Consensus on Molecular Testing in Lung Cancer

Abstract

Molecular testing for lung cancer has evolved dramatically over the last decade, driven primarily by the rapid development of targeted therapies. Initial testing was intended to make appropriate therapeutic choices with primary single gene testing and has evolved into larger sensitive and specific panels to evaluate multiple genes. The wide array of technologies and an increasing number of targeted therapies have resulted in increasingly complex management algorithms. In this article, we review the current guidelines, briefly discuss individual targets, and introduce some of the complexities associated with genomic testing. We generally recommend next generation sequencing (NGS) panel testing when available and discuss other reasonable alternatives. Circulating tumor assays are commonly utilized, particularly when tissue is unavailable for genomic testing.