What is your current practice for obtaining PD-L1 and mutation testing for newly diagnosed metastatic NSCLC?
What specific platforms do you use, individual biomarker/PD-L1 status vs NGS, tissue vs liquid or both?
Must you wait for PD-L1 testing if mutation testing is negative, since you could administer chemo-immunotherapy regardless of PD-L1 level?
Answer from: Medical Oncologist at Academic Institution
PD-L1 testing is done reflexively in my institution. Molecular testing needs to be ordered by oncology. When I see patient in the initial consultation, I already have PD-L1 expression available. I strongly believe in next generation sequencing for my lung cancer patients as it preserves tissue. Curr...
Answer from: Medical Oncologist at Community Practice
What is your current practice for obtaining PD-L1 and mutation testing for newly diagnosed metastatic NSCLC?I order molecular testing at initial diagnosis for all patients with advanced non-squamous non-small cell histology and consider squamous cell histology as well, especially if small samples or...
Answer from: Medical Oncologist at Community Practice
I am a generalist community oncologist with a practice that is primarily lung and GI cancers.
It has become my practice to test ALL locally advanced/metastatic cancers with NGS and PD-L1 up front. In non-squamous mNSCLC, it is more or less mandatory to get the testing done prior to initiation of tr...
Answer from: Medical Oncologist at Academic Institution
This is standard. At this point, we are testing all patients with locally advanced or metastatic NSCLC for PDL1. We obtain molecular markers on all patients with metastatic non-squamous NSCLC, regardless of smoking history, and all never smokers or minimal, past smokers, regardless of histology. I f...
Answer from: Medical Oncologist at Academic Institution
My current practice for a new lung cancer patient is to obtain the following:
Biopsy with PD-L1 staining
Tissue-based DNA NGS for actionable mutations with reflex to RNA-based (Archer) panel if negative (for fusions)
ctDNA testing at the time of presentation (both actionable mutations and...
Answer from: Medical Oncologist at Academic Institution
Currently, I use our in-house OncoPlus next-generation sequencing panel for tissue molecular testing, Guardant for ctDNA, and in-house reflex PD-L1 testing. PD-L1 testing always returns prior to the mutation testing, given it is IHC and returns reflexively at University of Chicago. If tissue was ins...
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Medical Oncologist at Yuma Regional Medical Center Cancer Center PDL-1 and tissue NGS for all mNSCLC.
cfDNA in two...