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EGFR Mutations in NSCLC

Testing for EGFR mutations may help inform eligibility for targeted treatment in patients with NSCLC.1

 Lung cancer constellation  Lung cancer constellation
Reading time: 18 min
 
Jump to:
  • Testing Recommendations
  • Prevalence
  • Sample Type
  • Diagnostic Assays
  • Interpreting & Reporting
  • Considerations for Your Practice
  • Helpful Resources

Testing for EGFR Mutations in Lung Cancer Can Help Guide Treatment Decisions2,3

Epidermal growth factor receptor (EGFR) mutations are actionable in non-small cell lung cancer (NSCLC), making them a potential target for therapy. 2

EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer.

Checklist icon light

NCCN Clinical Practice Guidelines In Oncology (NCCN Guidelines®) Recommend Testing for EGFR Mutations in NSCLC Stage IB—IIIA, IIIB (T3, N2) and Stage IV NSCLC3

  1. Resectable NSCLC
  2. Advanced/mNSCLC

Testing for certain biomarkers at diagnosis can help support critical treatment decisions in eligible patients with resectable NSCLC3

Biomarker DNA icon

Why test

To help inform therapeutic decisions.3

Confused individual icon

Whom to test

NCCN Guidelines® recommend testing for EGFR mutations, ALK rearrangements, and PD-L1 status for eligible patients with resectable Stage IB-IIIA, IIIB (T3, N2) NSCLC.3,a

Clinicopathologic features such as ethnicity, smoking status, or histology should NOT be used to select people for testing.3

Laboratory microscope icon

How to test

For EGFR mutations and ALK rearrangements, single-gene and multigene panel options are available.4–6 For PD-L1 expression levels, IHC-based assays are used.7

Importance of testing for EGFR mutations in NSCLC

DNA icon

Why test

To inform therapeutic decisions and eligibility for clinical trials.3

Question icon

Whom to test

NCCN Guidelines® recommend EGFR biomarker testing for all histologic subtypes in people with advanced or mNSCLC.3,b

microscope icon

How to test

Real-time PCR, Sanger sequencing (ideally paired with tumor enrichment), and sequential or concurrent tissue or plasma next-generation sequencing (NGS) are recommended in clinical guidelines to comprehensively identify biomarkers in advanced or mNSCLC – such as EGFR mutations.3

aThe NCCN Guidelines for NSCLC provide recommendations for individual biomarkers that should be tested and recommend testing techniques but do not endorse any specific commercially available biomarker assays or commercial laboratories.3 bNCCN also recommends testing for ALK rearrangements, BRAF mutations, ROS1 gene rearrangements, RET gene rearrangements, MET exon 14–skipping mutations, NTRK1/2/3 gene fusions, KRAS mutations, ERBB2 (HER2) mutations, and PD-L1 status in eligible people with advanced or mNSCLC.3

ALK, anaplastic lymphoma kinase; BRAF, v-Raf murine sarcoma viral oncogene homolog B; EGFR, epidermal growth factor receptor; ERBB2, erb-b2 receptor tyrosine kinase 2; FDA, US Food and Drug Administration; HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; KRAS, v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog; N2, node 2; NCCN, National Comprehensive Cancer Network; NGS, next-generation sequencing; NTRK, neurotrophic tyrosine receptor kinase; NSCLC, non-small cell lung cancer; mNSCLC, metastatic non-small cell lung cancer; MET, mesenchymal-epithelial transition; PD-L1, programmed death-ligand 1; RET, rearranged during transfection; ROS1, ROS proto-oncogene 1, receptor tyrosine kinase; T3, tumor 3.

DNA and patient icon

EGFR Mutations Are One of the Most Common Actionable Oncogenic Drivers in NSCLC8

Diagram representing prevalence of EGFR mutations in NSCLC Diagram representing prevalence of EGFR mutations in NSCLC
Up to

~1 in 5

patients with stage I–III NSCLC may have an EGFR mutation9,10,a

Up to

57%

of patients with stage IB–III EGFRm NSCLC also express PD–L1 at levels ≥1%11,b

PD-L1

EGFRm
&
PD-L1

EGFRm

aPrevalence of EGFR mutations in NSCLC adenocarcinoma was based on data from 2 references: Sholl et al (2015) performed mutation analysis on 1007 cases with confirmed diagnosis of lung adenocarcinoma. Testing was performed on 987 cases for EGFR sensitizing mutations (exon 19 deletions, EGFR L858R mutations, EGFR G719S mutations, EGFR L861Q mutations) and other EGFR mutations (any one or more mutations in EGFR other than those mentioned previously). Out of 987 cases, 331 cases that were analyzed had stage I-III NSCLC. D’Angelo et al (2012) analyzed tumor specimens from a cohort of 1118 people with stage I-III surgically resected lung adenocarcinomas with EGFR exon 19 deletions and L858R mutations only.9,10 bEGFR mutation status and PD-L1 expression overlap was examined in a retrospective analysis of 319 people with EGFRm NSCLC across all stages. EGFR mutations included exon 19 deletions (n=145), exon 21 L858R mutations (n=121), exon 19 nondeletions (n=26), exon 21 non-L858R mutations (n=3), exon 18 mutations (n=12), and exon 20 mutations (n=8). One person had both exon 18 and exon 20 mutations and 3 people had other mutations. PD-L1 expression ≥1% was observed in 86 out of 150 people with stage IB-III EGFRm NSCLC.11

EGFR, epidermal growth factor receptor; EGFRm, epidermal growth factor receptor mutation-positive; NSCLC, non-small cell lung cancer; PD-L1, programmed death-ligand 1.

Diagram representing prevalence of EGFR mutations in NSCLC 2 Diagram representing prevalence of EGFR mutations in NSCLC 2
Up to

~1 in 4

patients with mNSCLC may have an EGFR mutation8,a

Up to

~60%

of patients with EGFRm NSCLC also express PD-L1 at levels ≥1%12–15,b

PD-L1

EGFRm
&
PD-L1

EGFRm

Lung cancer icon

NCCN Guidelines state that:

In mNSCLC, knowing PD-L1 status is not enough to make 1L treatment decisions as targeted therapy for the oncogenic driver should take precedence.3

Lung cancer icon

Increased EGFR signaling promotes tumor cell growth and survival2,16

EGFR mutations may lead to unregulated proliferation and survival of tumor cells, making them a key molecular driver of disease, regardless of disease stage.2,16

aJordan et al (2017) prospectively analyzed a total of 915 tumors from 860 patients with recurrent or metastatic lung adenocarcinoma for mutations in >300 cancer-associated genes using the Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) assay, a hybridization capture-based, next-generation sequencing platform.8 bMazieres et al (2019) was a multicenter, international, retrospective study of 551 patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. 125 patients had an EGFR mutation. D'Incecco et al (2015) was a multicenter, retrospective, Italian study that assessed PD-L1 expression in 125 patients with mNSCLC and EGFR mutations, ALK translocations, or KRAS mutations. 56 patients had an EGFR mutation. Dietel et al (2019) was a multicenter, international, retrospective study that examined PD-L1 expression in 2368 tumor samples with histologically confirmed stage IIIB/IV primary NSCLC as classified by AJCC 7th edition. 448 patients had an EGFR mutation. Brown et al (2019) analyzed PD-L1 expression in 231 samples of untreated EGFR-mutated advanced NSCLC from the FLAURA trial of osimertinib.12–15

1L, first-line; ALK, anaplastic lymphoma kinase; EGFR, epidermal growth factor receptor; EGFRm, epidermal growth factor receptor mutation-positive; ICI, immune checkpoint inhibitor; KRAS, v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog; mNSCLC, metastatic non-small cell lung cancer; NSCLC, non-small cell lung cancer; PD-L1, programmed death ligand-1.

 Laboratory microscope light icon

Consider Sample Type by Specimen and Assay Availability to Maximize Detection of Therapeutically Actionable Mutations

  1. ctDNA testing
  2. Tissue testing

Integrating ctDNA alongside tissue testing may help reduce turnaround time and maximize identification of driver gene mutations in mNSCLC.3,17

Sample type Clinical relevance Limitations
Tissue specimen
(diagnostic biopsy)
  • Tissue specimens (including resections) provide high tumor volume, which may help ensure adequate tissue for molecular testing18
  • Well-established and commonly used at diagnosis when tissue is collected as part of routine workup17,19
  • QNS and/or prolonged turnaround time can delay treatment planning20
Cytology specimen
(diagnostic)
  • Biomarker testing of cytology specimens from pleural fluid can be used as an alternative to tissue testing21
  • Cytology specimens may provide limited material which may pose challenges for pathology22
Liquid biopsy (ctDNA)
  • Minimally invasive, requires only a small amount of blood, and avoids complications of biopsies23
  • Likely to better reflect tumor heterogeneity23
  • Lower tumor burden may decrease sensitivity of ctDNA analysis24
Concurrent liquid biopsy (ctDNA) and tissue biopsy
  • Concurrent testing may:
    • Deliver comprehensive results faster3
    • Help provide actionable results even in cases of tissue QNS25,a
    • Maximize the detection of therapeutically actionable mutations25,26,a,b
    • Reduce time to diagnosis which may result in earlier initiation of appropriate treatment27,c
  • Negative results by one method suggests the use of a complementary method3
  • Lack of standardization and training prevents implementation into clinical routine28
Lung cancer icon

Unlike ctDNA analysis used in mNSCLC, liquid biopsy (ctDNA) molecular testing has not been clinically validated in the resectable NSCLC setting.29,34


Mutation detection in ctDNA may be challenging in the resectable setting due to lower tumor burden and less shedding of tumor DNA.29,34

Tissue testing remains essential in resectable and metastatic settings, while plasma ctDNA is only clinically validated in mNSCLC.19,29

Sample type Clinical relevance Limitations
Tissue specimen
(preoperative biopsy)
  • A preoperative biopsy may be useful for patients with ≥Stage IB NSCLC who may be candidates for systemic therapy prior to surgery3
  • Preoperative biopsy samples may not always be sufficient for both diagnosis and biomarker testing30
Tissue specimen
(surgical resection sample)
  • Surgically resected tissue provides high tumor volume, which may help ensure adequate tissue for molecular testing30
  • Can be painful, invasive, costly, and time consuming31
Cytology specimen
  • Cytology specimens with adequate cellularity and preservation are suitable for biomarker testing according to the CAP/IASLC/AMP guidelines32
  • The diagnosis of NSCLC made on cytology (sputum, TTNA, bronchoscopic specimens, or pleural fluid) is reliable in people suspected of having NSCLC33
    • However, adequate tissue should be obtained to accurately define the histological type and to perform molecular analysis when applicable33
  • Cytology specimens may provide limited material which may pose challenges for pathology22
Lung cancer icon

Mutation detection in ctDNA may be challenging in the resectable setting due to lower tumor burden and less shedding of tumor DNA.29,34

aIn a single center prospective, cohort study of 323 patients with mNSCLC, 229 received concurrent testing. Therapeutically targetable mutations were detected in 113 patients, among whom 66 had the mutation detected in plasma only, 16 patients in tissue only, and 31 patients in plasma and tissue. Mutations for 35 of 113 patients (31%) were detected in plasma only when tissue DNA was insufficient or unavailable, or no mutation was detected in tissue.25 bIn a prospective analysis of 282 patients with previously untreated mNSCLC undergoing physician discretion SOC tissue genotyping and submitted a pre-treatment blood sample for comprehensive cfDNA analysis, the addition of cfDNA testing identified a guideline recommended biomarker in 32% (n=90/282) of patients who otherwise would not have had guideline-complete genotyping.26 cA retrospective study comparing patients with mNSCLC who underwent tissue genotyping alone (n=78) vs patients who underwent concurrent liquid and tissue genotyping (n=42) revealed a shorter mean time to diagnosis when undergoing concurrent testing (33.5 days vs 20.6 days respectively; p<0.001).27

AMP, Association for Molecular Pathology; CAP, College of American Pathologists; cfDNA, cell-free deoxyribonucleic acid; ctDNA, circulating tumor deoxyribonucleic acid; EGFR, epidermal growth factor receptor; IASLC, International Association for the Study of Lung Cancer; mNSCLC, metastatic non-small cell lung cancer; NCCN, National Comprehensive Cancer Network® (NCCN®); NSCLC, non-small cell lung cancer; QNS, quantity not sufficient; SoC, standard of care; TTNA, transthoracic needle aspiration.

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Utilize Diagnostic Assays for EGFR Mutation Testing to Help Inform Treatment Options35

Results may be ready in hours to within 2 weeks, depending on the type of test and where it is donea

Laboratory and test name Genes or alterations assessed Minimum sample requirements Turnaround time
Send-out
smallTube

Foundation Medicine

FoundationOne®CDx5,6,36,b

324 FFPE block or ≥11 unstained slides Median 8.8 days
smallTube

Foundation Medicine

FoundationOne®LiquidCDx37,b

>300 Blood: 2 tubes, 8.5 mL each <2 weeks

Guardant Health

Guardant360® CDx38,39,b

55 Blood: Minimum of 5 mL ≤7 days

Caris® Life Sciences

Caris Molecular Intelligence® Tumor Profiling40,41,b

~23,000 FFPE block or 25 unstained slides 10–14 days

TEMPUS

Tempus xT (RUO)42,43,c

648 FFPE block or 10 unstained slides + 1 H&E slide 9 days

NeoGenomics

NeoTYPE® Lung Tumor Profile (RUO)44,c

Analyzes 49 biomarkers through a combination of methods FFPE tissue (block) 14 days
In house

Thermo Fisher

OncomineTM Dx Target Test45,b

23 10 ng of DNA and RNA from FFPE tissue 4 days

Roche

cobas® EGFR Mutation Test v2 Solid Tumor4,46,47,b

1 1 × 5 μm FFPE tissue section OR 2 mL plasma <8 hours for tissue workflow and <4 hours for plasma workflow

Qiagen

therascreen® EGFR RGQ PCR48,b

1 FFPE clock Not reported

Biocartis

IdyllaTM EGFR Mutation Assay (RUO)49,c

1 1 × 5 μm FFPE tissue section 2.5 hours

Thermo Fisher

Oncomine™ Precision Assay (RUO)50,c

50 10 ng of DNA or RNA 1 day
test tube symbol represents laboratories that offer concurrent testingRepresents laboratories or assays that offer concurrent testing

AstraZeneca is not affiliated with and does not control these websites. Inclusion of a website on AZPrecisionMed.com does not constitute endorsement of its content by the associated organizations.

aThis document is intended as educational information and is not intended as a complete list of available testing options. AstraZeneca is not responsible for any test provider and does not endorse any particular diagnostic test. The accuracy and results of diagnostic tests vary, and AstraZeneca shall have no liability arising from such testing. Information provided herein should in no way be considered a guarantee of coverage, reimbursement, or patient assistance. Providers should contact third-party laboratories for information on their patient assistance programs. While diagnostic testing may assist providers in identifying appropriate treatment for patients, the decision and action should be decided by a provider in consultation with the patient. All products are trademarks of their respective holders, all rights reserved. bFDA approved companion diagnostic. cThis assay is not an FDA-approved companion diagnostic. The listed mutations detected by this assay could be informative for the treatment of NSCLC.

CDx, companion diagnostic; cfDNA, circulating cell-free deoxyribonucleic acid; DNA, deoxyribonucleic acid; EGFR, epidermal growth factor receptor; FDA, US Food and Drug Administration; FFPE, formalin-fixed paraffin-embedded; H&E, hematoxylin and eosin; NSCLC, non-small cell lung cancer; PCR, polymerase chain reaction; RNA, ribonucleic acid; RUO, research use only.

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Browse a selection of major laboratories offering a range of biomarker testing options.

Find a testing lab
This information is intended as educational and is not intended as a complete list of available testing options. AstraZeneca is not responsible for any test provider and does not endorse any particular diagnostic test. The accuracy and results of diagnostic tests vary, and AstraZeneca shall have no liability arising from such testing. Information provided herein should in no way be considered a guarantee of coverage, reimbursement, or patient assistance. Providers should contact third-party laboratories for information on their patient assistance programs. While diagnostic testing may assist providers in identifying appropriate treatment for patients, the decision and action should be decided by a provider in consultation with the patient. All products are trademarks of their respective holders, all rights reserved.

Find a list of FDA cleared or approved companion diagnostics.35

View diagnostic devices
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AstraZeneca is not affiliated with and does not control these websites. Inclusion of a website on AZPrecisionMed.com does not constitute endorsement of its content by the associated organizations.

FDA, US Food and Drug Administration.

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Accurate Interpretation and Reporting of Biomarker Test Results May Help to Ensure an Appropriate Diagnosis51

The American Society of Clinical Oncology has provided guidance on information to include for biomarker test reporting in cancer.

Reports should include basic information about the test such as51:

Elevation arrows

Detection limits

Cells under magnifying glass

Genes and gene regions evaluated

Biomarker detection

Variants detected

  • Including single nucleotide variants, insertion/deletion mutations, copy number variations, gene fusions, and gene expression
Failed biomarker detection

Variants that may not be detected

The College of American Pathologists provides a template for interpreting and reporting results of biomarker testing of specimens from patients with NSCLC.52

View CAP reporting template
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AstraZeneca is not affiliated with and does not control these websites. Inclusion of a website on AZPrecisionMed.com does not constitute endorsement of its content by the associated organizations.

CAP, College of American Pathologists; NSCLC, non-small cell lung cancer.

Guideline document icon

Considerations for Your Practice

Implement EGFR mutation testing protocols or standardize those already in place to ensure all eligible people with NSCLC can receive fully informed treatment options.

  • Follow NCCN Guidelines recommending EGFR testing for eligible patients with resectable stage IB to IIIA and stage IIIB (T3, N2) NSCLC
  • Find solutions to common challenges you may face during biomarker testing

EGFR, epidermal growth factor receptor; NCCN, National Comprehensive Cancer Network; NSCLC, non-small cell lung cancer.

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EGFR, epidermal growth factor receptor; EGFRm, epidermal growth factor receptor mutation-positive; mNSCLC, metastatic non-small cell lung cancer; NSCLC, non-small cell lung cancer.

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  1. Le X, et al. Cancers (Basel). 2023;15(11):2917.
  2. Chevallier M, et al. World J Clin Oncol. 2021;12(4):217–237.
  3. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer. V.11.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed October 22, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org.
  4. Roche Diagnostics. cobas® DNA Sample Preparation Kit. Accessed September 03, 2024. https://diagnostics.roche.com/us/en/products/params/cobas-dna-sample-preparationkit.html
  5. Foundation Medicine. FoundationOne® CDx Specimen Instructions. Accessed September 03, 2024. https://​info​.foundationmedicine.com​/hubfs​/FMI Labels/Foundation​One​_CDx​_Label​_Technical​_Info​.pdf
  6. Foundation Medicine. What is FoundationOne® CDx? Accessed September 03, 2024. https://www.foundationmedicine.com/test/foundationone-cdx
  7. NeoGenomics. PD-L1 22C3 FDA for NSCLC. Accessed September 03, 2024. https://neogenomics.com/test-menu/pd-l1-22c3-fda-nsclc
  8. Jordan EJ, et al. Cancer Discov. 2017;7(6):596–609.
  9. Sholl LM, et al. J Thorac Oncol. 2015;10(5):768–777 + suppl appendix 1&2.
  10. D’Angelo SP, et al. J Thorac Oncol. 2012;7(12):1815–1822[ST2].
  11. Cho JH, et al. Cancer Res Treat. 2018;50(1):95–102.
  12. Mazieres J, et al. Article and supplementary material. Ann Oncol. 2019;30(8):1321–1328.
  13. D’Incecco A, et al. Br J Cancer. 2015;112(1):95–102.
  14. Brown H, et al. J Thorac Oncol. 2020;15(1):138–143.
  15. Dietel M, et al. Lung Cancer. 2019;134:174–179.
  16. Black RC and Khurshid H. R I Med J. 2015;98(10):25–28.
  17. Rolfo C, et al. J Thorac Oncol. 2018;13(9):1248–1268.
  18. Lim C, et al. Curr Oncol. 2017;24(2):103–110.
  19. Ofiara LM, et al. Front Oncol. 2014;4:253.
  20. Gregg JP, et al. Transl Lung Cancer Res. 2019;8(3):286–301.
  21. Ellison G, et al. J Clin Pathol. 2013;66:79–89.
  22. Bubendorf L, et al. Eur Respir Rev. 2017;26(144):170007.
  23. Ilié M and Hofman P. Transl Lung Cancer Res. 2016;5(4):420–423.
  24. Semenkovich NP, et al. J Immunother Cancer. 2023;11:e006284.
  25. Aggarwal C, et al. JAMA Oncol. 2019;5(2):173–180.
  26. Leighl NB, et al. Clin Cancer Res, 2019;25(15):4691–4700.
  27. Maity AP, et al. JCO Oncol Pract. 2023;19:620–625.
  28. Casagrande GMS, et al. Int J Mol Sci. 2023;24:2505.
  29. Chen Y, et al. Neoplasma. 2019;66(4):652–660.
  30. Aggarwal C, et al. Lung Cancer. 2021;162:42–53.
  31. Hirahata T, et al. Cancer Inform. 2022;21:1–7.
  32. Lindeman NI, et al. Arch Pathol Lab Med. 2018;142(3):321–346.
  33. Detterbeck FC, et al. CHEST. 2013;143(suppl 5):7S–37S.
  34. Merker JD, et al. J Clin Oncol. 2018;36(16):1631–1641.
  35. US Food and Drug Administration. List of cleared or approved companion diagnostic devices (in vitro and imaging tools). Accessed September 03, 2024. https://www.fda.gov/medical-devices/in-vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools
  36. Foundation Medicine. FoundationOne® CDx Specimen Instructions. Accessed September 03, 2024. https://www.foundationmedicine.co.uk/content/dam/rfm/uk_v2-en_uk/Downloads/M-GB-00002744_FMI_CDx_Specimen_Instructions.pdf
  37. Foundation Medicine. FoundationOne®Liquid CDx. Accessed September 03, 2024. https://www.foundationmedicine.com/test/foundationone-liquid-cdx#
  38. Guardant Health. FDA Approved Guardant360® CDx. Accessed September 03, 2024. https://www.guardantcomplete.com/products/guardant360-cdx
  39. Guardant Health. Guardant360® CDx Technical Information. Accessed September 03, 2024. https://www.guardantcomplete.com/assets/pdf/Guardant360-CDx-Technical-Information-US.pdf
  40. Caris® Life Sciences. Comprehensive Molecular Profiling. Accessed October 15, 2024. https://www.carislifesciences.com/products-and-services/molecular-profiling/
  41. Caris® Life Sciences. Specimen Preparation Instructions. Accessed September 03, 2024. https://www.carislifesciences.com/wp-content/uploads/2020/08/TN0252-v8_Specimen_Prep_Instructions_hi-rez.pdf
  42. Tempus. Tempus xT Solid Tumor + Normal Match DNA Sequencing. Accessed September 03, 2024. https://www.tempus.com/oncology/genomic-profiling/xt-xr/
  43. Tempus. Specimen Guidelines for Providers. Accessed September 03, 2024. https://www.tempus.com/wp-content/uploads/2024/11/Tempus-Onco_Specimen-Guidelines.pdf
  44. NeoGenomics. NeoTYPE® Lung Tumor Profile. Accessed September 03, 2024. https://neogenomics.com/test-menu/neotype-lung-tumor-profile
  45. ThermoFisher Scientific. Oncomine™ Dx Target Test. Accessed September 18, 2024. https://assets.thermofisher.com/TFS-Assets/LSG/brochures/oncomine-dx-target-test-brochure.pdf
  46. Roche Diagnostics. cobas® EGFR Mutation Test v2. Accessed September 03, 2024. https://diagnostics.roche.com/us/en/products/params/cobas-egfr-mutation-test-v2.html
  47. Roche Diagnostics. cobas® cfDNA Sample Preparation Kit. Accessed September 03, 2024. https://diagnostics.roche.com/us/en/products/params/cobas-cfdna-sample-preparation-kit.html
  48. Qiagen. therascreen® EGFR RGQ PCR kit instructions for use (handbook). Accessed September 03, 2024. https://www.qiagen.com/us/resources/resourcedetail?id=ebc6f982-739f-449f-97e6-bd0b39c08070&lang=en
  49. Biocartis. Technical Sheet Idylla™ EGFR Mutation Assay. Accessed September 03, 2024. https://www.biocartis.com/sites/default/files/2019-11/idylla_egfr_technical_sheet.pdf
  50. ThermoFisher Scientific. Oncomine™ Precision Assay. Accessed September 03, 2024. https://assets.thermofisher.com/TFS-Assets/CSD/Flyers/oncomine-precision-assay-flyer.pdf
  51. Brown NA, et al. Am Soc Clin Oncol Educ Book. 2018;38:708–715.
  52. College of American Pathologists. Cancer protocol templates. Lung biomarker reporting. Accessed September 03, 2024. https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

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