Lung Cancer Targeted Gene Panel [A Test in Focus]

Therapy selection in lung cancer patients is critical to achieving the best outcomes. Our targeted lung cancer panel assesses for mutations in eight genes, and rearrangements in four genes, including those recommended by the National Comprehensive Cancer Network: EGFR, ROS1, BRAF, and ALK. The results of this panel ensure that physicians have the information they need to target therapy for their patient. This genetic information can also be useful in prognosis.

Kevin Halling, M.D., gives an overview of this test available through Mayo Clinic Laboratories. He discusses when this testing should be ordered, how this testing compares to previous testing approaches, and what clinical action can be taken due to the results of this testing.

Testing

Useful for:

  • Identifying lung tumors that may respond to targeted therapies by assessing multiple gene targets simultaneously in EGFR, BRAF, KRAS, HRAS, NRAS, ALK, ERBB2MET, ALK, ROS1, RET, and NTRK1 genes
  • Diagnosis and management of patients with lung cancer
  • This test is not intended for use for hematological malignancies.

Specimen Requirements

Specimen Type 

Varies

Necessary Information

Pathology report (final or preliminary) at minimum containing the following information mustaccompany specimen in order for testing to be performed:

1. Patient name

2. Block number-must be on all blocks, slides and paperwork (can be handwritten on the paperwork)

3. Tissue collection date

4. Source of the tissue

Specimen Required 

This assay requires at least 20% tumor nuclei.

-Preferred amount of tumor area with sufficient percent tumor nuclei: tissue144 mm(2)

-Minimum amount of tumor area: tissue 36 mm(2)

-These amounts are cumulative over up to 10 unstained slides and must have adequate percent tumor nuclei.

-Tissue fixation: 10% neutral buffered formalin, not decalcified

-For specimen preparation guidance, see Tissue Requirement for Solid Tumor Next-Generation Sequencing in Special Instructions. In this document, the sizes are given as 4mm x 4mm x 10 slides as preferred: approximate/equivalent to 144 mm(2) and the minimum as 3mm x 1mm x 10 slides: approximate/equivalent to 36mm(2).

Preferred:

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block with acceptable amount of tumor tissue.

Acceptable:

Specimen Type: Tissue slide

Slides: 1 stained and 10 unstained

Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides with 5-micron thick sections of the tumor tissue.

Note: The total amount of required tumor nuclei can be obtained by scraping up to 10 slides from the same block.

Specimen Type: Cytology slide (direct smears or ThinPrep)

Slides: 1 to 3 slides

Collection Instructions: Submit 1 to 3 slides stained and cover slipped with a preferred total of 5000 nucleated cells or a minimum of at least 3000 nucleated cells.

Note: Glass coverslips are preferred; plastic coverslips are acceptable but will result in longer turnaround times.

Additional Information: Cytology slides will not be returned.

Performance Information

Day(s) and Time(s) Test Performed 

Monday-Friday, varies

Analytic Time 

12 days

Alyssa Frank

Alyssa Frank

Alyssa Frank is a Marketing Segment Manager at Mayo Clinic Laboratories. She leads marketing strategies for product management and specialty testing. Alyssa has worked at Mayo Clinic since 2015.