Skip to main content
Top
Published in: memo - Magazine of European Medical Oncology 1/2020

01-03-2020 | NSCLC | special report

The 2020 update of the recommendations of the Austrian working group on lung pathology and oncology for the diagnostic workup of non-small cell lung cancer with focus on predictive biomarkers

Authors: Prof. Helmut H. Popper, M.D., Ulrike Gruber-Mösenbacher, Georg Pall, Leonhard Müllauer, Maximilian Hochmair, Dagmar Krenbek, Luka Brcic, Katja Schmitz, Bernd Lamprecht, Josef Eckmayr, Wolfgang Hilbe, Georg Hutarew, Peter Errhalt, Rainer Kolb, Robert Pirker, Ulrike Setinek, Gerald Webersinke, Gudrun Absenger, Tamara Hernler, Markus Rauter, Richard Wasicky

Published in: memo - Magazine of European Medical Oncology | Issue 1/2020

Login to get access

Summary

The knowledge on molecular alterations in lung cancer have increased during the last decade considerably. Almost every year new genes were detected being targetable, and drugs have been developed and provided for those patients being diagnosed with such a lung cancer. Therefore, it was necessary to update previous recommendations to facilitate a uniform handling for the diagnosis and molecular tests of lung cancer specimen all over Austria. Originally mutation of the epidermal growth factor receptor (EGFR) was the only actionable molecular alteration, now there are more than 10 driver mutations known, and more are detected, and clinical studies are performed. In addition, the technique to test for these mutations have improved, next generation sequencing has opened the option to test several genes in one test. Immuno-oncology has entered the field, and besides the checkpoint death receptor and ligand molecules PD-1/PD-L1 more molecules have been detected and are also tested in clinical studies.
To provide equal opportunities to our patients the tests have to be implemented in all pathological institutes involved in lung cancer management. Because pathologists as part of the tumor board have to explain the diagnosis and the molecular alterations and suggest possible treatment options, the tests should be performed in-house, which will provide the optimal quality control.
Footnotes
1
MIC = mononuclear immune cells: macrophages, lymphocytes, dendritic cells
 
Literature
1.
2.
go back to reference Yatabe Y. RT_PCR and nonmultiplex platforms. In: Hirsch FR, Tsoa MH, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. 2nd ed. North Fort Myers: Editorial Rx PRess; 2016. pp. 63–7. Yatabe Y. RT_PCR and nonmultiplex platforms. In: Hirsch FR, Tsoa MH, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. 2nd ed. North Fort Myers: Editorial Rx PRess; 2016. pp. 63–7.
4.
go back to reference Sequist LV, Neal JW. Personalized, genotype-directed therapy for advanced non-small cell lung cancer. Edited by UpToDate. Waltham, MA: UpToDate, Inc.; 2019. Sequist LV, Neal JW. Personalized, genotype-directed therapy for advanced non-small cell lung cancer. Edited by UpToDate. Waltham, MA: UpToDate, Inc.; 2019.
5.
go back to reference Kashofer K, editor. Tumor mutational burden (TMB) and neoantigens as immunological therapy predictors? 43rd Annual Meeting of the AustrianSociety of Pneumology an of the Austria Thoracic Society; Vienna. 2019. Kashofer K, editor. Tumor mutational burden (TMB) and neoantigens as immunological therapy predictors? 43rd Annual Meeting of the AustrianSociety of Pneumology an of the Austria Thoracic Society; Vienna. 2019.
7.
go back to reference Wistuba I. ALK and ROS1 testing with NGS. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 69–72. Wistuba I. ALK and ROS1 testing with NGS. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 69–72.
9.
go back to reference Böcking AS, Juncker K. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. In: Deutsche Krebsgesellschaft, AWMF, editors. Leitlinienprogramm Onokologie. Langversion 1.0. 2018. pp. 113–26. Böcking AS, Juncker K. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. In: Deutsche Krebsgesellschaft, AWMF, editors. Leitlinienprogramm Onokologie. Langversion 1.0. 2018. pp. 113–26.
10.
go back to reference Thunissen E. ALK testing with IHC. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 25–33. Thunissen E. ALK testing with IHC. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 25–33.
11.
go back to reference Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline focused update. Arch Pathol Lab Med. 2018;142(11):1364–82. https://doi.org/10.5858/arpa.2018-0902-SA.CrossRefPubMed Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline focused update. Arch Pathol Lab Med. 2018;142(11):1364–82. https://​doi.​org/​10.​5858/​arpa.​2018-0902-SA.CrossRefPubMed
12.
go back to reference Krenbek D, editor. Which biomarkers do we need and what can they do? 43rd Annual Meeting of the Austrian Society of Pneumology and of th Austrian Society of thoracic Surgery; Vienna. 2019. Krenbek D, editor. Which biomarkers do we need and what can they do? 43rd Annual Meeting of the Austrian Society of Pneumology and of th Austrian Society of thoracic Surgery; Vienna. 2019.
13.
go back to reference Tsao M. EGFR testing. In: Mok TC, Hirsch FR, editors. IASLC atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 19–26. Tsao M. EGFR testing. In: Mok TC, Hirsch FR, editors. IASLC atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 19–26.
14.
go back to reference Yoshida A. ALK Testing with FISH. 2016. pp. 41–52. Yoshida A. ALK Testing with FISH. 2016. pp. 41–52.
15.
go back to reference Lung Cancer, Nonsmall Cell Lung Cancer (NSCLC)/Bronchialkarzinom (OMIM #211980). In: Bundesministerium Arbeit S, Gesundheit und Konsumentenschutz, editor. Somatische Mutationen – Molekulare Hämatoonkologie, Molekularpathologie. Austria 2018. Lung Cancer, Nonsmall Cell Lung Cancer (NSCLC)/Bronchialkarzinom (OMIM #211980). In: Bundesministerium Arbeit S, Gesundheit und Konsumentenschutz, editor. Somatische Mutationen – Molekulare Hämatoonkologie, Molekularpathologie. Austria 2018.
16.
go back to reference The Netherlands Cancer Institute. Lung Cancer Early Molecular Assessment Trial (LEMA). ClinicalTrialsgov Edited by National Library of Medicine. Bethesda, Maryland: National Institute of Health; 2017. ClinicalTrials.gov Identifier: NCT02894853 The Netherlands Cancer Institute. Lung Cancer Early Molecular Assessment Trial (LEMA). ClinicalTrialsgov Edited by National Library of Medicine. Bethesda, Maryland: National Institute of Health; 2017. ClinicalTrials.gov Identifier: NCT02894853
17.
go back to reference Hochmair MF, Holzer S, Illini O, Setinek U, Krenbek D, Georg B, Draxler H, Weinlinger C, Watzka S, Müller MR, Huemer F, Dworan N, Burghuber OC, Valipour A. EGFR, EML4-ALK, ROS1 and BRAF testing in Austrian patients with NSCLC. In: Department of respiratory and critical care medicine KN-KF. Proceedings of the 43rd Annual Meeting of the Austrian Societies of Pneumology and Thoracic Surgery; Vienna. 2019. Hochmair MF, Holzer S, Illini O, Setinek U, Krenbek D, Georg B, Draxler H, Weinlinger C, Watzka S, Müller MR, Huemer F, Dworan N, Burghuber OC, Valipour A. EGFR, EML4-ALK, ROS1 and BRAF testing in Austrian patients with NSCLC. In: Department of respiratory and critical care medicine KN-KF. Proceedings of the 43rd Annual Meeting of the Austrian Societies of Pneumology and Thoracic Surgery; Vienna. 2019.
20.
go back to reference Marchetti A, Martella C, Felicioni L, Barassi F, Salvatore S, Chella A, et al. EGFR mutations in non-small-cell lung cancer: analysis of a large series of cases and development of a rapid and sensitive method for diagnostic screening with potential implications on pharmacologic treatment. J Clin Oncol. 2005;23(4):857–65. https://doi.org/10.1200/JCO.2005.08.043.CrossRefPubMed Marchetti A, Martella C, Felicioni L, Barassi F, Salvatore S, Chella A, et al. EGFR mutations in non-small-cell lung cancer: analysis of a large series of cases and development of a rapid and sensitive method for diagnostic screening with potential implications on pharmacologic treatment. J Clin Oncol. 2005;23(4):857–65. https://​doi.​org/​10.​1200/​JCO.​2005.​08.​043.CrossRefPubMed
26.
go back to reference Popper HH, Gruber-Mösenbacher U, Müllauer L, Hutarew G, Vesely M, Pirker R, et al. Recommendations of the Austrian working group on lung pathology and oncology for predictive molecular and Immunohisochemical testing in non-small-cell lung cancer. memo. 2013;6:83–91. https://doi.org/10.1007/s12254-013-0087-7 CrossRef Popper HH, Gruber-Mösenbacher U, Müllauer L, Hutarew G, Vesely M, Pirker R, et al. Recommendations of the Austrian working group on lung pathology and oncology for predictive molecular and Immunohisochemical testing in non-small-cell lung cancer. memo. 2013;6:83–91. https://​doi.​org/​10.​1007/​s12254-013-0087-7 CrossRef
27.
go back to reference Aisner D. Reporting, interpretations, and quality assurence. In: Mok TC, Carbone DP, Hirsch FR, editors. IASLC Atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 53–8. Aisner D. Reporting, interpretations, and quality assurence. In: Mok TC, Carbone DP, Hirsch FR, editors. IASLC Atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 53–8.
28.
go back to reference Hochmair MJ, Buder A, Schwab S, Burghuber OC, Prosch H, Hilbe W, et al. Liquid-biopsy-based identification of EGFR T790M mutation-mediated resistance to afatinib treatment in patients with advanced EGFR mutation-positive NSCLC, and subsequent response to Osimertinib. Target Oncol. 2019;14(1):75–83. https://doi.org/10.1007/s11523-018-0612-z.CrossRefPubMed Hochmair MJ, Buder A, Schwab S, Burghuber OC, Prosch H, Hilbe W, et al. Liquid-biopsy-based identification of EGFR T790M mutation-mediated resistance to afatinib treatment in patients with advanced EGFR mutation-positive NSCLC, and subsequent response to Osimertinib. Target Oncol. 2019;14(1):75–83. https://​doi.​org/​10.​1007/​s11523-018-0612-z.CrossRefPubMed
35.
go back to reference Yang J. EGFR gene mutations. In: Mok TC, Carbone DP, Hirsch FR, editors. IASLC atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 33–41. Yang J. EGFR gene mutations. In: Mok TC, Carbone DP, Hirsch FR, editors. IASLC atlas of EGFR testing in lung cancer. North Fort Myers: Editorial Rx Press; 2017. pp. 33–41.
39.
41.
go back to reference Nicholson A. Sample acquisition, processing, and general diagnostic procedures. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. 2nd ed. North Fort Myers: Editorila Rx PRess; 2016. pp. 19–23. Nicholson A. Sample acquisition, processing, and general diagnostic procedures. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. 2nd ed. North Fort Myers: Editorila Rx PRess; 2016. pp. 19–23.
43.
44.
go back to reference Lantuéjoul S. Comparison of different assa platforms for ALK testing. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 73–83. Lantuéjoul S. Comparison of different assa platforms for ALK testing. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 73–83.
47.
go back to reference Thunissen E. Reporting of ALK and ROS1 testing. In: Tsao MS, Hirsch FR, Yasushi Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 91–4. Thunissen E. Reporting of ALK and ROS1 testing. In: Tsao MS, Hirsch FR, Yasushi Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 91–4.
54.
go back to reference Hirsch FR, Tsao MS, et al. Candidates for ALK and ROS1 Testing. In: Tsao MS, Hirsch F, Yasushi Y, editors. IASLC Atlas of ALK and ROS1 Testing in Lung Cancer. Noth Fort Myers: Editorial Rx Press; 2016. pp. 15–8. Hirsch FR, Tsao MS, et al. Candidates for ALK and ROS1 Testing. In: Tsao MS, Hirsch F, Yasushi Y, editors. IASLC Atlas of ALK and ROS1 Testing in Lung Cancer. Noth Fort Myers: Editorial Rx Press; 2016. pp. 15–8.
55.
go back to reference Sholl LY, Nicholson AG, lantejoul S, Hirsch FR, et al. ROS1 Testind with IHC. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 35–40. Sholl LY, Nicholson AG, lantejoul S, Hirsch FR, et al. ROS1 Testind with IHC. In: Tsao MH, Hirsch FR, Yatabe Y, editors. IASLC Atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx PRess; 2016. pp. 35–40.
60.
go back to reference Varella-Garcia M. ROS1 testing with FISH. In: Tsao MS, Hirsch FR, Yatabe Y, editors. IASLC atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 52–62. Varella-Garcia M. ROS1 testing with FISH. In: Tsao MS, Hirsch FR, Yatabe Y, editors. IASLC atlas of ALK and ROS1 testing in lung cancer. North Fort Myers: Editorial Rx Press; 2016. pp. 52–62.
64.
go back to reference Lindeman NI, Cagle PT, Aisner DL, Arcila ME, Beasley MB, Bernicker EH, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: guideline from the college of American pathologists, the international association for the study of lung cancer, and the association for molecular pathology. Arch Pathol Lab Med. 2018;142(3):321–46. https://doi.org/10.5858/arpa.2017-0388-CP.CrossRefPubMed Lindeman NI, Cagle PT, Aisner DL, Arcila ME, Beasley MB, Bernicker EH, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: guideline from the college of American pathologists, the international association for the study of lung cancer, and the association for molecular pathology. Arch Pathol Lab Med. 2018;142(3):321–46. https://​doi.​org/​10.​5858/​arpa.​2017-0388-CP.CrossRefPubMed
79.
go back to reference Bronte GU, Verlicchi A, Cravero P, Delmonte A, Crino L. Targeting RET-rearranged non-small-cell lung cancer: future prospects. Lung Cancer. 2019;10:27–36.PubMedPubMedCentral Bronte GU, Verlicchi A, Cravero P, Delmonte A, Crino L. Targeting RET-rearranged non-small-cell lung cancer: future prospects. Lung Cancer. 2019;10:27–36.PubMedPubMedCentral
Metadata
Title
The 2020 update of the recommendations of the Austrian working group on lung pathology and oncology for the diagnostic workup of non-small cell lung cancer with focus on predictive biomarkers
Authors
Prof. Helmut H. Popper, M.D.
Ulrike Gruber-Mösenbacher
Georg Pall
Leonhard Müllauer
Maximilian Hochmair
Dagmar Krenbek
Luka Brcic
Katja Schmitz
Bernd Lamprecht
Josef Eckmayr
Wolfgang Hilbe
Georg Hutarew
Peter Errhalt
Rainer Kolb
Robert Pirker
Ulrike Setinek
Gerald Webersinke
Gudrun Absenger
Tamara Hernler
Markus Rauter
Richard Wasicky
Publication date
01-03-2020
Publisher
Springer Vienna
Published in
memo - Magazine of European Medical Oncology / Issue 1/2020
Print ISSN: 1865-5041
Electronic ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-019-00565-0

Other articles of this Issue 1/2020

memo - Magazine of European Medical Oncology 1/2020 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine