Genomic Testing

Gene profile testing, which is done by microarray assay or reverse transcription-polymerase chain, is done for lung cancers. For Lung, there are several Genomic testing data items. These are called Site-Specific Data Items (SSDIs), and are collected for each case.

See Schemas | SSDI and Grade Data for the SSDI manual and the schema information or SEER*RSA in the Lung schema for complete coding instructions for these data items.

Note: For the SSDIs, it is very important that you read the general instructions (see NAAACR link above) first. For example, the general instructions tell you how to code when there is a range, when “less than” or “greater than” is used. After the general instructions are reviewed, you move to the data specific instructions.

More information for these SSDIs can be found in the SSDI Manual.

ALK Rearrangement

ALK may be recorded for all histologies and stages; however, it is primarily performed for advanced non-small cell carcinoma.

ALK helps control cell growth. When cancer cells have the changed ALK gene or make too much ALK protein, the cancer cells grow more quickly. If a patient is ALK+, then the cancer may respond to a targeted inhibitor treatment (Tyrosine Kinase Inhibitor).

ALK can only be determined with microscopic/histological examination. If there is no histological confirmation, then code 9.

EGFR Mutational Analysis

EGFR may be recorded for all histologies and stages; however, it is primarily performed for advanced non-small cell carcinoma.

EGFR is a protein that is involved in the cell pathways that control cell division and survival. If there are changes (mutations) in this protein, may result in higher than normal amounts in cancer cells, which leads to faster division of cells. Blocking EGFR Mutation may keep the cells from dividing.

EGFR can only be determined with microscopic/histological examination. If there is no histological confirmation, then code 9.

PD-L1

PD-L1 may be recorded for all histologies and stages; however, it is primarily performed for advanced non-small cell carcinoma.

Like ALK and EGFR, PD-L1 may indicate that a patient will benefit from a targeted inhibitor in their treatment.

PD-L1 can only be determined with microscopic/histological examination. If there is no histological confirmation, then code 9.

Note: ALK, EGFR and PD-L1, are all recommended by treatment guidelines for patients with advanced lung cancer as a prognostic marker and factor in determining appropriate therapy.

Updated: April 8, 2026