Lung Cancer

Testing is available for Stage IIIB/IV non-small cell, non-neuroendocrine lung adenocarcinoma, for patients both prior to TKI therapy (pre-treatment) as well as following progression on TKI therapy.

Testing is also available for early stage (Stage IB to IIIA) lung cancer, please see the ALTER project webpage for more information.

Pre-treatment

Available molecular test:

Concurrently with the above molecular testing, pre-treatment lung cancer specimens will also be evaluated for PD-L1, ALK and ROS1 by IHC (see the BC Cancer Laboratory Services website for details). Equivocal (1+ or 2+) ALK specimens or positive ROS1 specimens will receive confirmatory FISH testing.

Progression

Targeted testing to detect the T790M TKI-resistance mutation in EGFR is offered for two different specimen types, FFPE surgical specimens (surgical or cytology) and plasma circulating tumour DNA:

The clinical sensitivity of plasma testing is highly dependent upon the release of tumour DNA into the circulation. For this reason, tissue collected post-progression (if available) may be a more informative specimen type for T790M testing.