My Treatment Approach: My Treatment Approach: Navigating Genetic Testing and RET-Targeted Treatments in NSCLC - Episode 3

Testing Methodologies and Standards in Metastatic NSCLC

December 17, 2024

Heather A. Wakelee, MD, FASCO, Jacob Sands, MD

Panelists discuss the various tests available for detecting genetic mutations in advanced non–small cell lung cancer (NSCLC), including next-generation sequencing (NGS), reverse transcription polymerase chain reaction (RT-PCR), fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and Sanger sequencing, and explore whether one method is considered the “gold standard” according to the NCCN guidelines. They also address the appropriate use of circulating tumor DNA (ctDNA) testing, comparing it to tissue testing in this disease state.

EP. 1: Patient Case: 67 Year-Old Male With Stage IIIB+ NSCLC Awaiting for Mutation Testing

EP. 2: Next Steps to Stage IIIB NSCLC Patient Case Awaiting Molecular Testing and Usability of Liquid Biopsy

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EP. 3: Testing Methodologies and Standards in Metastatic NSCLC

EP. 4: Practical Considerations in Metastatic NSCLC: Access and Timing of Testing

EP. 5: Clinical-Decision Making: When to Treat Advanced NSCLC Without Mutational Results

EP. 6: Initial Approach to Management of RET-Positive NSCLC

Dr Sands to Dr Wakelee: What tests are available for detecting genetic mutations (ie, NGS, RT-PCR, FISH, IHC, Sanger, etc) in advanced NSCLC?
Is one considered the “gold standard” or preferred compared with the others?
NCCN Guidelines Version 10.2024 Non-Small Cell Lung Cancer
Dr. Wakelee: Describe when circulating tumor DNA (ctDNA) testing is appropriate.
How does it compare to tissue testing in this disease state?