Predictive testing is a crucial part of the complete diagnostic process of non-small cell lung cancer (NSCLC) and a necessary requirement in order to determine proper course of treatment. However, the possibilities of testing and the spectrum of examined markers are quickly evolving as a result of the progress in diagnostic and therapeutic possibilities, and as such it is necessary to regularly update the current guidelines to achieve proper standards of care in routine practice.

To provide a complex overview of the current problematics of predictive testing in NSCLC at a molecular level, considering also the evaluation of PD-L1 expression based on the international and national guidelines. To summarize the current state of predictive testing employed in NSCLC in the Czech Republic.

Predictive testing in NSCLC is a part of routine diagnostic practice; however, as a result of the expanding spectrum of diagnostic and therapeutic possibilities, it is undergoing significant development. The existing method of the sequential testing of individual markers is becoming unsuitable; given the increasing number of potential predictors and complex molecular testing, the use of new generation sequencing appears to represent a more suitable solution. The immunohistochemical evaluation of PD-L1 expression is also a necessary part of predictive testing in NSCLC.

Predictive testing in NSCLC is a part of routine diagnostic practice; however, as a result of the expanding spectrum of diagnostic and therapeutic possibilities, it is undergoing significant development. The existing method of the sequential testing of individual markers is becoming unsuitable; given the increasing number of potential predictors and complex molecular testing, the use of new generation sequencing appears to represent a more suitable solution. The immunohistochemical evaluation of PD-L1 expression is also a necessary part of predictive testing in NSCLC.Nowadays, selection of appropriate therapy in patients with lung cancer is based on comprehensive molecular characteristics of their tumors. On molecular level, lung cancer is one of the best described solid tumors. Currently, there are already methods in routine clinical practice that enable a relatively quick, accurate and cost-effective analysis of dozens of genes and thus make it possible to determine a complex molecular characteristic of a tumor. This creates new possibilities to tailor the treatment to the patients to achieve long-term survival with a good quality of life. New technologies bring more and more information and to transform it into the best clinical benefit for the patient can be challenging. This is a place for the multidisciplinary approach in the form of a molecular tumor board. Its role is to try to indicate appropriate therapy based on the identified genetic alteration. Today, dozens of targeted drugs are available and new treatment options are emerging even for genetic alterations, which until now seemed to be undruggable.Decisions about the treatment of a patient with lung cancer depend on the clinical stage of the disease, morphological diagnosis, examination of predictive markers and overall clinical condition; the wishes of a well-informed patient must also be taken into account. read more Accurate diagnosis is essential for the future of a patient with lung cancer. The epidemiology of lung cancer is related to cigarette consumption. The risk of the disease increases with the number of cigarettes smoked. The relative risk for smokers is 22.4, for very heavy smokers with a load of more than 25 packets, it can reach up to 50. Most cases of lung cancer are caught in the advanced stages of the disease, when surgery and sometimes other active treatments are no longer possible. Searching for lung cancer in at-risk groups is essential for reducing lung cancer mortality, leading to the detection of the disease at a low stage when the tumor is operable.All radical S-adenosylmethionine (radical-SAM) enzymes, including the noncanonical radical-SAM enzyme diphthamide biosynthetic enzyme Dph1-Dph2, require at least one [4Fe-4S](Cys)3 cluster for activity. It is well-known in the radical-SAM enzyme community that the [4Fe-4S](Cys)3 cluster is extremely air-sensitive and requires strict anaerobic conditions to reconstitute activity in vitro. Thus, how such enzymes function in vivo in the presence of oxygen in aerobic organisms is an interesting question. Working on yeast Dph1-Dph2, we found that consistent with the known oxygen sensitivity, the [4Fe-4S] cluster is easily degraded into a [3Fe-4S] cluster. Remarkably, the small iron-containing protein Dph3 donates one Fe atom to convert the [3Fe-4S] cluster in Dph1-Dph2 to a functional [4Fe-4S] cluster during the radical-SAM enzyme catalytic cycle. This mechanism to maintain radical-SAM enzyme activity in aerobic environments is likely general, and Dph3-like proteins may exist to keep other radical-SAM enzymes functional in aerobic environments.A variety of chemical substances used in plastic production may be released throughout the entire life cycle of the plastic, posing risks to human health, the environment, and recycling systems. Only a limited number of these substances have been widely studied. We systematically investigate plastic monomers, additives, and processing aids on the global market based on a review of 63 industrial, scientific, and regulatory data sources. In total, we identify more than 10’000 relevant substances and categorize them based on substance types, use patterns, and hazard classifications wherever possible. Over 2’400 substances are identified as substances of potential concern as they meet one or more of the persistence, bioaccumulation, and toxicity criteria in the European Union. Many of these substances are hardly studied according to SciFinder (266 substances), are not adequately regulated in many parts of the world (1’327 substances), or are even approved for use in food-contact plastics in some jurisdictions (901 substances). Substantial information gaps exist in the public domain, particularly on substance properties and use patterns. To transition to a sustainable circular plastic economy that avoids the use of hazardous chemicals, concerted efforts by all stakeholders are needed, starting by increasing information accessibility.