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Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment with Tyrosine Kinase Inhibitors (TKI)

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

Background

The 2018 "Updated Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment with Targeted Tyrosine Kinase Inhibitors (TKI)" sets evidence-based standards for clinical molecular testing of non-small cell lung cancers (NSCLC) that effectively guides targeted therapy and treatment.

We followed up on our 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 2018 guideline update 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: In Review
Originally Published: June 2013
Update published online ahead of print: January 22, 2018
Published: March 2018
Joint partners:
- International Association for the Study of Lung Cancer
- Association for Molecular Pathology