Pathological pathway adaptations for adjuvant osimertinib treatment in patients with early stage NSCLC (IB-IIIA).

Abstract

In recent years, pathological diagnostics have increasingly become an integrated component in a multidisciplinary anatomo-clinical context, of which it is essential to know all the implications in order to manage diagnostic-predictive analyses with maximum effectiveness and efficiency. The encouraging results related to the recent anticipation of the use of TKIs, including osimertinib, from the metastatic setting of non-small cell lung cancer (NSCLC) to the setting of stage IB-IIIA disease, underline the importance of adapting pathologic pathways in order to guarantee the execution of diagnostic investigations, in particular molecular tests, in an increasing proportion of NSCLC patients. In this document, the authors intend to provide simple recommendations regarding the main requirements of the pathological pathway for the appropriate management of this disease. Firstly, the critical issues of the pre-analytical phases concerning both the cytology/biopsy samples and the surgically-resected tissues were highlighted and some solutions were then provided in order to guarantee accuracy, adequacy and sustainability in the innovative approach that will be introduced in clinical practice for NSCLC patients.