For patients with advanced stage non-small cell lung cancer (NSCLC), treatment strategies have changed significantly due to the introduction of targeted therapies and immunotherapy. In the last few years, we have seen an explosive growth of newly introduced targeted therapies in oncology and this development is expected to continue in the future. Besides primary targetable aberrations, emerging diagnostic biomarkers also include relevant co-occurring mutations and resistance mechanisms involved in disease progression, that have impact on optimal treatment management. To accommodate testing of pending biomarkers, it is necessary to establish routine large-panel next-generation sequencing (NGS) for all patients with advanced stage NSCLC. For cost-effectiveness and accessibility, it is recommended to implement predictive molecular testing using large-panel NGS in a dedicated, centralized expert laboratory within a regional oncology network. The central molecular testing center should host a regional Molecular Tumor Board and function as a hub for interpretation of rare and complex testing results and clinical decision-making.

Charles University and Thomayer Hospital Prague Czech Republic

Department of Laboratory Medicine Institute of Biomedicine Sahlgrenska Academy of University of Gothenburg Gothenburg Sweden

Department of Oncology University Hospital Antwerp University of Antwerp Edegem Belgium

Department of Pathology and Medical Biology University Medical Center Groningen University of Groningen Groningen the Netherlands

Department of Pathology University Hospital Antwerp University of Antwerp Edegem Belgium

Department of Pulmonary Diseases and Tuberculosis University Medical Center Groningen University of Groningen Groningen the Netherlands

Department of Respiratory and Critical Care Medicine Klinik Floridsdorf Vienna Healthcare Group Vienna Austria

Diagnostic and Research Institute of Pathology Medical University of Graz Graz Austria

Faculty of Medicine of the University of Porto Portugal

IHU RespirERA FHU OncoAge Nice University Hospital Côte d'Azur University Nice France

Institute for Research and Innovation in Health Porto Portugal

Institute of Medical Genetics and Applied Genomics University of Tuebingen Tuebingen Germany

Institute of Molecular Pathology and Immunology of the University of Porto Porto Portugal

Karl Landsteiner Institute of Lung Research and Pulmonary Oncology Klinik Floridsdorf Vienna Austria

Laboratory for Cytology and Pathology University Clinic Golnik Golnik Slovenia

Lung Cancer Group Cologne Department 1 for Internal Medicine and Center for Integrated Oncology Cologne Bonn University Hospital Cologne Cologne Germany

Lung Unit Royal Marsden NHS Trust London England UK

Oncostat U1018 Inserm Paris Saclay University Gustave Roussy Villejuif France

Pulmonology Department Centro Hospitalar Universitário de São João Porto Portugal

The Fingerland Department of Pathology Charles University Medical Faculty and University Hospital Czech Republic

University Clinic of Respiratory and Allergic Diseases Golnik Slovenia

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Costs of biomarker testing in advanced non-small cell lung cancer: a global study comparing next-generation sequencing and single-gene testing

Developments in predictive biomarker testing and targeted therapy in advanced stage non-small cell lung cancer and their application across European countries