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Updated: Feb 24, 2026
Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing
Published on: October 10, 2025
The changing diagnostic pathway for lung cancer patients in Shanghai, China
Tao Jiang1, Shengxiang Ren1, Xuefei Li2
1Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, PR China.
Abstract:
Accumulating evidence suggest that patients with advanced non-small-cell lung cancer (NSCLC) and specific genomic alterations including epidermal growth factor receptor and microtubule-associated protein-like 4 anaplastic lymphoma kinase could significantly benefit from molecular-targeted therapies compared with chemotherapy. Recently, immunotherapy based on programmed cell death 1 (PD-1) and its ligand (PD-L1) blockade prolong survival in patients with advanced NSCLC, especially in those patients with positive expression of PD-L1 and when used in the first-line setting. Therefore, the diagnosis, clinical staging and molecular genotyping must be quick and efficient so that we can make a timely and precise decision for treatment strategy. In our department, it takes a median 4 working days (range 3-6) for a new patient from initial respiratory consultation to treatment decision, whereas in many countries, 14 workdays is considered a reasonable timeline. In this article, we will provide detailed information on the diagnostic pathway for a new patient suspected of having lung cancer to the final treatment decisions in our department.
Insights
Advanced non-small-cell lung cancer (NSCLC) patients benefit from targeted therapies and immunotherapy. Rapid diagnosis, staging, and molecular genotyping are crucial for timely treatment decisions, with our department achieving this in a median of 4 working days.
Area of Science:
- Oncology
- Pulmonology
- Genetics
Background:
- Advanced non-small-cell lung cancer (NSCLC) patients with specific genomic alterations show improved outcomes with molecular-targeted therapies over chemotherapy.
- Immunotherapy, particularly programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) blockade, enhances survival in advanced NSCLC, especially with PD-L1 expression in the first-line setting.
Purpose of the Study:
- To outline the diagnostic pathway for NSCLC patients from initial consultation to treatment decision.
- To highlight the importance of efficient diagnostic processes for timely and precise treatment strategy selection.
- To compare the departmental diagnostic timeline with international standards.
Main Methods:
- Review of the diagnostic workflow for new NSCLC patients within the department.
- Analysis of the time taken from initial respiratory consultation to treatment decision.
- Comparison of the departmental median diagnostic time (4 working days) with the generally accepted 14-workday timeline.
Main Results:
- The department's diagnostic process for NSCLC patients takes a median of 4 working days (range 3-6 days).
- This timeline is significantly faster than the 14-workday standard considered reasonable in many countries.
- Efficient diagnosis, staging, and molecular genotyping are emphasized as critical for treatment decisions.
Conclusions:
- A streamlined diagnostic pathway enables rapid treatment decisions for advanced NSCLC patients.
- The department's efficient process facilitates timely access to potentially life-saving molecular-targeted therapies and immunotherapy.
- Optimizing diagnostic timelines is essential for improving patient outcomes in NSCLC management.
