In this segment, the panelists discuss choosing the most appropriate laboratory for molecular testing. To avoid invalid test results, Alan B. Sandler, MD, recommends a laboratory at an institution that is CLIA certified. Moving forward, he feels there will be less of a need for reference laboratories and more of the testing will be done at larger community centers.

Corey J. Langer, MD, believes that community centers will not be utilized for testing for many more years, due to accuracy concerns. At this time, in the community, Langer notes that test results are generally sent to a central laboratory. However, he points out, even if the results are incredibly accurate they lose some value if they are not ready for 3-5 weeks. On this note, Langer stresses the need for continued dialogue between a community oncologist and their local pathologist.

Mark A. Socinski, MD, and moderator David R. Gandara, MD, touch on the fact that FISH testing for the ALK fusion can be very difficult to perform. In the future, Gandara feels, testing will be done initially with IHC and confirmed using FISH.

In the international community, Anne S. Tsao, MD, points out that many other countries are centralizing their testing. Gandara also adds that in Japan they do not perform FISH testing, all mutations are confirmed using IHC.