Biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

Abstract

In 2011, the Spanish Society of Medical Oncology and the Spanish Society of Pathology started a joint project to establish recommendations on biomarker testing in patients with advanced non-small-cell lung cancer based on the current evidence. Most of these recommendations are still valid, but new evidence requires some aspects to be updated. Specifically, the recommendation about which biomarkers to test in which patients is being amended, and the best way to manage tumour samples and minimum requirements for biomarker test material are defined. Suitable techniques for testing for epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement are also reviewed, and a consensus is reached on which situations warrant re-biopsy.

Updated guidelines for predictive biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

“…The general requirements for a specimen to be optimal are conservation in 10% buffered formalin for 6-12 h for small biopsies and 24-48 h for surgical resections [5], and the presence of at least 50-100 viable cells for IHC studies or fluorescence in situ hybridisation (FISH). For real-time polymerase chain reaction (PCR) tests, a minimum 5% of tumour cells in NSCLCs are recommended [1,6]. This percentage should be increased to 20-30% for direct next-generation sequencing (NGS) studies [7].…”

“…EGFR-TKI inhibitor drugs are currently available, and administration as first-line therapy is standard in the main clinical guidelines [17], since these improve progressionfree survival (PFS) and quality of life when compared to the administration of platinum doublet chemotherapy [17]. Therefore, the recommendations from the last SEOM/SEAP consensus statements are still valid [1]:…”

“…It represents both a significant therapeutic opportunity and a challenge in predictive biomarkers determination. This third consensus statement update guidelines published in 2012 and 2015 focused on predictive biomarker testing in patients with advanced NSCLC [1,2]. The current document is, supported by the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM).…”

Testing for ROS1 in non-small cell lung cancer: a review with recommendations

“…Although this should ideally occur in parallel, this is not possible in all cases. Therefore, in order to save tissue and time, it is wise to cut extra blank sections at the first cutting session [60]. FISH remains the core test for the time being.…”

Non-small cell lung cancer biomarkers and targeted therapy - two faces of the same coin fostered by nanotechnology

“…Currently, there are no FDA-approved anti-KRAS therapies. Several trials have been directed at the specific inhibition of mutant KRAS [40,83,84], where others focused on the inhibition of downstream MAPK and AKT/ PI3K pathways [40,[85][86][87]. Kinase inhibitors (such as MEK or MTOR inhibitors) that target kinases in pathways downstream of RAS may thus be effective against KRAS mutant cells [88].…”