Pathologist-initiated reflex testing for biomarkers in non-small-cell lung cancer: expert consensus on the rationale and considerations for implementation

Biomarker tests in lung cancer have been traditionally ordered by the treating oncologist upon confirmation of an appropriate pathological diagnosis. The delay this introduces prolongs yet further what is already a complex, multi-stage, pre-treatment pathway and delays the start of first-line system...

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Bibliographic Details
Published in:ESMO open 2023-08, Vol.8 (4), p.101587-101587, Article 101587
Main Authors: Gosney, J.R., Paz-Ares, L., Jänne, P., Kerr, K.M., Leighl, N.B., Lozano, M.D., Malapelle, U., Mok, T., Sheffield, B.S., Tufman, A., Wistuba, I.I., Peters, S.
Format: Article
Language:English
Subjects:
molecular pathology
non-small-cell lung cancer
NSCLC
Original Research
predictive biomarkers
reflex testing
turnaround time
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Summary:Biomarker tests in lung cancer have been traditionally ordered by the treating oncologist upon confirmation of an appropriate pathological diagnosis. The delay this introduces prolongs yet further what is already a complex, multi-stage, pre-treatment pathway and delays the start of first-line systemic treatment, which is crucially informed by the results of such analysis. Reflex testing, in which the responsibility for testing for an agreed range of biomarkers lies with the pathologist, has been shown to standardise and expedite the process. Twelve experts discussed the rationale and considerations for implementing reflex testing as standard clinical practice. •Complete and timely biomarker testing is crucial for selecting first-line systemic therapy for patients with non-small-cell lung cancer.•Reflex testing is expeditious and standardises the ordering of biomarker tests to ensure more patients are tested.•Recent clinical and technological advancements will help to overcome concerns of increased costs and limited reimbursement.•Reflex testing must be governed by a protocol defined by the multidisciplinary team (MDT).•MDT collaboration and engagement with policy makers are required to establish and maintain the reflex testing protocol.
ISSN:2059-7029
2059-7029
DOI:10.1016/j.esmoop.2023.101587