1. EGFR mutation testing Target population: EGFR mutation testing is recommended for all NSCLC patients with a pathological diagnosis of lung adenocarcinoma, adenocarcinoma-containing components and adenocarcinoma differentiation, and is recommended for patients with small biopsy specimens or non-smoking [cancer patients. Laboratory requirements: The laboratory performing the EGFR mutation test should be accredited. The operator performing the test must be a trained technician, and a laboratory quality management system is required to ensure the accuracy of the test results. Specimen type and processing: Tissue specimens from surgical excision and biopsy are the most common types of specimens used for EGFR mutation testing, and it is recommended that tissue specimens are preferred for testing, and standardized processing of tissue specimens can meet the testing requirements. Both primary and metastatic tissue specimens can be used for EGFR mutation detection, and cytological specimens can also be used for detection. The treatment of different specimens should be standardized. Tissue specimens should be fixed with 10% neutral buffered formalin, avoiding acidic and heavy metal ion-containing fixatives. Tumor tissue sections should be reviewed by the pathologist to assess the tumor cell content, and if necessary, the tumor tissue area should be manually cut and scraped under the microscope to ensure that there are sufficient tumor cells to extract DNA. should be re-collected. There should be measures to avoid cross-contamination between tissues of different cases. The processing and quality control of the above specimens should be the responsibility of experienced pathologists, and all specimens should be tested in as short a time as possible. EGFR mutation detection methods: Currently, the most commonly used methods for detecting EGFR mutations are direct sequencing and amplification mutation blocking systems. It is recommended to use EGFR mutation detection kits approved and marketed by authoritative institutions. The test report should include basic personal information of the patient, medical record number, pathological diagnosis, specimen type, tumor cell content (e.g. number or percentage of tumor cells), test method, test results, along with the specimen receipt date and report date, and be reviewed and issued by the test operator and another experienced physician. The EGFR basal mutation type in the test result is named by applying the International Common Human Genome Variation Association nomenclature. 2. Treatment of patients with EGFR-sensitive mutations in advanced NSCLC First-line treatment: First-line treatment with EGFR-TKI drugs is recommended for patients with EGFR-sensitive mutations. Second-line therapy: EGFR-TKI-based therapy is recommended for patients with EGFR-sensitive mutations who have not been treated with EGFR-TKI-based drugs before. Maintenance therapy: Patients with EGFR-sensitive mutations who benefit from first-line chemotherapy may be treated with EGFR-TKI-based maintenance therapy. 3. ALK fusion gene testing Target population: ALK fusion gene testing is recommended for all NSCLC patients with a pathological diagnosis of lung adenocarcinoma, adenocarcinoma-containing components and adenocarcinoma differentiation. Laboratory requirements: The same as those for EGFR mutation testing in this guideline. Specimen type: Histological or cytological specimens from primary or metastatic tumor sites are acceptable for ALK fusion testing, and the specimen handling requirements are the same as for EGFR mutation testing in this guideline. Regardless of the specimen type used, sufficient tumor cells should be ensured, and non-tumor tissues and cells should be excluded as much as possible. The thickness of paraffin tissue section is generally (5±1) μm, and measures should be taken to avoid cross-contamination between tissues of different cases. Experienced pathologists should be responsible for the processing and quality control of the above specimens. All specimens should be tested in as short a time as possible. ALK fusion gene detection method: FISH can specifically and sensitively detect ALK fusion gene, which is currently the classical method for detecting ALK fusion gene and was approved by the FDA as an accompanying diagnostic method for EML4-ALK positive NSCLC when crizotinib was launched. RT-PCR can sensitively detect known types of fusion genes. The Chinese FDA-approved IHC technology platform is highly consistent with FISH. Recommendation: Separate probe labeled FISH technology, RT-PCR and IHC technology platforms approved by authorities can be used to detect ALK fusion genes. Other IHC detection platforms can be used as primary screening tools for ALK fusion genes and are recommended to be confirmed by FISH or RT-PCR methods. The test method and test platform need to be indicated in the test report, and the FISH method needs to indicate the number of tumor cells and the percentage of positive cells. Please refer to the EGFR gene testing section for the requirements of basic information such as patients and specimens. 4. Treatment of patients with ALK fusion gene positive NSCLC Recommendation: Patients with ALK fusion gene positive advanced NSCLC can be treated with crizotinib. The discovery of these two targets, EGFR and ALK, and the development of related drugs have brought the treatment of NSCLC into the era of individualized treatment based on molecular targets, and the detection and treatment for these targets are of great significance. The expert committee will update this guideline periodically as new research findings continue to emerge.