历史上,非小细胞肺癌(NSCLC)与不良预后和低5年生存率相关。但在过去10年中,靶向治疗在NSCLC中的应用改善了患者的预后.新的靶向疗法的发展步伐正在加快,与对新的可靶向改变的分子测试的相关需求。随着非小细胞肺癌生物标志物检测的复杂性增加,有必要指导如何管理非小细胞肺癌的液体护理标准,确定实用的分子测试要求,并优化结果报告。由医学肿瘤学代表的多学科专家工作组,病理学,和临床遗传学通过虚拟会议召集,为检测NSCLC新的可靶向改变创建共识建议。工作组强调了准确,及时地测试所有可靶向改变以使用靶向疗法优化疾病管理的重要性。因此,专家小组建议在NSCLC诊断中对所有可靶向改变进行反射性测试,作为综合小组的一部分,使用可以检测所有相关可靶向改变的方法。此外,在对靶向治疗产生耐药性时,应应治疗临床医生的要求进行全面的生物标志物检测.专家多学科工作组还提出了报告建议,以通过治疗临床医生来提高结果的清晰度和易用性,并适应这些改变的临床可操作性的快速发展。NSCLC中所有可靶向改变的分子检测是治疗决策和获得新疗法的关键。这些共识建议旨在作为进一步优化新的可靶向改变的分子测试的指南。
Non-small cell lung cancer (NSCLC) has historically been associated with a poor prognosis and low 5-year survival, but the use of targeted therapies in NSCLC has improved patient outcomes over the past 10 years. The pace of development of new targeted therapies is accelerating, with the associated need for molecular testing of new targetable alterations. As the complexity of biomarker testing in NSCLC increases, there is a need for guidance on how to manage the fluid standard-of-care in NSCLC, identify pragmatic molecular testing requirements, and optimize result reporting. An expert multidisciplinary working group with representation from medical oncology, pathology, and clinical genetics convened via virtual meetings to create
consensus recommendations for testing of new targetable alterations in NSCLC. The importance of accurate and timely testing of all targetable alterations to optimize disease management using targeted therapies was emphasized by the working group. Therefore, the panel of experts recommends that all targetable alterations be tested reflexively at NSCLC diagnosis as part of a comprehensive panel, using methods that can detect all relevant targetable alterations. In addition, comprehensive biomarker testing should be performed at the request of the treating clinician upon development of resistance to targeted therapy. The expert multidisciplinary working group also made recommendations for reporting to improve clarity and ease of interpretation of results by treating clinicians and to accommodate the rapid evolution in clinical actionability of these alterations. Molecular testing of all targetable alterations in NSCLC is the key for treatment decision-making and access to new therapies. These
consensus recommendations are intended as a guide to further optimize molecular testing of new targetable alterations.