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In the United States, lung cancer remains the leading cause of cancer mortality in both men and women, with more than 50% of patients presenting with locally advanced, inoperable, or metastatic disease. Approximately 33% of patients with non–small-cell lung cancer (NSCLC) present with advanced-stage disease while most patients with early stage NSCLC will eventually develop metastatic lung cancer. Despite the numerous therapeutic options available, only 15% of patients with lung cancer survive beyond 5 years from diagnosis. Recent advances in genetic and histological markers, coupled with emerging targeted agents for NSCLC, have the potential to improve patient outcomes. There also has been much progress in the treatment of advanced NSCLC in the last several years as clinical trials have demonstrated improved outcomes with novel therapeutic agents directed against a wide array of molecular targets. Pathologists function in several broad areas, including as diagnosticians and investigators, and are uniquely positioned to assist oncologists with the development of a comprehensive treatment plan. The following educational activity, which is the second in a series of 4 activities, discusses the latest treatment options and diagnostic markers, using 3 patient cases, to help pathologists improve patient outcomes.


To provide pathologists with up-to-date information on the diagnosis and management of patients with NSCLC.


This activity is designed for pathologists. No prerequisites required.


After completing this activity, the participant will demonstrate the ablity to:

  • Describe the prognostic and predictive role of histologic and immunohistochemical markers in NSCLC therapy, focusing on discussion of new aspects of lung cancer staging by AJCC 7th Edition and the impact of histologic subtype on multiple nodules staging.
  • Based on tumor biology, evaluate current and emerging therapeutic strategies that incorporate targeted agents with chemotherapy for patients with advanced NSCLC.
  • Recognize how gene expression profiling and mutation analysis may help to customize therapy for patients with NSCLC, specifically focusing on the role of mutation analysis and high throughput copy number analysis in resolving problems of synchronous primary tumors versus metastasis.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.


The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Johns Hopkins University School of Medicine is a provider for Self-Assessment Modules as defined by the American Board of Pathology, and has designated this educational activity for a maximum of 1.0 SAM credits.

The estimated time to complete this activity: 1 hour.

Release date: June 1, 2011. Expiration date: June 1, 2013.


The following interactive case activity consists of 3 sections: a pre-test, an interactive case with decision points, and a CME post-test with an evaluation. All 3 sections must be completed to receive CME credit. A certificate of participation will be available online immediately following successful completion of the module.


As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationships have been reported for this activity:

Course Director
Peter B. Illei, MD

Assistant Professor of Pathology
Johns Hopkins School of Medicine
Baltimore, Maryland

Participating Faculty
Alain C. Borczuk, MD

Director and Vice-Chairman for Anatomic Pathology
Professor of Clinical Pathology
Columbia University Medical Center/New York Presbyterian
New York, New York

Participating Faculty Disclosures
Dr Borczuk reports having no relationships with commercial interests related to this activity.

Planner Disclosures
Dr Illei reports receiving grants/research support from Neogenix; serving as a pathology advisory board member for Prometheus Laboratories; and serving as a lecturer for Leica Microsystems.

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).


No faculty member has indicated that their presentation will include information on off-label products.


The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.


The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based activity. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

Supported by an educational grant from Lilly USA, LLC.

procced to pretest

Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.