Wendy A. Cooper^1,2,3, Benhur Amanuel^4,5,6,7, Caroline Cooper^8,9, Stephen B. Fox^10,11, Jon W.A. Graftdyk¹², Peter Jessup¹³, Sonja Klebe^14,15, Wei-Sen Lam^16,17, Trishe Y-M. Leong^18,19, Zarnie Lwin^20,21, Rachel Roberts-Thomson²², Benjamin J. Solomon^23,24, Rebecca Y. Tay²⁵, Janney L. Wale^{26, 27} Nick Pavlakis^28,29,30

¹Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; ²Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; ³School of Medicine, Western Sydney University, Sydney, NSW, Australia; ⁴Anatomical Pathology, PathWest, Western Australia, Australia; ⁵School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; ⁶School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Australia; ⁷Molecular Anatomical Pathology, PathWest, Western Australia, Australia; ⁸Anatomical Pathology, Pathology Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; ⁹Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia; ¹⁰Pathology, Peter MacCallum Cancer Centre, Parkville, Melbourne, Victoria, Australia; ¹¹Sir Peter MacCallum Department of Oncology and the Collaborative Centre for Genomic Cancer Medicine, University of Melbourne, Parkville, Victoria, Australia; ¹²ALK Positive Australia Inc.; ¹³Anatomical Pathology, Royal Hobart Hospital, Hobart, Tasmania, Australia; ¹⁴Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; ¹⁵SA Pathology, Adelaide, South Australia, Australia; ¹⁶Department of Medical Oncology, Fiona Stanley Hospital, Perth, Western Australia, Australia; ¹⁷WA Regional Clinical Trial Coordinating Centre, WA Country Health Service, Western Australia, Australia; ¹⁸Anatomical Pathology, Melbourne Pathology, Sonic Healthcare, Melbourne, Victoria, Australia; ¹⁹Department of Clinical Pathology, University of Melbourne, Melbourne, Victoria, Australia; ²⁰Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia; ²¹The Prince Charles Hospital, University of Queensland, Chermside, Queensland, Australia; ²²The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; ²³Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; ²⁴Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia; ²⁵Department of Medical Oncology, Royal Hobart Hospital, Hobart, Tasmania, Australia; ²⁶Independent Consumer Advocate, Melbourne, Victoria, Australia; ²⁷Chair of the RCPA Community Advisory Committee, Surry Hills, New South Wales, Australia; ²⁸Department of Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; ²⁹Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; ³⁰The Thoracic Oncology Group of Australasia, Thornbury, Victoria, Australia

Molecular testing of lung cancer is essential for guiding appropriate management, and forms part of routine pathological assessment. Advancements in targeted therapies and immunotherapy have led to changing indications for molecular testing at differing stages of disease as well as addition of multiple new biomarkers, making it difficult for pathologists to keep up to date. To ensure appropriate molecular testing is undertaken to guide optimal patient care, consensus best practice recommendations for molecular biomarker testing in lung cancer have been developed by RCPA in collaboration with the Thoracic Oncology Group of Australasia. Representative pathologists and oncologists from all Australian states, together with consumer representatives, formed a steering committee to develop the guidelines. Sixteen recommendations were established that address which biomarkers should be tested for differing lung cancer subtypes and tumour stage, as well as optimal specimen type, assays and quality assurance. It is envisaged that these multidisciplinary evidence-based recommendations will standardise best practice in molecular testing of lung cancer, ensuring laboratories provide high quality molecular testing for all Australians with lung cancer, including those from regional or remote communities.