Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer
In advanced non-small cell lung cancer (NSCLC), patients with actionable genomic alterations may derive additional clinical benefit from targeted treatment compared to cytotoxic chemotherapy. Current guidelines recommend extensive testing with next generation sequencing (NGS) panels. We investigated...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/7/352 |
| _version_ | 1797440042164027392 |
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| author | Shelley Kuang Andrea S. Fung Kirstin A. Perdrizet Kaitlin Chen Janice J. N. Li Lisa W. Le Michael Cabanero Ola Abu Al Karsaneh Ming S. Tsao Josh Morganstein Laura Ranich Adam C. Smith Cuihong Wei Carol Cheung Frances A. Shepherd Geoffrey Liu Penelope Bradbury Prodipto Pal Joerg Schwock Adrian G. Sacher Jennifer H. Law Tracy L. Stockley Natasha B. Leighl |
| author_facet | Shelley Kuang Andrea S. Fung Kirstin A. Perdrizet Kaitlin Chen Janice J. N. Li Lisa W. Le Michael Cabanero Ola Abu Al Karsaneh Ming S. Tsao Josh Morganstein Laura Ranich Adam C. Smith Cuihong Wei Carol Cheung Frances A. Shepherd Geoffrey Liu Penelope Bradbury Prodipto Pal Joerg Schwock Adrian G. Sacher Jennifer H. Law Tracy L. Stockley Natasha B. Leighl |
| author_sort | Shelley Kuang |
| collection | DOAJ |
| description | In advanced non-small cell lung cancer (NSCLC), patients with actionable genomic alterations may derive additional clinical benefit from targeted treatment compared to cytotoxic chemotherapy. Current guidelines recommend extensive testing with next generation sequencing (NGS) panels. We investigated the impact of using a targeted NGS panel (TruSight Tumor 15, Illumina) as reflex testing for NSCLC samples at a single institution. Molecular analysis examined 15 genes for hotspot mutation variants, including <i>AKT1</i>, <i>BRAF</i>, <i>EGFR</i>, <i>ERBB2</i>, <i>FOXL2</i>, <i>GNA11</i>, <i>GNAQ</i>, <i>KIT</i>, <i>KRAS</i>, <i>MET</i>, <i>NRAS</i>, <i>PDGFRA</i>, <i>PIK3CA</i>, <i>RET</i> and <i>TP53</i> genes. Between February 2017 and October 2020, 1460 samples from 1395 patients were analyzed. 1201 patients (86.1%) had at least one variant identified, most frequently <i>TP53</i> (47.5%), <i>KRAS</i> (32.2%) or <i>EGFR</i> (24.2%). Among these, 994 patients (71.3%) had clinically relevant variants eligible for treatment with approved therapies or clinical trial enrollment. The incremental cost of NGS beyond single gene testing (<i>EGFR</i>, <i>ALK</i>) was CAD $233 per case. Reflex upfront NGS identified at least one actionable variant in more than 70% of patients with NSCLC, with minimal increase in testing cost. Implementation of NGS panels remains essential as treatment paradigms continue to evolve. |
| first_indexed | 2024-03-09T12:02:25Z |
| format | Article |
| id | doaj.art-1eeb191a55df4e19870dc32a209c27eb |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T12:02:25Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-1eeb191a55df4e19870dc32a209c27eb2023-11-30T23:01:50ZengMDPI AGCurrent Oncology1198-00521718-77292022-06-012974428443710.3390/curroncol29070352Upfront Next Generation Sequencing in Non-Small Cell Lung CancerShelley Kuang0Andrea S. Fung1Kirstin A. Perdrizet2Kaitlin Chen3Janice J. N. Li4Lisa W. Le5Michael Cabanero6Ola Abu Al Karsaneh7Ming S. Tsao8Josh Morganstein9Laura Ranich10Adam C. Smith11Cuihong Wei12Carol Cheung13Frances A. Shepherd14Geoffrey Liu15Penelope Bradbury16Prodipto Pal17Joerg Schwock18Adrian G. Sacher19Jennifer H. Law20Tracy L. Stockley21Natasha B. Leighl22Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, CanadaIn advanced non-small cell lung cancer (NSCLC), patients with actionable genomic alterations may derive additional clinical benefit from targeted treatment compared to cytotoxic chemotherapy. Current guidelines recommend extensive testing with next generation sequencing (NGS) panels. We investigated the impact of using a targeted NGS panel (TruSight Tumor 15, Illumina) as reflex testing for NSCLC samples at a single institution. Molecular analysis examined 15 genes for hotspot mutation variants, including <i>AKT1</i>, <i>BRAF</i>, <i>EGFR</i>, <i>ERBB2</i>, <i>FOXL2</i>, <i>GNA11</i>, <i>GNAQ</i>, <i>KIT</i>, <i>KRAS</i>, <i>MET</i>, <i>NRAS</i>, <i>PDGFRA</i>, <i>PIK3CA</i>, <i>RET</i> and <i>TP53</i> genes. Between February 2017 and October 2020, 1460 samples from 1395 patients were analyzed. 1201 patients (86.1%) had at least one variant identified, most frequently <i>TP53</i> (47.5%), <i>KRAS</i> (32.2%) or <i>EGFR</i> (24.2%). Among these, 994 patients (71.3%) had clinically relevant variants eligible for treatment with approved therapies or clinical trial enrollment. The incremental cost of NGS beyond single gene testing (<i>EGFR</i>, <i>ALK</i>) was CAD $233 per case. Reflex upfront NGS identified at least one actionable variant in more than 70% of patients with NSCLC, with minimal increase in testing cost. Implementation of NGS panels remains essential as treatment paradigms continue to evolve.https://www.mdpi.com/1718-7729/29/7/352lung cancernext generation sequencinggenomic alterationsCanada |
| spellingShingle | Shelley Kuang Andrea S. Fung Kirstin A. Perdrizet Kaitlin Chen Janice J. N. Li Lisa W. Le Michael Cabanero Ola Abu Al Karsaneh Ming S. Tsao Josh Morganstein Laura Ranich Adam C. Smith Cuihong Wei Carol Cheung Frances A. Shepherd Geoffrey Liu Penelope Bradbury Prodipto Pal Joerg Schwock Adrian G. Sacher Jennifer H. Law Tracy L. Stockley Natasha B. Leighl Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer Current Oncology lung cancer next generation sequencing genomic alterations Canada |
| title | Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer |
| title_full | Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer |
| title_fullStr | Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer |
| title_full_unstemmed | Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer |
| title_short | Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer |
| title_sort | upfront next generation sequencing in non small cell lung cancer |
| topic | lung cancer next generation sequencing genomic alterations Canada |
| url | https://www.mdpi.com/1718-7729/29/7/352 |
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