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.
Available molecular test:
- Focus Panel (solid-tumour NGS panel)
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.
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:
- EGFR T790M (Tissue) by Focus Panel (can detect T790M as well as other variants associated with resistance to EGFR-TKI)
- EGFR T790M (Plasma) by ddPCR
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.