The Royal College of Pathologists of Australasia (RCPA), in collaboration with the Thoracic Oncology Group of Australasia (TOGA), has announced new best practice recommendations for Molecular Testing of Lung Cancer in Australia. Developed by a team of leading Australian experts in lung cancer pathology and oncology, these recommendations aim to help lung cancer patients have access to the most appropriate molecular testing to determine optimal personalised treatments so they can live longer and healthier lives with fewer side effects. The best practice recommendations have been launched ahead of the National Lung Cancer Screening program, which will come into effect in July this year.
Lung cancer is Australia’s fifth most diagnosed cancer and is the leading cause of cancer deaths, accounting for more cancer-related deaths than prostate and breast cancer combined. When a person is diagnosed with lung cancer, special molecular (or biomarker) testing is undertaken by pathologists to help determine the most effective treatment pathway. Until now, the absence of best practice recommendations for molecular testing has led to inconsistencies in care. The new best practice recommendations, consisting of 16 specific recommendations, help ensure that all patients across Australia, including those in rural or lower socioeconomic areas, have equitable access to high-quality lung cancer diagnostics.
While international guidelines exist, RCPA President, Associate Professor Trishe Leong, highlighted the importance of tailored recommendations for the Australian healthcare sector.
“Without local recommendations from a trusted source, laboratories, and clinicians may struggle to determine best practice. We hope that these Australian best practice recommendations will improve consistency in molecular testing, align practices with global best standards, and enhance patient care.” Trishe Leong
The best practice recommendations guide on:
- Which molecular tests should be performed based on the type and stage of lung cancer
- When to conduct molecular tests to ensure timely treatment and the possible outcomes
- How to perform molecular tests to maintain high-quality, reliable results.
According to Professor Wendy Cooper, lead author of the best practice recommendations, “Lung cancer treatment has advanced significantly in recent years, resulting in increasingly complex treatment plans. Yet, evidence shows that biomarker-driven therapies can significantly improve survival rates and treatment responses compared to traditional methods. Early and accurate identification of genetic mutations in biomarkers such as EGFR, ALK, ROS1, MET, RET, NTRK, HER2, BRAF, KRAS, and PD-L1 enables patients to receive the most effective care with tailored solutions that are targeted specifically to their tumour, potentially avoiding less effective and toxic treatments.”
Jon Graftdyk, a 50-year-old father from Victoria, was diagnosed with ALK-positive lung cancer in April 2022. ALK-positive lung cancer, a genetic variation accounting for only 3-5% of lung cancer cases, was an unexpected diagnosis for Jon, who was relatively young and had been a non-smoker for over a decade, with only a light smoking history. However, pathology tests identified an ALK-positive biomarker which allowed him to access highly targeted therapy in the form of daily oral medication that inhibits the effects of ALK. Fortunately, this treatment resulted in a complete metabolic response, eliminating all traces of tumours from his body. Although Jon still has stage four cancer, his treatment has allowed him to avoid traditional treatments such as chemotherapy and lead a relatively normal life.
Professor Nick Pavlakis, Medical Oncologist at the Royal North Shore Hospital and Chair of the TOGA Board of Directors said, “These best practice recommendations ensure every lung cancer patient in Australia has access to high-quality molecular testing, leading to more effective, targeted treatments. Standardising testing means faster, more precise care, giving patients the best chance at improved outcomes and quality of life.”
By implementing best practices for molecular testing nationwide, lung cancer patients can avoid unnecessary biopsies, reduce treatment delays, and improve survival outcomes. Pathologists, oncologists, respiratory physicians, and other healthcare professionals are encouraged to adopt these best practice recommendations or review their current diagnostic processes to align with the new recommendations.
Professor Wendy Cooper will officially launch the best practice recommendations at Pathology Update 2025, held at the Melbourne Convention and Exhibition Centre from February 21–23, 2025. The session will take place on Friday, 21 February at 2.45 pm, where Professor Cooper will discuss key insights into the new recommendations and their impact on patient outcomes.
For more information on the molecular testing of lung cancer in Australia best practice recommendations, visit the RCPA website.
