Challenges and Limitations in Molecular Testing of Resected Non-Small Cell Lung Cancer Specimens

Area of Science:

• Oncology
• Molecular Diagnostics
• Genomics

Background:

• Non-small cell lung cancer (NSCLC) is a leading cause of cancer mortality.
• Molecular diagnostics and targeted therapies have advanced NSCLC treatment.
• Integrating molecular testing into routine care for resected NSCLC presents challenges.

Purpose of the Study:

• To review technical, clinical, and systemic barriers to molecular testing in NSCLC.
• To compare conventional methods with next-generation sequencing (NGS).
• To examine real-world obstacles and emerging innovations.

Main Methods:

• Review of literature on molecular testing in NSCLC.
• Analysis of tissue quality, FFPE limitations, and testing methodologies (IHC, FISH, RT-PCR, NGS).
• Examination of genomic alterations (TP53, KRAS, EGFR, ALK) and their clinical relevance.

Main Results:

• Significant challenges exist in tissue handling, sample adequacy, and testing accessibility.
• Conventional methods and NGS have comparative roles and limitations.
• Common genomic alterations impact prognosis and treatment selection.

Conclusions:

• Overcoming barriers in molecular testing is essential for personalized NSCLC treatment.
• Emerging innovations like liquid biopsy and AI offer future solutions.
• Optimizing tissue handling and testing algorithms can improve patient outcomes and survival.