Molecular testing techniques for targetable alterations in non-small cell lung cancer (NSCLC)

	Tissue PCR sequencing	Tissue allele specific PCR sequencing	Tissue FISH	Tissue IHC	Tissue NGS	ctDNA PCR	ctDNA NGS	Tissue RNA
EGFR (sensitizing and T790M)	+	++	0	0	++	+	+	+
HER2 mutation	+	++	0	0	++	+	+	+
METex14 mutation	0	++	0	0	++	+	+	++
BRAF mutation	+	++	0	0	++	+	+	+
KRAS mutation	+	++	0	0	++	+	+	+
ALK rearrangement	0	0	++	++	+	+	+	++
ROS1 rearrangement	0	0	++	0	+	0	+	++
MET amplification	0	0	++	0	+	0	+	+
RET rearrangement	0	0	++	0	+	+	+	++
NTRK fusion	0	0	++	+	+	0	+	++
NRG1 fusion	0	0	++	+	+	0	+	++
HER2 protein expression	0	0	0	++	0	0	0	0
PD-L1 protein expression	0	0	0	++	0	0	0	0

++: Highest sensitivity.
+: Lower sensitivity (higher chance of false negative).
0: Not useful.

ALK: anaplastic lymphoma kinase; ctDNA: circulating tumor DNA; EGFR: epidermal growth factor receptor; FISH: fluorescence in situ hybridization; HER2: human epidermal growth factor receptor 2; IHC: immunohistochemistry; NGS: next generation sequencing; NRG1: neuregulin 1; NTRK: neurotrophic receptor tyrosine kinase; PCR: polymerase chain reaction; PD-L1: programmed cell death-ligand 1.

* FISH is highly sensitive but not recommended due to low yield and no approved targeted therapy.

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Molecular testing techniques for targetable alterations in non-small cell lung cancer (NSCLC)

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