Tumor Tip of the Week-08-01-2025 “Alk Phos” and “eGFR” are not the same as “ALK” and “EGFR”

08-01-2025

Scenario:

• Pathology:

• RUL Lung bx – pos for invasive adenocarcinoma, mediastinal and hilar nodes positive for mets Comment: NGS ordered will be reported as an addendum
• Addendum #1: ADDITIONAL TESTING: Next generation sequencing (NGS) lung molecular, ALK gene rearrangement Right upper lobe lung, biopsies: Invasive adenocarcinoma:

• Negative for ALK gene rearrangements by FISH

• Addendum: #2 ADDITIONAL TESTING: Polymerase Chain Reaction (PCR) for EGFR mutations: Right upper lobe lung, biopsies: Invasive adenocarcinoma, consistent with lung primary.

• Negative for EGFR mutations by PCR

• Labs:
• ALK PHOS 80 u/L (Range: 53-141) – Normal
• eGFR 50 (Range: >60) – Low

Question: Which values will you use to assign the SSDI’s ALK Rearrangement & EGFR Mutational Analysis?

• Pathology
• Lab

Answer: Pathology

Alk Phos/Alkaline phosphatase & eGFR are blood tests. Alk Phos tests liver function and eGFR tests kidney function. The SSDIs that need to be supported are for mutations in the ALK and EGFR genes. The results come from the primary site and can be found in the path report and their addendums.