Navigating Molecular Testing Workflow and Turnaround Time in NSCLC

This episode takes up the practical mechanics of molecular testing in community oncology, beginning with turnaround time. The panel compares plasma and tissue-based next-generation sequencing, describing the two as complementary rather than interchangeable, and discusses falling back on tissue when a liquid result is non-diagnostic, along with reimbursement obstacles to sending both at once. Attention shifts to the report itself, which can run to many pages and is easy to misread, particularly when HER2 and ERBB2 appear interchangeably alongside unfamiliar variant notation. The faculty encourage clinicians to call molecular pathology when significance is unclear, framing that call as routine rather than an admission of inexperience. The discussion then covers workflow: reflex testing at diagnosis, nurse and tissue navigators who chase down outside pathology, home-based blood draws, and who orders testing versus who acts on the result. The episode closes on bridging therapy, and why the panel favors withholding immunotherapy while sequencing is pending.