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Guidance on when and who to test

  • CAP/IASLC/AMP guidance on when to test

    • Molecular testing should be initiated as soon as a diagnosis of adenocarcinoma is established
    • As an absolute minimum, EGFR, ALK, and ROS1 testing must be offered by all laboratories that test lung cancers

    Lindemann NI et al. Arch Pathol Lab Med. 2018 Mar;142(3):321-346

  • CAP/IASLC/AMP guidance on who to test

    • Mutational testing is strongly recommended in all patients with NSCLC favour adenocarcinomas, regardless of histological grade
    • Physicians may use molecular biomarker testing in tumors with histologies other than adenocarcinoma when clinical features indicate a higher probability of an oncogenic driver.
    • Clinical characteristics should not be used to either select or exclude patients from testing for ROS1 rearrangements.
    • If there are apparently separate primary tumors, each may be tested; testing multiple areas within a single tumor is not necessary
    • Primary tumors and metastatic lesions are equally suitable for testing
    • Testing patients with stage I, II and III disease is encouraged but the decision to do so should be made locally

    Lindemann NI et al. Arch Pathol Lab Med. 2018 Mar;142(3):321-346