8
Diagnosis
Section 3: Testing for Gene Fusions and Exon Skipping Variants
PCO 3.1
➤ In patients with metastatic or advanced solid tumors, fusion
testing should be performed if there are fusion-targeted therapies
with regulatory approval for that specific disease. (Strong
recommendation)
PCO 3.2.1
➤ Neurotrophic tyrosine receptor kinase (NTRK) fusion testing should
be performed in patients with metastatic or advanced solid tumors
who may be candidates for tyrosine receptor kinase (TRK)-inhibitor
therapy, considering the prevalence of NTRK fusions in individual
tumor types. (Moderate recommendation)
PCO 3.2.2
➤ Testing for other fusions is recommended in patients with
metastatic or advanced solid tumors if no oncogenic driver
alterations are identified on large panel DNA sequencing (Moderate
recommendation)
PCO 3.3
➤ Testing for MET exon 14 skipping should be performed for patients
with all types of non-small cell lung cancer (NSCLC). (Strong
recommendation)
Section 4: Diseases with No Approved Disease-Specific
Markers
PCO 4.1
➤ Genomic testing should be considered to determine candidacy for
tumor-agnostic therapies in patients with metastatic or advanced
solid tumors without approved genomic biomarker-linked therapies.
(Moderate recommendation)
PCO 4.2
➤ For tumors with actionable genomic alterations without approved
genomic biomarker-linked targeted therapies, patient participation in
clinical trials is encouraged after considering the expected efficacy of
available standard-of-care options. (Strong recommendation)
