Requests for Molecular testing must always be discussed at MDT meetings with either Dr Lipsita Patnaik or Dr Danielle Bury More information can be found HERE Specimen Requirements/Instructions for Transportation Internal Requests: Analysis of PD-L1 expression in tumour cells can be used to inform first and second line treatment for NSCLC. Tumours express high levels of cell surface PD-L1 which facilitates evasion of immune cells and allows the tumour cell to proliferate. Programmed death ligand-1 (PD-L1) is a transmembrane protein that is weakly expressed on the cell surface of all healthy cells. Detection of a ROS-1 translocation suggests Crizotinib treatment is likely to inhibit ROS-1 kinase activity in ROS-1 positive NSCLC patients. ROS-1 rearrangements occur in 1-2% of cases of NSCLC. Detection of EGFR mutation status in NSCLC patients is vital for determining the most appropriate treatment regime ROS-1Ĭhromosomal rearrangement can lead to kinase fusions in the ROS-1 oncogene causing the active kinase domain to become constitutively active causing NSCLC. A collection of activating EGFR mutations have been associated with effective TKI treatment, however, other EGFR mutations have been linked with resistance to first and second generation TKIs. In some NSCLC patients, EGFR mutations contribute to tumour cell proliferation. Detection of an ALK translocation advocates first line NSCLC treatment with a suitable tyrosine kinase inhibitor (TKI) treatment, for example Crizotinib EGFR:Įpidermal growth factor receptor (EGFR) is normally associated with cellular proliferation and development. ALK:Īnaplastic Lymphoma Kinase (ALK) gene translocations are present in <2% of non-small cell carcinomas (NSCLC). Currently, the Molecular tests performed by this department focus on lung cancer markers only, these are ALK, EGFR, ROS-1 and PD-L1. The molecular Pathology laboratory is a specialised area of the Histopathology department that investigates treatment options for patients post-diagnosis. Requests, clinical advice and general enquiries can be made by emailing us at: Services offered by the Laboratory Welcome to the Molecular Pathology department.
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