The College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) are teaming up to revise the evidence-based guideline, “Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors.” The three organizations collaborated in 2013 to develop the original version of the guideline, which addressed which patients and samples should be tested and when and how testing should be performed.
The updated guideline will include new recommendations for ALK testing by IHC, ALK-EGFR resistance, and a number of emerging target molecular targets which will include, but are not limited to, ROS1, MET, ERBB2, RET, and NTRK1. Multiplexed “next generation sequencing” multigene panels and the reassessment of immunohistochemistry will be reviewed. The role of rebiopsy and repeat analysis in the setting of post-treatment relapse, along with testing of blood samples for mutations in circulating tumor cells, cell free tumor DNA, or exosomes will be considered.
The revision of the guideline will be based on evidence from unbiased review of published experimental literature. The revisions will be recommended by an expert panel made up of global leaders in the field. The process will start early this year and take approximately 18 months to complete.
“Although only one year has passed since the molecular testing guideline was published, rapid accumulation of scientific knowledge and new evidence in this field indicate that the guidelines should be updated. Thus, an update has begun that includes an expanded list of genes and new methods that are clinically relevant,” says Yasushi Yatabe, MD, PhD, Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, and IASLC member.
Read the current guidelines on the archives of pathology website
