Molecular Testing for Treatment of Metastatic XXXX : How to Implement Evidence-Based Recommendations.

@entity1 @entity5 @entity1149 @entity2 @entity4207 @entity4149
UNASSIGNED: : The recent discovery of relevant biomarkers has reshaped our approach to therapy selection for @entity1 with @entity1149 . The unprecedented outcomes demonstrated with @entity4149 kinase inhibitors in molecularly defined cohorts of @entity1 has underscored the importance of genetic profiling in this disease. Despite published guidelines on biomarker testing, successful @entity5 genotyping faces significant hurdles at both @entity4207 and community-based practices. Oncologists are now faced with interpreting large-scale genomic data from multiple @entity5 types, possibly making it difficult to stay current with practice @entity2 . In addition, physicians' lack of time, resources, and face-to-face opportunities can interfere with the multidisciplinary approach that is essential to delivery of care. Finally, several challenges exist in optimizing the amount and quality of tissue for molecular testing. Recognizing the importance of biomarker testing, a series of advisory boards were recently convened to address these hurdles and clarify best practices. We reviewed these challenges and established recommendations to help optimize tissue acquisition, processing, and testing within the framework of a multidisciplinary approach. IMPLICATIONS FOR PRACTICE: Although several professional societies have incorporated biomarker testing recommendations into clinical practice guidelines for the diagnosis and management of @entity1149 ( @entity1149 ), health care providers still face considerable challenges when establishing and implementing these standards. Developing and instituting protocols to ensure that all appropriate @entity1 are tested for molecular biomarkers requires communication among the various specialists involved in the care of @entity1 with @entity1149 . This report provides insights into key challenges and recommendations for molecular testing of @entity1 with metastatic @entity1149 , summarized from a multidisciplinary team of experts spanning @entity4207 , community, and integrated health systems.
