Molecular Testing for Selection of Patients With Lung Cancer for Epidermal Growth Factor Receptor and Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitors: American Society of Clinical Oncology Endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology Guideline

• Type of Material: Article
• Authors: Natasha B. Leighl, Princess Margaret Cancer Centre; Natasha Rekhtman, Memorial Sloan Kettering Cancer Center, New York; William A. Biermann, Einstein Medical Center Montgomery, East Norriton, PA; James Huang, Memorial Sloan Kettering Cancer Center, New York; Mari Mino-Kenudson, Massachusetts General Hospital; Suresh Ramalingam, Emory University; Howard West, Swedish Cancer Institute; Sara Whitlock, Free to Breathe, Madison, WI; Mark R. Somerfield, American Society of Clinical Oncology
• Language: English
• Date: 2014-11-10
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2014 by American Society of Clinical Oncology.
• Final Published Version (URL): http://dx.doi.org/10.1200/JCO.2014.57.3055
• Title of Journal or Parent Work: Journal of Clinical Oncology
• Volume: 32
• Issue: 32
• Start Page: 3673
• End Page: 3681
• Grant/Funding Information: None declared
• Keywords: Oncology; Life Sciences & Biomedicine; Lung cancer; Standardization; Epidermal growth factor; Molecular pathology; Science & Technology
• Research Categories: Biology, Molecular; Health Sciences, Pathology; Health Sciences, Oncology

Abstract

Purpose: The College of American Pathologists (CAP), the International Association for the Study of Lung Cancer (IASLC), and the Association for Molecular Pathology (AMP) guideline on molecular testing for the selection of patients with lung cancer for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors was considered for endorsement. Methods: American Society of Clinical Oncology (ASCO) staff reviewed the CAP/IASLC/AMP guideline for developmental rigor; an ASCO ad hoc review panel of experts reviewed the guideline content. Results: The ASCO panel concurred that the recommendations are clear, thorough, and based on the most relevant scientific evidence in this content area and present options that will be acceptable to patients. The CAP/IASLC/AMP guideline comprises 37 recommendations (evidence grade A or B), expert consensus opinions, or suggestions that address the following five principal questions: (1) When should molecular testing be performed? (2) How should EGFR testing be performed? (3) How should ALK testing be performed? (4) Should other genes be routinely tested in lung adenocarcinoma? (5) How should molecular testing be implemented and operationalized? Conclusion: The ASCO review panel endorses the CAP/IASLC/AMP guideline. This guideline represents an important advance toward standardization of EGFR and ALK testing practices and is of major clinical relevance in advancing the care of patients with lung cancer. In the Discussion section, the ASCO review panel highlights three evolving areas: advances in ALK testing methodology, considerations for selecting appropriate populations for molecular testing, and emergence of other targetable molecular alterations.