Abstract
With a growing number of clinically relevant biomarkers needed to guide the management of patients with non-small cell lung cancer (NSCLC), pathologists are keenly aware of the need to collect adequate tissue not only for a diagnosis, but also for ancillary studies to provide predictive and prognostic information. Small specimens collected by minimally invasive techniques such as fine needle aspiration and core needle biopsy often fall short in meeting adequacy requirements for lung cancer molecular biomarkers. The College of American Pathologists (CAP) recently published an evidence-based clinical practice guideline, “Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies”, to help direct clinicians and pathology laboratory personnel to optimally collect and handle thoracic small specimens for ancillary testing. This review summarizes the published guideline statements and provides a brief overview of the recommendations and how they impact the practice of pathology.
Highlights
In an era of predictive oncology and precision medicine, pathologists are keenly aware of the need to collect adequate tissue to arrive at a diagnosis and to provide predictive and prognostic information that would guide patient care [1,2,3,4,5]
This is especially true in the realm of non-small cell lung cancer (NSCLC), where biomarker testing is routinely used for the clinical management of patients with advanced stage disease [5,6,7,8]
Small specimens collected by minimally invasive techniques such as fine needle aspiration (FNA) and core needle biopsy (CNB) often fall short in meeting adequacy requirements for a growing list of biomarkers, especially when tested using single gene testing methodologies [11,12,13,14]
Summary
In an era of predictive oncology and precision medicine, pathologists are keenly aware of the need to collect adequate tissue to arrive at a diagnosis and to provide predictive and prognostic information that would guide patient care [1,2,3,4,5] This is especially true in the realm of non-small cell lung cancer (NSCLC), where biomarker testing is routinely used for the clinical management of patients with advanced stage disease [5,6,7,8]. Sixteen guideline statements on the best practices for the acquisition and handling of thoracic small specimens for ancillary studies were developed as part of this effort (Table 1). Reproduced in part and reprinted from “Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies: Guideline from the College of American Pathologists in Collaboration with the American College of Chest Physicians, Association for Molecular Pathology, American Society of Cytopathology, American Thoracic Society, Pulmonary Pathology Society, Papanicolaou. A brief overview of the guideline statements is discussed below
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