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Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Clinical Utility of Comprehensive Genomic Profiling for Advanced Non-Small Cell Lung Cancer: A Single-Center
Shuji Murakami1, Yukihiko Hiroshima2, Seigo Katakura1
1Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Background:
For advanced non-small cell lung cancer (NSCLC), biomarker testing using multiplex companion diagnostics has become the standard of care. However, challenges remain in detecting rare mutations and resistance mechanisms after targeted therapy. We evaluated the prevalence of druggable genetic aberrations and the clinical utility of comprehensive genomic profiling (CGP) performed after completion of standard treatment in real-world practice.
Methods:
This retrospective study analyzed 108 patients with advanced or recurrent non-small cell lung cancer who underwent comprehensive genomic profiling testing between January 2019 and December 2023 at the Kanagawa Cancer Center Hospital, Japan. Profiling was conducted using the OncoGuide NCC Oncopanel System, FoundationOne, and FoundationOne Liquid companion diagnostics.
Results:
Druggable genetic aberrations were detected in 37% of the patients, with epidermal growth factor receptor mutations being the most common. Resistance mechanisms were identified in 9 of 19 patients who underwent re-biopsy after targeted therapy. Non-smokers had a significantly higher rate of druggable mutations (55.6%) than did smokers (27.8%). Treatment based on comprehensive genomic profiling findings was recommended for 35.2% of the patients; however, only 16.6% received the suggested therapy. In a landmark survival analysis, patients who received genomically matched therapy demonstrated a trend toward prolonged overall survival compared with those who did not (log-rank p = 0.054).
Conclusions:
CGP testing can identify actionable mutations missed by conventional diagnostics and may provide additional therapeutic opportunities in NSCLC.
Insights
Comprehensive genomic profiling (CGP) identified actionable mutations in advanced non-small cell lung cancer (NSCLC) missed by standard tests. This approach may offer new therapeutic options for patients, particularly non-smokers.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Standard care for advanced non-small cell lung cancer (NSCLC) involves multiplex companion diagnostics for biomarker testing.
- Challenges persist in identifying rare mutations and resistance mechanisms post-targeted therapy.
- This study assessed the utility of comprehensive genomic profiling (CGP) for detecting druggable genetic aberrations after standard treatment.
Purpose of the Study:
- To evaluate the prevalence of druggable genetic aberrations in advanced NSCLC.
- To determine the clinical utility of CGP in real-world practice.
- To identify potential therapeutic opportunities missed by conventional diagnostics.
Main Methods:
- Retrospective analysis of 108 advanced or recurrent NSCLC patients.
- CGP performed using OncoGuide NCC Oncopanel System, FoundationOne, and FoundationOne Liquid.
- Data collected between January 2019 and December 2023 at Kanagawa Cancer Center Hospital, Japan.
Main Results:
- Druggable genetic aberrations found in 37% of patients; EGFR mutations were most common.
- Resistance mechanisms identified in 9/19 patients after re-biopsy.
- Non-smokers showed a higher rate of druggable mutations (55.6%) than smokers (27.8%).
- Genomically matched therapy showed a trend towards prolonged overall survival (p=0.054).
Conclusions:
- CGP testing identifies actionable mutations missed by conventional diagnostics in NSCLC.
- CGP may offer additional therapeutic opportunities for NSCLC patients.
- The findings support CGP's role in guiding treatment decisions for advanced NSCLC.