Focused lung panel informs the use of targeted cancer therapies    


Test in Focus

Molecular testing is a standard-of-care diagnostic for individuals with non-small cell lung cancer. In this "Test in Focus" episode of the "Answers From the Lab" podcast, Ying-Chun Lo, M.D., Ph.D., explains how Mayo Clinic Laboratories' new MayoComplete Lung Cancer Panel updates a previous assay to better guide clinical decision-making.

"This new assay includes almost all genetic and genomic alterations that are currently associated with FDA-approved targeted therapy for lung cancer — in particular, non-small cell lung cancer," Dr. Lo says. The assay also assesses microsatellite instability, a biomarker for response to checkpoint inhibitor treatment.

The mid-sized lung panel provides more information than single-gene assays and faster results than a comprehensive solid-tumor panel covering hundreds of genes. Mayo Clinic Laboratories validated the new MayoComplete Lung Cancer Panel for use with several types of surgical and cytologic specimens.

"The panel has a very reasonable turnaround time and relatively low material requirements," Dr. Lo says. "We believe it will be the best go-to molecular test for lung cancer in daily community practice."

Listen to learn more about Mayo Clinic Laboratories' updated MayoComplete Lung Cancer Panel.

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Testing

Useful information

MCLNG | MayoComplete Lung Cancer Panel

  • Diagnosis and management of patients with lung cancer
  • Assessment of microsatellite instability
  • Validated on cytology specimens

MCLNM | MayoComplete Lung Cancer Mutations

  • Diagnosis and management of patients with lung cancer
  • Assessment of microsatellite instability
  • Validated on cytology specimens

MCLNR | MayoComplete Lung Rearrangements

  • Identifying lung tumors that may respond to targeted therapies by simultaneously assessing multiple genes involved in rearrangements resulting in fusion transcripts
  • Diagnosis and management of patients with lung cancer

Specimen requirements

MCLNG | MayoComplete Lung Cancer Panel

This assay requires at least 20% tumor nuclei

  • Preferred amount of tumor area with sufficient percent tumor nuclei: tissue 360mm(2)
  • Minimum amount of tumor area: tissue 72mm(2)
  • These amounts are cumulative over up to 15 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 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 wit 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
Additional Information: Unused unstained slides will not be returned

MCLNM | MayoComplete Lung Cancer Mutations

This assay requires at least 20% tumor nuclei

  • Preferred amount of tumor area with sufficient percent tumor nuclei: tissue 216mm(2)
  • Minimum amount of tumor area: tissue 36mm(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 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 wit 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

Additional Information: Unused unstained slides will not be returned

  • 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

MCLNR | MayoComplete Lung Rearrangements

This assay requires at least 10% tumor nuclei

  • Preferred amount of tumor area with sufficient percent tumor nuclei: tissue 72 mm(2)
  • Minimum amount of tumor area: tissue 18 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

Preferred:

  • Specimen Type: Tissue block and cell block
  • Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block or cell block with acceptable amount of tumor tissue

Acceptable

  • Specimen Type: Tissue slides
  • Slides: 1 Stained and 5 unstained
  • Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 5 unstained, nonbaked slides wit 5-micron thick sections of the tumor tissue

Note: The total amount of required tumor nuclei can be obtained by scraping up to 5 slides from the same block

Additional Information: Unused unstained slides will not be returned

  • Specimen Type: Cytology slides (direct smears)
  • Slides: 1 to 3 Slides for smears
  • Collection Instructions: Submit 1 to 3 slides unstained or stained with Diff Quik or Pap 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 used in testing will have everything scraped and not be returned

Performance information

MCLNG | MayoComplete Lung Cancer Panel and MCLNM | MayoComplete Lung Cancer Mutations

Analytic time: 12 days

Days performed: Monday through Friday

MCLNR | MayoComplete Lung Rearrangements

Analytic time: 4 days

Days performed: Varies

The latest from Test in Focus

Barbara J. Toman (@barbaratoman)

Barbara J. Toman

Barbara J. Toman is a Senior Communications Specialist at Mayo Clinic Laboratories. She is also the science writer for Mayo’s Neurosciences Update newsletter, which helps referring physicians to stay informed about Mayo’s treatment and research. Barbara has worked at Mayo Clinic since 2007. She enjoys international travel and cooking.