Several emerging therapies are being investigated for both NSCLC and SCLC. Therapies that show promise for treating NSCLC include targeted therapies and immunotherapies, while chemotherapies, immunotherapies and targeted therapies also show promise for treating SCLC (Yang et al. 2019; Zhang et al. 2019).

The key principle for precision medicine is prompt and clinically oriented communication and coordination with an accredited laboratory and pathologist. Tissue is integral for emerging therapies and it should be treated carefully to instigate appropriate histopathological or molecular diagnostic tests.

Current and emerging therapies for some subtypes of lung cancer rely on cancer biomarkers. Procedural investigations should ensure adequate samples are obtained for molecular biomarkers where possible. Pathologists should perform minimal ancillary investigations to ensure adequate tissue remains for biomarker testing. Biomarker testing should use the most efficient methodologies and be performed by appropriately accredited laboratories and pathologists.

There is an increasing use of molecular tumour boards to discuss and identify uncommon molecular results for emerging or available precision therapies.

Timeframes for commencing treatment

Initial histopathology/cytology results should be available within three days of sample collection for a diagnosis of cancer, and the turnaround time should be two weeks or less for common molecular biomarker testing.