Recommendations for the use of next-generation sequencing in patients with metastatic cancer in the Asia-Pacific...

Area of Science:

• Oncology
• Genomics
• Clinical Diagnostics

Background:

• Next-generation sequencing (NGS) has demonstrated clinical utility in predicting survival benefits for targeted therapies in specific cancer types.
• There is a lack of established guidelines for NGS use in metastatic cancer patients from an Asian perspective.

Purpose of the Study:

• To present the Asia-Pacific Oncology Drug Development Consortium (APODDC) recommendations for the clinical application of NGS in metastatic cancers.
• To address the current NGS landscape, challenges, and adapt existing guidelines for the Asia-Pacific region.

Main Methods:

• A group of clinical cancer genomics experts was convened by the APODDC.
• Evaluated the applicability of NGS in nine cancer types within the Asia-Pacific context, considering ethnicity, accessibility, reimbursement, and local practices.
• Adapted European Society for Medical Oncology guidelines for local use.

Main Results:

• NGS testing is recommended for metastatic non-small-cell lung cancer (NSCLC).
• Routine NGS testing is not recommended for metastatic breast cancer, gastric cancer, nasopharyngeal cancer, cholangiocarcinoma, and hepatocellular carcinoma.
• Germline/somatic genetic testing for BRCA1/2 is suggested for epithelial ovarian cancer; poly (ADP-ribose) polymerase inhibitors are crucial for NGS utility in prostate cancer; and specific NGS panels are suggested for colorectal cancer.

Conclusions:

• This document provides practical guidance on the clinical utility of NGS for specific metastatic cancer indications in the Asian population.
• Recommendations are tailored to the unique characteristics and challenges of the Asia-Pacific region.