In this episode of The Pathology Report, Pranav Dorwal interviews Professor Wendy Cooper about the recently released evidence-based best practice recommendations for molecular testing in lung cancer. These guidelines were developed by the Royal College of Pathologists of Australasia (RCPA) in collaboration with the Thoracic Oncology Group Australasia (TOGA).

Key Discussion Points:

• Rationale for New Guidelines: Professor Cooper explains the need for Australian-specific guidelines given previous reliance on overseas standards and inconsistencies in local practices. The goal was to ensure uniformity and optimal patient care in molecular testing for lung cancer.
• Collaborative Process: Outlining how the RCPA and TOGA worked together to combine pathology and oncology expertise, emphasising the importance of including oncologists due to the predictive and treatment-focused role of molecular testing.
• Consensus Building and Challenges: The process for reaching consensus within a multidisciplinary advisory group. While most recommendations were unanimous, they also debated how to proceed with molecular testing when the cancer stage is unknown, ultimately recommending testing in such cases to avoid delays in treatment.
• Guidance on Early vs. Advanced Stage Disease: The evolving role of molecular testing in early-stage lung cancer, driven by emerging adjuvant and neoadjuvant therapies. The guidelines recommend biomarker testing for EGFR, ALK, ROS1, and PD-L1 from stage 1B and above.
• Guideline Updates: Professor Cooper states that the guidelines will be formally reviewed every two years, or sooner if significant new evidence emerges.
• Access to Guidelines: Listeners are reminded that the full guidelines are available on the RCPA website and through recent publications in the RCPA journal.

Links & Resources:

• Best practice recommendations: Molecular-Testing-of-Lung-Cancer-28-Feb-2025.pdf.aspx
• Pathology journal article: Molecular testing of lung cancer in Australia: consensus best practice recommendations from the Royal College of Pathologists of Australasia in collaboration with the Thoracic Oncology Group of Australasia – ScienceDirect
• Information for patients: Molecular-Testing-of-Lung-Cancer-Plain-Language-Summary-25.pdf.aspx

The Pathology Report is produced by the Royal College of Pathologists of Australasia and is part of the Talking HealthTech Podcast Network.

Learn more about the RCPA at rcpa.edu.au and discover other shows in the network at talkinghealthtech.com/podcast/network.