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

Lung Cancer Guideline FAQ

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The 2018 Molecular Testing Guideline, jointly issued by the College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP), provides updated recommendations for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors (TKIs). The guideline is based on the strength of available data and expert consensus.<br /><br />The guideline emphasizes the importance of molecular testing for lung cancer patients, as targeted TKI therapy has been shown to significantly improve survival and quality of life for patients with specific molecular alterations. The guideline recommends testing for EGFR and ALK mutations in patients with advanced stage disease, and the use of next generation sequencing (NGS) panels to identify other potential treatment options beyond EGFR and ALK.<br /><br />The guideline also addresses testing methods, stating that tissue-based analysis is preferred, but if not feasible, cell-free DNA assays or plasma testing may be utilized. Immunohistochemistry is recommended as an alternative to fluorescent in situ hybridization (FISH) for ALK testing. However, the use of immunohistochemistry for EGFR mutation testing is not recommended.<br /><br />The guideline also briefly mentions the use of biomarkers for immunomodulatory therapies such as checkpoint inhibitors, stating that separate efforts are currently underway to develop evidence-based recommendations.<br /><br />Compliance with the guideline is not mandatory, but laboratories are encouraged to adopt the recommendations. Future updates to the guideline are anticipated as technology, scientific understanding, and clinical practice evolve.<br /><br />Overall, the guideline provides comprehensive and updated recommendations for molecular testing in the selection of lung cancer patients for targeted TKI therapy, with the aim of improving patient outcomes.

Keywords

Molecular Testing Guideline

2018

College of American Pathologists

International Association for the Study of Lung Cancer

Association for Molecular Pathology

lung cancer

targeted tyrosine kinase inhibitors

EGFR mutations

ALK mutations

next generation sequencing