Lung cancer is the most common cancer worldwide as well as the leading cause of cancer-related mortality.1 Of all the subtypes, non-small cell lung cancer (NSCLC) is the most common, comprising 85% of lung cancers.2,3 Despite the diagnostic and therapeutic advancements, NSCLC prognosis remains grim, with only 17.4% of patients surviving five years past diagnosis.4 Recently, there has been a rapid expansion of our knowledge regarding the molecular pathology of NSCLC that has led to the development of targeted therapies, including those targeting epidermal growth factor receptor (EGFR) mutations -- one of the most frequent “actionable” alterations in NSCLC.5,6 With these advancements and expanded treatment options, including the recent FDA approval of the third-generation EGFR tyrosine kinase inhibitor (TKI), new clinical algorithms that take into account individual patient molecular and clinical profiles are needed.

The National Comprehensive Cancer Network and the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology have recently published guidelines and a consensus statement regarding key pathologic, diagnostic, and therapeutic considerations, including optimal choice of EGFR TKI, the role of repeat biopsies, and use of circulating free DNA.7,8,9 Thus, it is imperative for clinicians to stay up-to-date and understand the molecular pathology of NSCLC, when molecular testing is appropriate, and how to interpret test results to guide therapy. Due to this rapidly evolving nature of NSCLC treatment paradigm, all of the members of the oncology team must be knowledgeable about the safety and efficacy of current and emerging NSCLC therapies.

References
1Ferlay J, et al. Int J Cancer. 2015. 2Ettinger DS, et al. J Natl Compr Canc Netw. 2012. 3George J, et al. Nature. 2015. 4National Cancer Institute. Available at: http://seer.cancer.gov/statfacts/html/lungb/html. 5Cancer Genome Atlas Research. Nature. 2014. 6Berge EM, et al. Semin Oncol. 2014. 7National Comprehensive Cancer Network. Available at: http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. 8Lindeman NI, et al. J Mol Diagn. 2013. 9Tan DS, et al. J Thorac Onco. 2016.