Twitter Chat: Molecular Testing Guideline for the Selection of Lung Cancer Patients

This January 15 #capchat focuses on this updated guideline that strengthens or reaffirms the majority of 2013 recommendations from the CAP, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology for patients with lung adenocarcinoma, and it also recommends testing for some new genes. This guideline continues to set evidence-based standards for clinical molecular testing of non-small cell lung cancers (NSCLC) that effectively guides targeted therapy and treatment.

In addition, this update addresses 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.

• Host: Ziad-El-Zaatari, MD, tweeting from @Pathologists
• Erik Bernicker, MD, FCAP (@EricBernicker)
• Timothy Allen, MD, JD, FCAP (@TimAllenMDJD)

Q1: Are guidelines such as this one standard of care?
Q2: How fast was this guideline developed; and how is it kept current?
Q3: Are pathologists, as well as other physicians, required to follow this guideline?
Q4: How does a doctor use this guideline?
Q5: Which is better: tissue or liquid biopsy?
Q6: Do all lung cancers need molecular testing?
Q7: At what time in the process should testing be performed?
Q8: Why isn’t BRAF included in the “must-test” list of biomarkers?
Q9: Is there a role for liquid biopsy testing in lung cancer?
Q10: What is the role of PD-L1 in lung cancer biomarker testing?
Q11: What do you advise we say to patients who ask about the benefits of this guideline, and how it helps their treatment? 

Note: This Twitter chat will be following a Q&A format. The host, tweeting from @Pathologists, will ask questions or post discussion topics (beginning with Q1, Q2, etc.); the leaders will post answers starting with “A” and the corresponding question number (A1, A2, etc.). Ask your question or comment on one of the discussion questions/answers by referencing the specific discussion question beginning your tweet with “QX”, with X referring to the question number.

Please read the guidelines supporting documents before the #capchat to ensure a robust twitter event.

• Summary of Recommendations (PDF, 204 KB)
• Methodology Supplement (PDF, 796 KB)
• Teaching Presentation (PDF, 687 KB)
• Frequently Asked Questions (PDF, 305 KB)
• Infographic (PDF, 1.6 MB)