Molecular classification of lung cancer developed in the past decades to the level
where even the rare genetic alterations are included. Unfortunately, adenocarcinoma
benefited from this development almost exclusively. Furthermore, the tumor-agnostic
novel therapy indications influence the molecular diagnostics of lung cancer including
microsatellite status, tumor mutation burden or NTRK fusion gene determinations. On
the other hand, the still low resection rate of lung cancer and limited availability
of tumor tissue for diagnosis opened the way of routine use of liquid biopsy technologies.
The routine use of target therapies triggered the development of various genetic resistance
mechanisms, the monitoring of which gradually became a standard of monitoring of the
disease. Beside the "targeted" diagnostics, multigene panel testing or whole exome
sequencing are more frequent, resulting in a more complex genetic picture of lung
cancer. This requires the categorization of genetic alterations into predictive levels
for standard, investigational or hypothetic target therapies in the molecular pathology
reports.
