[Molecular diagnostics of lung cancer and its clinical relevance].

Abstract

Molecular classification of lung cancer developed in the past decades to the level where even the rare genetic alterations are included. Unfortunately, adenocarcinoma benefited from this development almost exclusively. Furthermore, the tumor-agnostic novel therapy indications influence the molecular diagnostics of lung cancer including microsatellite status, tumor mutation burden or NTRK fusion gene determinations. On the other hand, the still low resection rate of lung cancer and limited availability of tumor tissue for diagnosis opened the way of routine use of liquid biopsy technologies. The routine use of target therapies triggered the development of various genetic resistance mechanisms, the monitoring of which gradually became a standard of monitoring of the disease. Beside the "targeted" diagnostics, multigene panel testing or whole exome sequencing are more frequent, resulting in a more complex genetic picture of lung cancer. This requires the categorization of genetic alterations into predictive levels for standard, investigational or hypothetic target therapies in the molecular pathology reports.