Operationalizing Screening for Non-Small Cell Lung Cancer: An International Discussion - Episode 10
The Logistics of NGS Testing: Reflex vs. Ordered Systems in NSCLC
Experts compare systems for implementing comprehensive biomarker testing. While the ideal is reflex testing—where NGS is automatically ordered upon a cancer diagnosis—billing and healthcare structures often require a manual order. Both agree that integrating test ordering by the diagnosing physician (e.g., the pulmonologist or surgeon) is crucial to ensure results are available when the medical oncologist first sees the patient.
They highlight different models to ensure testing compliance: one center uses a mandatory multidisciplinary tumor board review for every new patient as part of a certification process, while another relies on a large team of specialized thoracic oncologists to follow standard protocols. Both acknowledge systemic pitfalls, such as critical results getting lost when a patient is admitted to a non-oncology service, underscoring the need for streamlined pathways to guarantee every patient receives the personalized therapy they need.