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Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors
Published on: September 20, 2016
Multi-marker Solid Tumor Panels Using Next-generation Sequencing to Direct Molecularly Targeted Therapies
Michael Marrone1, Kelly K Filipski1, Elizabeth M Gillanders1
1Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Rockville, Maryland, USA.
Abstract:
In contemporary oncology practices there is an increasing emphasis on concurrent evaluation of multiple genomic alterations within the biological pathways driving tumorigenesis. At the foundation of this paradigm shift are several commercially available tumor panels using next-generation sequencing to develop a more complete molecular blueprint of the tumor. Ideally, these would be used to identify clinically actionable variants that can be matched with available molecularly targeted therapy, regardless of the tumor site or histology. Currently, there is little information available on the post-analytic processes unique to next-generation sequencing platforms used by the companies offering these tests. Additionally, evidence of clinical validity showing an association between the genetic markers curated in these tests with treatment response to approved molecularly targeted therapies is lacking across all solid-tumor types. To date, there is no published data of improved outcomes when using the commercially available tests to guide treatment decisions. The uniqueness of these tests from other genomic applications used to guide clinical treatment decisions lie in the sequencing platforms used to generate large amounts of genomic data, which have their own related issues regarding analytic and clinical validity, necessary precursors to the evaluation of clinical utility. The generation and interpretation of these data will require new evidentiary standards for establishing not only clinical utility, but also analytical and clinical validity for this emerging paradigm in oncology practice.
Insights
Next-generation sequencing tumor panels offer a molecular blueprint for cancer treatment. However, limited data exists on their clinical validity and impact on patient outcomes for targeted therapies.
Area of Science:
- Oncology
- Genomics
- Molecular Biology
Background:
- Contemporary oncology increasingly focuses on evaluating multiple genomic alterations in tumor-driving pathways.
- Commercially available tumor panels utilizing next-generation sequencing (NGS) aim to create comprehensive molecular tumor blueprints.
- The goal is to match actionable variants with targeted therapies, irrespective of tumor origin.
Purpose of the Study:
- To review the current state of post-analytic processes for NGS tumor panels.
- To assess the existing evidence for the clinical validity of these panels in solid tumors.
- To highlight the need for new evidentiary standards for NGS-based oncology diagnostics.
Main Methods:
- Review of current literature on next-generation sequencing tumor panels.
- Analysis of data regarding post-analytic processes and clinical validity.
- Examination of existing research on treatment response and patient outcomes.
Main Results:
- Limited information is available on the post-analytic procedures specific to NGS platforms used in commercial tumor testing.
- Evidence demonstrating the clinical validity of genetic markers in these panels, linking them to treatment response for targeted therapies, is scarce across solid tumor types.
- No published data currently supports improved patient outcomes when using these commercial NGS tests for treatment guidance.
Conclusions:
- Next-generation sequencing tumor panels present unique challenges regarding analytical and clinical validity.
- Establishing robust evidentiary standards is crucial for evaluating the clinical utility of these tests in oncology.
- Further research is needed to validate NGS-based diagnostics and demonstrate their impact on clinical decision-making and patient outcomes.
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