Putting Comprehensive Genomic Profiling into Practice With Advanced Lung Cancer
An expert discusses how molecular profiling has become essential for most solid tumor cancers, particularly in lung cancer, where both tissue- and plasma-based testing using next-generation sequencing help identify actionable genomic targets and monitor resistance patterns.
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The National Comprehensive Cancer Network (NCCN) provides specific recommendations for comprehensive genomic profiling in metastatic non–small cell lung cancer management. These guidelines address the strategic use of plasma testing in relation to tissue samples, outlining pros and cons of each approach. The recommendations emphasize when plasma testing may require reflexive tissue testing, particularly in cases of low tumor fraction where insufficient DNA in plasma necessitates tissue-based analysis to prevent missed results.
Hatim Husain, MD, observes increasing guideline adherence in community practice settings, noting improvements in meeting previously unmet needs for broader testing adoption. However, opportunities for improvement remain, particularly in developing appropriate workflows and educational initiatives. The focus on streamlining clinic flow and completing testing processes requires targeted education about each genomic target’s relevance and practical implementation strategies.
Successful implementation of comprehensive genomic profiling requires systematic workflow optimization and multidisciplinary team coordination. This includes establishing efficient processes for test ordering, result reporting, and clinical decision-making based on molecular findings. The integration of genomic testing into routine clinical practice demands ongoing education and process refinement to ensure timely, comprehensive molecular characterization of advanced lung cancer.
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