ASCO Endorses Joint Guideline for Molecular Testing

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The American Society of Clinical Oncology endorsed a joint clinical practice guideline on molecular testing published by the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology.

The guideline focuses on the selection of patients with lung cancer for therapies targeting epidermal growth factor receptor and anaplastic lymphoma kinase, and defines which patients should be offered EGFR and ALK genetic testing, and when and how such testing should be performed.

“This guideline is incredibly important, as it increases the ability to personalize lung cancer care and improve outcomes for patients with advanced lung cancer,” said Natasha Leighl, co-chair of the ASCO expert panel that endorsed the guideline.

“It describes the current evidence and helps oncologists and pathologists understand and put molecular testing into clinical practice,” Leighl said. The endorsement was published in the Journal of Clinical Oncology.

The guideline comprises 37 recommendations, consensus opinions, or suggestions. Key recommendations include: offering EGFR and ALK testing to all patients with lung adenocarcinoma irrespective of characteristics such as gender, race and smoking status; the use of a range of testing methods, provided they meet certain technical requirements, with certain types of tests not recommended; adherence to guidance regarding specimen processing, testing validation, quality assurance, and turnaround times for reporting results.

CAP, IASLC and AMP are currently updating their guideline based on new evidence regarding ALK testing, testing for molecular alterations associated with acquired resistance to EGFR and ALK inhibitors, new markers such as ROS1, RET, ERBB2 (HER2), BRAF, MET and next-generation sequence testing.

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