special report Recommendations of the Austrian Working Group on Lung Pathology and Oncology 83 1 3 Abstract Te introduction of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for non- small cell lung cancer (NSCLC) with activating mutations of the EGFR has opened a new area of lung cancer treat- ment strategies and led to an enthusiastic search for ad- ditional mutations. Since then, numerous driver muta- tions such as EML4-ALK and ROS1 have been detected and specifc treatment options have already been devel- oped. However, molecular tests have to follow specifc rules if applied in daily practice. Te Austrian Working Group on Pulmonary Pathology and Oncology (AWGP- PO) is presenting an updated version of their previous recommendation published in 2011. Several practical questions raised during the last 2 years will be addressed, such as refex testing, selection of tissues, order of mo- lecular tests, and the issue of resistance mechanisms. Keywords: Algorithm of molecular testing of non-small cell lung cancer, EGFR, EML4-ALK, Targeted therapy, NSCLC memo (2013) 6:83–91 DOI 10.1007/s12254-013-0087-7 Recommendations of the Austrian Working Group on Lung Pathology and Oncology for predictive molecular and immunohistochemical testing in non-small cell lung cancer Helmut H. Popper · Ulrike Gruber-Moesenbacher · Leonhard Müllauer · Georg Hutarew · Michael Vesely ·  Robert Pirker · Wolfgang Hilbe · Ferdinand Ploner · Ulrike Setinek · Wolfgang Hulla · Hans Maier · William Sterlacci · Klaus Kirchbacher · Rainer Kolb · Maximilian Hochmair · Gerald Webersinke · Elvira Stacher · Patricia Grabher · Tamara Hernler H. H.  Popper, MD () · E. Stacher, MD Institute of Pathology, Medical University Graz, Graz, Austria e-mail: helmut.popper@medunigraz.at U. Gruber-Moesenbacher, MD · W. Sterlacci, MD Institute of Pathology, Teaching Hospital Feldkirch, Feldkirch, Austria L. Müllauer, MD Institute of Pathology, Medical University Vienna—AKH, Vienna, Austria G. Hutarew, MD Institute of Pathology, Paracelsus Private Medical University Salzburg, Salzburg, Austria M. Vesely, MD Institute of Pathology, Hospital Hietzing, Vienna, Austria Mag R. Pirker, MD Department of Oncology, Medical University Vienna—AKH, Vienna, Austria W. Hilbe, MD Department of Internal Medicine 5 (Haematology and Oncology), Medical University Innsbruck, Innsbruck, Austria F. Ploner, MD Department of Oncology, Medical University Graz, Graz, Austria Received: 9 January 2013 / Accepted: 15 May 2013 / Published online: 18 June 2013 © Springer-Verlag Wien 2013 U. Setinek, MD · P. Grabher, MD Institute of Pathology, Otto Wagner Hospital, Vienna, Austria W. Hulla, MD Institute of Pathology, Kaiser-Franz-Josef Hospital, Vienna, Austria H. Maier, MD Institute of Pathology, Medical University Innsbruck, Innsbruck, Austria K. Kirchbacher, MD Department of Pulmonology, Otto Wagner Hospital, Vienna, Austria R. Kolb, MD Department of Pulmonology, Hospital Wels-Grieskirchen, Wels, Austria M. Hochmair, MD Department of Pulmonology I, Otto Wagner Hospital, Vienna, Austria G. Webersinke, MD Laboratory of Molecular Biology and Tumorcytogenetics, Internal Medicine I, Hospital of Barmherzige Schwestern, Linz, Austria T. Hernler, MD Department of Pulmonology, Hospital Hohenems, Hohenems, Austria