Multidisciplinary Collaboration to Facilitate Pathology-Driven Reflex Testing (OLC)

Course overview

Broad molecular profiling to assess biomarkers that drive treatment decisions are now recommended by guidelines for numerous solid tumors. Pathologists, oncologists, radiologists, histologists, and molecular biologists are all key stakeholders in ensuring biomarker testing is performed according to the guidelines. Multidisciplinary teams must work together to break down the silos across disciplines in order to standardize biomarker testing and improve tissue utilization. Opening up lines of communication throughout the multidisciplinary team is now more important than ever to enable guideline-driven biomarker testing. Turnaround time is critical, as biomarker test results are used to determine appropriate treatment options. Enabling pathologists to order biomarker testing at diagnosis decreases the time to an actionable biomarker result. Biomarker testing algorithms should be developed in conjunction with the multidisciplinary team to facilitate reflexive testing by tumor type. As we move into the age of precision medicine, it is even more essential that we take care to ensure tissue is preserved properly and triaged to ensure biomarker testing can be performed after the diagnosis is rendered. Due to the dearth of tissue available from fine needle aspirates or core needle biopsies, tissue stewardship is necessary to allocate the available tissue appropriately. The multidisciplinary team should also be utilized to address pre-analytical variables affecting the quality of biomarker testing results. It is important to understand how preanalytical variables that occur during tissue processing affect different technologies and how to work together across disciplines to optimize tissue quality and utilization to drive biomarker testing.