Updated Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment with Targeted Tyrosine Kinase Inhibitors, Methodology and Other Supplemental Materials-Supplemental Materials

Supplemental Materials

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A new guideline developed by various organizations provides recommendations for the molecular testing of lung cancer patients to guide treatment with targeted tyrosine kinase inhibitors. The expert panel that developed the guideline reviewed previous guidelines and conducted a systematic evidence review to identify new evidence. They made reaffirmed recommendations and new recommendations based on the strength of the evidence.<br /><br />The reaffirmed recommendations include the use of molecular testing for genetic targets on lung lesions to guide initial therapy selection, the use of ALK and EGFR molecular testing for lung adenocarcinoma patients, and the use of tissue sparing techniques to preserve tumor tissue for diagnosis and subsequent biomarker testing. It is also recommended that laboratories do not use total EGFR expression by IHC testing to select patients for EGFR-targeted therapy.<br /><br />New recommendations include the performance of ROS1 testing on all advanced stage lung adenocarcinoma patients, the use of ROS1 IHC as a screening test in these patients, and the inclusion of BRAF as part of testing panels when routine testing for EGFR, ALK, and ROS1 is negative.<br /><br />The guideline emphasizes the importance of using formalin-fixed, paraffin-embedded specimens or fresh, frozen, or alcohol-fixed specimens for biomarker testing and assessing the tumor content of each specimen. It also recommends that testing reports include both results and interpretation sections that are easily understandable.<br /><br />The supplemental digital document contains tables summarizing the quality assessment results and study findings related to molecular testing guidelines for different markers. The document also includes a flow diagram describing the search and selection process for the literature review.<br /><br />Overall, the guideline provides evidence-based recommendations for the selection of lung cancer patients for targeted therapy based on molecular testing. It aims to improve personalized care and outcomes for lung cancer patients.

Keywords

molecular testing

lung cancer

targeted therapy

tyrosine kinase inhibitors

genetic targets

ALK

EGFR

ROS1

BRAF

biomarker testing