Training activity information
Details
Select the correct genetic tests for gene fusion testing on oncology samples to include;
- FISH, e.g. lung cancer
- RT-PCR, e.g. AML, ALL
- RNA fusion panel, e.g. NTRK
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What are gene fusions, and why are they important in oncology? What are some common gene fusions in lung cancer, AML, ALL, and involving NTRK?
- What are the principles, advantages, and limitations of FISH, RT-PCR, and RNA fusion panel testing for detecting gene fusions?
- In what clinical scenarios or cancer types is each of these testing methodologies most appropriate?
- What specific insights do you hope to gain regarding the selection of the most suitable gene fusion testing method for different oncology samples?
- How will you learn to consider factors like turnaround time, sample type, and sensitivity when choosing a gene fusion test?
- Will you discuss specific examples of gene fusions and the preferred testing methods with your training officer or a senior scientist?
- What resources will you review regarding the clinical significance of different gene fusions and the technical aspects of the various detection methods?
- What potential challenges might you encounter in selecting the correct gene fusion test (e.g., limited sample, broad screening vs. targeted approaches)? How might you approach these?
In action
- How are you currently approaching the selection of gene fusion methodologies, and what specific factors—such as tumour type (e.g., lung cancer, AML) or the advantages and limitations of FISH, RT-PCR, and RNA panels—are guiding your choice right now?
- What challenges are you encountering in this moment—such as evaluating the sensitivity and specificity of different platforms or interpreting requests for rare fusions—and how effectively are you matching the clinical need with the most appropriate testing target?
- How are you managing ambiguity or logistical constraints, for instance by deciding on a method when unspecified in a referral or seeking specialist advice, to ensure your selection aligns with available laboratory platforms and critical turnaround times?
On action
- For which cancer types were FISH, RT-PCR, and RNA fusion panels most relevant?
- What were the specific gene fusions being investigated in the examples you considered?
- What are the technical differences between these different methodologies for detecting gene fusions?
- Did you improve your understanding of the clinical significance of gene fusions in different cancers?
- Did you learn about the advantages and disadvantages of FISH, RT-PCR, and RNA fusion panels?
- How do gene fusion results impact diagnosis, prognosis, and treatment strategies?
- How will you determine the most appropriate method for gene fusion testing in different clinical scenarios?
- What resources will you use to stay updated on clinically relevant gene fusions in oncology?
- How do you interpret and report on gene fusion testing results effectively?
Beyond action
- Considering your subsequent learning about the methodologies (FISH, RT-PCR, RNA fusion panels) and their specific applications, how has your understanding of gene fusion testing in oncology deepened?
- Have MDT discussions or case reviews highlighted the clinical significance of specific gene fusions (e.g., NTRK in various cancers) in a way that has changed your initial perspective on test selection?
- How does your experience in selecting gene fusion tests relate to your ability to select other types of molecular diagnostic tests?
- As new fusion partners and targeted therapies emerge, how will the principles learned in this DTA help you navigate the evolving landscape of gene fusion testing?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Apply appropriate sample selection criteria for the commonly referred cancer samples, taking into account the implications of the referral with respect to sample type, sampling mixed cell populations, limits of detection, sensitivity of assay and patient management. |
| # 2 |
Outcome
Select the laboratory testing strategy for the commonly referred cancer samples at all stages of the patient pathway. |