The molecular analysis of lung cancer patients is becoming more and more complex,” and clinicians therefore need to consider any additional tissue requirements upfront, Dr. Horn commented.

At Vanderbilt University, testing for EGFR, KRAS, and eight other mutations is done using the Lung SnaPshot platform, she explained. If clinicians wish to also test for the ALK, ROS, and RET fusion genes, they must obtain additional tumor specimens for the fluorescence in situ hybridization (FISH) testing used to identify those molecular alterations. “So we need to make sure that we obtain adequate tissue at the time of biopsy to allow molecular testing to be performed,” Dr. Horn noted.

However, new technologies are addressing this logistic challenge. “There are some other platforms, such as Foundation Medicine, where all of these mutations and rearrangements can be performed on a single specimen,” she said. ■