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Next-Generation Sequencing Trends among Adult Patients with Select Advanced Tumor Types: A Real-World Evidence

Andrea Ferreira-Gonzalez1, Brian Hocum2, Gilbert Ko2

  • 1Department of Pathology, Virginia Commonwealth University, Richmond, Virginia.

The Journal of Molecular Diagnostics : JMD
|January 31, 2024
PubMed

Insights

Next-generation sequencing (NGS) use in cancer care increased modestly but remained low overall. Further efforts are needed to improve NGS adoption for molecular biomarker-based therapies.

Area of Science:

  • Oncology
  • Genomics
  • Health Services Research

Background:

  • Next-generation sequencing (NGS) is crucial for identifying actionable oncogenic variants to guide molecular biomarker-based therapies.
  • Limited data exist on the prevalence and trends of NGS utilization in the United States across various cancer types.
  • Increasing approvals of targeted therapies necessitate understanding current NGS adoption rates.

Purpose of the Study:

  • To examine the trends in NGS utilization among adult patients with select metastatic solid tumors and central nervous system tumors in the US.
  • To identify factors associated with NGS use and analyze time-to-test metrics.
  • To assess the current landscape of NGS adoption in the context of evolving treatment paradigms.

Main Methods:

  • Retrospective analysis of US health care claims data (Optum Clinformatics Data Mart) from January 1, 2014, to June 30, 2021.
  • Inclusion of 63,209 adult patients diagnosed with specific metastatic solid tumors or central nervous system tumors.
  • Examination of NGS use trends over time, time to NGS from diagnosis, and predictors of testing.

Main Results:

  • NGS utilization showed a modest increase from 2015 (0.0%-1.5%) to 2021 (2.1%-17.4%) across tumor types.
  • NGS rates remained below 10% in the final period for breast, colorectal, head and neck, soft tissue sarcoma, thyroid, and CNS cancers.
  • Median time to NGS varied by cancer type, being shortest for non-small-cell lung cancer and longest for breast cancer. Predictors of NGS varied by tumor type, with comparable rates for minorities and White patients in select cancers.

Conclusions:

  • Despite improvements in payer policies and therapy approvals, NGS rates remain low across many cancer types.
  • The observed increase in NGS use is modest, highlighting a gap in adoption for molecular biomarker-based treatments.
  • Further interventions are necessary to enhance NGS utilization and improve patient outcomes through precision oncology.

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