CMOCO Forms

LUNG PANEL (all subtypes)2, 3, 4

 

Thoracic Oncology Requistion Form

 

Initial presentation/testing:

Mutations: EGFR, KRAS, BRAF, ERBB2, METex14

Fusions: ALK, ROS1, METex14, NTRK1/2/3

Amplifications: ERBB2, MET by FISH

ICH: PD-L1 (SP263) (If not previously done)

Smoking history (Optional)

 

 

Resistance to targeted therapy:

Mutations: EGFR, KRAS, BRAF, ERBB2, METex14 PLUS kinase domain relevant driver (ALK, ROS1, RET) as indicated by clinical history.

Fusions: ALK, ROS1, METex14, NTRK1/2/3, RET

Amplifications: ERBB2, MET by FISH

 

Relatedness of multiple lesions (multiple primary vs metastasis):

Mutations: Full panel

If truncal mutation negative, reflex to:

Fusions: ALK, ROS1, METex14, NTRK1/2/3, RET

 

Rapid Panel:

Mutations: Rapid EGFR, Rapid KRAS

IHC: ALK, PD-L1 (if not previously done)

Will reflex to initial lung panel if EGFR/KRAS negative

 

Rapid KRAS reflex to panel:

Mutations: Rapid KRAS

if negative, will reflex to initial lung panel.