Communication among multidisciplinary teams in lung cancer diagnostics: full reporting of key data for a better clinical decision making

 

Communication among multidisciplinary teams in lung cancer diagnostics: full reporting of key data for a better clinical decision making

Management of lung cancer in the clinical setting is a team effort in the hands of multidisciplinary tumour boards. Whether we are pulmonologists doing the biopsy work, pathologists doing the molecular testing, or any other specialist involved in a tumour board, we should all be aware that communication among team members is vital to achieve an accurate diagnosis and to make informed clinical decisions.

Dr. John Longshore (Director of Molecular Pathology, Carolinas Pathology Group, North Carolina) stresses the importance of communication between parties. In his view, successful communication among the team always includes reporting preclinical data on the patient and the samples, technical details of the tests used, and relevant results and interpretation of the molecular testing (see table below).

The importance of completeness of reporting is further examined in a panel discussion available online, where Dr. Longshore and other renowned specialists in the field highlight key factors to improve lung cancer diagnostics and overall management of the patients: www.youtube.com/watch?v=zHM6PX4XAwY.

FACTORS TO BE CONSIDERED FOR A COMPLETE REPORTING
Preclinical Results

Patient identification

Names of clinically significant mutations identified

Specimen identification + morphologic characteristics

Incidental findings

Diagnosis and tumour content

Variants of uncertain significance

Histopathologic characteristics that could affect interpretation:

Histopathologic assessment of tumour content for the tumour section tested
 - Extent of necrosis Reason for inconclusive results
 - A typical specimen processing or fixation  - Assay failure
 - Insufficient tumour content  - Insufficient specimen
   - Another reason
Technical Interpretation
Basic methodology Assessment of tumour's likelihood to respond or resist targeted therapy based on mutation present  

Assay sensitivity
Exon(s) sequenced or mutation(s) targeted: T790M Reason for assay failure and requirements for repeating testing  
Statement regarding FDA oversight of LDT
Assay quality control and control results  

Rudy Hovelinck
Diagnostics Manager AstraZeneca

 

NS ID BE-1565-RD05/2018-LB Local code 509

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About the Author

Rudy Hovelinck

Diagnostics Manager AstraZeneca

rudy.hovelinck@astrazeneca.com

M. +32 (0) 476 42 22 58

Rudy Hovelinck obtained a scientific degree first in biochemistry at Ghent University and later in Molecular Biology at the ULB. Initially exploring the academic world in diverse fields as genetics, protein chemistry and virology, he soon realised that bridging scientific knowledge to the medical world was a more meaningful way of spending his professional life. This journey started in the field of pathology biomarker testing, introducing HER2 IHC and ISH testing for patient therapy selection and continued in the field of molecular oncology. Today at AstraZeneca he works as a diagnostics manager. In this role he is passionately contributing to the successful introduction of novel biomarkers and support current testing strategies for patient selection. In his own time he enjoys travelling with his family exploring the world and spending time close to nature. Specialties: Oncology, Anatomic Pathology, Biomarker Development, Medical Devices.