Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment with TKI

Background

The "Updated Molecular Testing Guideline for the Selection Of Lung Cancer Patients For Treatment With Targeted Tyrosine Kinase Inhibitors (TKI)" continues to set evidence-based standards for clinical molecular testing of non-small cell lung cancers (NSCLC) that effectively guides targeted therapy and treatment.

The College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology followed up their 2013 evidence-based guideline to address the rapid advancements in the understanding of lung cancer, and corresponding growth in available molecularly-targeted therapies. NSCLC patients whose tumors harbor specific molecular alterations may be candidates for targeted TKI therapy, which may improve survival and quality of life.

The updated guideline strengthens or reaffirms the majority of 2013 recommendations for patients with lung adenocarcinoma, and it also recommends testing for some new genes. Most notably, it provides answers to these important clinical questions:

• Which new genes should be tested for lung cancer patients?
• What methods should be used to perform molecular testing?
• Is molecular testing appropriate for lung cancers that do not have an adenocarcinoma component?
• What testing is indicated for patients with targetable mutations who have relapsed on targeted therapy?
• What is the role of testing for circulating cell-free DNA for lung cancer patients?

Stakeholders are encouraged to review the guideline and implement recommendations to guide optimal patient care.

Guideline Information

• Guideline status: Active
• Originally Published: June 2013
• Update published online ahead of print: January 22, 2018
• Published: March 2018

Guideline Tools and Resources

Download the following:

• Summary of Recommendations (PDF, 204 KB)
• Methodology Supplement (PDF, 796 KB)
• Teaching Presentation (PDF, 687 KB)
• Frequently Asked Questions (PDF, 305 KB)
• Infographic (PDF, 1.6 MB)

This guideline was endorsed by the American Society of Clinical Oncology on February 5, 2018.