Training activity information
Details
Analyse the appropriate genetic tests for circulating tumour referrals, to include:
- NSCLC/EGFR
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 the established clinical indications and guidelines for requesting ctDNA testing for EGFR in NSCLC patients?
- What specific clinical information (e.g., stage of disease, treatment history) is necessary to determine if a ctDNA referral for EGFR testing is appropriate?
- What are some scenarios where ctDNA testing for EGFR in NSCLC might not be the most appropriate initial approach?
- What specific insights do you hope to gain regarding the appropriate use of ctDNA testing for EGFR in NSCLC?
- How will you develop your ability to evaluate referral details and determine if ctDNA testing is the optimal strategy in a given clinical context?
- How will this activity enhance your understanding of the clinical applications and limitations of ctDNA testing
- Will you review clinical guidelines and consensus statements on the use of ctDNA in NSCLC with your training officer?
- What specific referral scenarios will you consider to understand the nuances of appropriateness for ctDNA testing?
- What potential challenges might you encounter when analysing the appropriateness of a ctDNA referral (e.g., insufficient clinical details, unclear prior testing history)? How might you address these?
In action
- How are you currently approaching the analysis of ctDNA results, and what real-time decisions are you making regarding variant allele frequencies (VAF) and the clinical significance of EGFR mutations in the context of the referral?
- What challenges are you encountering in this moment—such as interpreting low-level signals, technical noise, or discordant tissue and liquid biopsy results—and how effectively are you detecting and characterising these mutations while being mindful of liquid biopsy technical considerations?
- How are you managing unexpected results or discrepancies, for instance by seeking specialist advice or investigating lack of clinical correlation, to ensure your analysis accounts for the dynamics of ctDNA and the sensitivity/limitations of the assay used?
On action
- What types of genetic alterations were detected in the ctDNA samples you analysed?
- How did the variant allele frequencies relate to the clinical context (e.g., treatment response, disease monitoring)?
- Were there any technical considerations that impacted the interpretation of the ctDNA results?
- Did you enhance your understanding of the analysis of ctDNA data in the context of NSCLC?
- Did you learn about the specific analytical challenges associated with ctDNA testing?
- How can ctDNA analysis be used to monitor treatment response and detect resistance mechanisms?
- What further learning will you undertake regarding the analysis and interpretation of ctDNA data in oncology?
- How will you account for pre-analytical and analytical factors that can influence ctDNA results?
- How will you communicate the findings of ctDNA analysis in a clinically meaningful way?
Beyond action
- Considering your later experiences, how has your ability to analyse data from circulating tumour DNA testing improved, particularly in the context of EGFR analysis in NSCLC?
- Have you gained a better understanding of the nuances of interpreting ctDNA results, such as the clinical significance of low-level variants or the impact of pre-analytical factors?
- How does your experience in analysing ctDNA data inform your analysis of other liquid biopsy analytes or methodologies?
- As liquid biopsy technologies advance, how will your foundational analytical skills help you to interpret and integrate new types of data derived from circulating biomarkers?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Analyse, interpret and report on genetic testing for circulating tumour referrals. |