat Molecular Testing Considered?
Repeat testing may be considered when scans or symptoms show that lung cancer is progressing after targeted therapy. Depending on the situation, doctors may use a tissue re-biopsy or a liquid biopsy, which analyses circulating tumour DNA from a blood sample. Liquid biopsy can be useful when obtaining another tissue sample is difficult, although a negative blood test may not completely rule out a mutation, and tissue testing may still be recommended.
Can Resistance Testing Change the Treatment Plan?
It can. If a new, clinically meaningful alteration is identified, the result may help doctors consider another targeted treatment or a different treatment strategy. However, molecular results are only one part of the decision. The oncologist also considers the cancer’s stage, previous treatments, overall health, scan results, and other biomarkers before choosing the next step. Current lung-cancer guidance specifically includes molecular testing for patients who relapse or progress after targeted therapy.
Benefits and Limitations of Molecular Testing for Lung Cancer
Molecular testing for lung cancer can give doctors important information about the genetic changes and biomarkers present in a tumour. These results may help the oncology team choose a more suitable treatment, especially when a tumour has an actionable mutation that can be matched with targeted therapy. Biomarker testing can also help identify patients who may benefit from certain immunotherapies or clinical trials.
Benefits of Molecular Testing
- Helps guide treatment: Molecular testing can identify mutations or biomarkers that may point toward specific targeted treatments.
- Supports personalised cancer care: Instead of relying only on cancer type and stage, doctors can consider the molecular features of the tumour when planning treatment.
- Can identify actionable mutations: Tests may detect changes in genes such as EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, or NTRK, depending on the patient’s cancer and the testing approach.
- May help avoid unsuitable treatment: If testing shows that a particular treatment is unlikely to work, this information can help doctors consider other options.
- Can support treatment planning after cancer progression: In some situations, repeat biomarker or mutation testing can help identify changes that have developed after treatment.
- May help identify clinical trials: Some clinical trials select patients based on specific molecular changes found in their cancer.
Limitations of Molecular Testing
Molecular testing is valuable, but it does not guarantee that a particular treatment will work. A test may not find an actionable biomarker, there may not be a suitable treatment for an identified change, or the tumour may not contain enough tissue for testing. Cancer cells can also change over time, so an older molecular test may not always reflect the tumour’s current characteristics.
Why Choose Pinak Cancer Hospital for Molecular Testing for Lung Cancer?
Choosing the right cancer hospital is important when molecular testing may help guide your treatment. Pinak Cancer Care & Superspeciality Hospital in Varanasi provides comprehensive cancer care under the guidance of Dr. Pankaj Singh, helping patients understand their diagnosis and explore suitable treatment options. Molecular testing for lung cancer can identify specific genetic changes and biomarkers that may help doctors consider targeted therapy and other personalized treatment approaches.
Expert Guidance from Dr. Pankaj Singh
Dr. Pankaj Singh, an experienced oncologist at Pinak Cancer Care & Superspeciality Hospital, focuses on personalized cancer treatment based on each patient’s cancer type, stage, test results, and overall health. For patients undergoing molecular testing for lung cancer, expert interpretation of the results is important because a detected mutation or biomarker does not automatically mean that one specific treatment is suitable.
Personalized Lung Cancer Treatment
Molecular and biomarker testing can provide important information about the biology of lung cancer. Based on the results, Dr. Pankaj Singh and the oncology team can assess whether treatments such as targeted therapy, immunotherapy, chemotherapy, radiation therapy, or surgery may be appropriate. This approach helps create a treatment plan based on the individual patient’s needs rather than using the same treatment for every patient.
Comprehensive Cancer Care in Varanasi
For patients seeking lung cancer treatment in Varanasi, Pinak Cancer Care offers multiple cancer treatment services within a comprehensive oncology-care setting. Patients can discuss their biopsy, molecular testing, biomarker results, and available treatment options with their oncology team, helping them make informed decisions about their cancer care.
Focus on Individual Patient Needs
Molecular testing is an important part of modern precision cancer treatment, but it is only one part of the overall treatment decision. The results need to be considered along with the cancer type, stage, pathology findings, other biomarkers, previous treatments, and overall health. Under the guidance of Dr. Pankaj Singh, patients can discuss these factors and understand how their test results may influence their personalized lung cancer treatment plan.
Also Read: https://pinakcancerhospital.com/tobacco-oral-cancer-risk/
Conclusion
Molecular testing for lung cancer can help doctors identify genetic changes and biomarkers that may guide personalized treatment. It can support decisions about targeted therapy, immunotherapy, chemotherapy, and other treatment options based on the patient’s condition. Tests such as NGS can examine multiple genes and provide a broader view of the cancer’s molecular profile. For patients seeking lung cancer treatment in Varanasi, discussing appropriate biomarker testing with an experienced oncology team can help clarify treatment choices. At Pinak Cancer Care & Superspeciality Hospital, Dr. Pankaj Singh provides personalized cancer care based on each patient’s diagnosis and treatment needs.
Frequently Asked Questions
1. What is molecular testing for lung cancer?
Molecular testing for lung cancer examines tumor tissue, blood, or other samples for specific genetic changes and biomarkers. These findings can provide information that may help doctors select appropriate treatments. It is particularly important in many cases of non-small cell lung cancer (NSCLC).
2. Why is molecular testing important in lung cancer?
Molecular testing can identify changes that may make a cancer suitable for a targeted treatment. It can also provide information that helps doctors understand treatment options more precisely. The test is therefore an important part of personalized treatment planning for appropriate patients.
3. Which genes are tested in lung cancer?
Depending on the cancer type and clinical situation, testing may include EGFR, ALK, ROS1, BRAF, KRAS, MET, RET, NTRK, and HER2/ERBB2. Broader NGS panels can test several genes at the same time and may identify additional actionable alterations.
4. Is molecular testing necessary for every lung cancer patient?
Not every patient requires exactly the same molecular tests. The need for testing depends on factors such as the type and stage of lung cancer, pathology findings, treatment plan, and current clinical guidelines. Your oncologist can recommend which biomarkers are relevant to your case.
5. What is NGS testing for lung cancer?
Next-generation sequencing (NGS) is a testing method that can examine multiple genes at the same time. Instead of testing several genes separately, a multiplexed panel can provide broader molecular information and may identify multiple potentially actionable alterations.
6. What is liquid biopsy for lung cancer?
A liquid biopsy uses a blood sample to look for cancer-related genetic material, such as circulating tumor DNA (ctDNA). It can be useful in selected situations, particularly when obtaining enough tumor tissue is difficult, but a negative blood test does not always rule out a mutation.
7. Is molecular testing the same as genetic testing?
No. Molecular or biomarker testing for lung cancer generally looks for changes in the tumor that may affect treatment. Hereditary genetic testing looks for inherited changes that may be passed through families, so the purpose and interpretation of the tests are different.
8. Can molecular testing determine lung cancer treatment?
Molecular testing can provide important information for treatment selection, but it does not determine treatment by itself. Doctors also consider the cancer type and stage, pathology, overall health, previous treatment, and other biomarkers before recommending a treatment plan.
9. Can molecular testing find mutations that can be treated with targeted therapy?
Yes. Some molecular alterations are actionable, meaning they may have an approved or clinically appropriate targeted treatment. For example, certain EGFR, ALK, ROS1, BRAF, RET, MET, and other alterations can influence targeted-treatment decisions.
10. What if molecular testing does not find a mutation?
A negative molecular test does not mean that treatment options are unavailable. Doctors can consider other approaches, such as immunotherapy, chemotherapy, radiation therapy, surgery, or combinations of treatments, depending on the patient’s cancer and biomarkers such as PD-L1.