Test Details: Lung Cancer is the leading cause of cancer death worldwide. Chemotherapy for non small cell lung carcinoma (NSCLC), accounting for 85% of lung cancer cases, remains marginally effective. Activating mutations in EGFR are present in approximately 10-12% of NSCLC, most of which predict a good response to treatment with EGFR inhibitors such as gefitinib and erlotinib. Exceptions are insertion mutations in exon 20 and the T790M substitution, which confer resistance to these drugs. ALK gene rearrangements are present in approximately 5% of NSCLC, the most common being EML4-ALK fusion. Activation of ALK kinase through these gene fusions can be inhibited by ALK inhibitors such as crizotinib. Gene fusions involving ROS1 are present in 1-2% of NSCLC. ROS1 gene fusions activate ROS kinase which is sensitive to crizotinib. MET gene amplification, detected by FISH, has been associated with unfavourable prognosis in NSCLC and resistance to EGFR inhibitors.