Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment With Targeted Tyrosine Kinase Inhibitors-Updated Molecular Testing Guideline

Updated Molecular Testing Guideline - Key Messages

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The College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) have updated and revised their 2013 Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors. The updated guideline sets evidence-based standards for the molecular testing of non-small cell lung cancers (NSCLC) for targeted therapy. The guideline recommends testing for ROS1 mutations for all lung cancer patients and suggests the use of multiplexed genetic sequencing panels for identifying treatment options beyond EGFR, ALK, and ROS1. Other genes such as BRAF, ERBB2, MET, RET, and KRAS are also recommended to be tested when using NGS. Testing for EGFR T790M in relapse is required and can be done by either biopsy or cell-free circulating DNA. The guideline reinforces previous recommendations such as the use of IHC for ALK detection and inclusion of any cytology sample with adequate cancer content. The guideline also addresses molecular testing for lung cancers without an adenocarcinoma component. The guideline was developed by a panel of experts from various disciplines and underwent extensive review and feedback. Clinicians are encouraged to review and adopt the guideline to benefit lung cancer patients. The organizations involved in developing the guideline aim to continually educate stakeholders and improve the quality of diagnostic medicine for lung cancer patients. As the field continues to evolve, updates to the guidelines are anticipated in the future.

Keywords

Molecular Testing Guideline

Lung Cancer Patients

EGFR

ALK

Tyrosine Kinase Inhibitors

ROS1 Mutations

Multiplexed Genetic Sequencing Panels

NGS

EGFR T790M

IHC