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Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Biomarker Testing Among Patients With Nonsquamous NSCLC Across Three Time Periods and Three Testing Platforms-A Brief
Zhen Jason Fan1, Roxana Tudor1,2, Michael Cabanero3
1Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
JTO Clinical and Research Reports
|July 30, 2026
Summary
Genomic testing for non-small cell lung cancer (NSCLC) has evolved. While comprehensive next-generation sequencing (NGS) finds more alterations, it can delay treatment initiation due to longer turnaround times.
Area of Science:
- Oncology
- Genomics
- Clinical Diagnostics
Background:
- Biomarker testing is crucial for guiding treatment decisions in advanced nonsquamous non-small cell lung cancer (NSCLC).
- Genomic testing platforms have evolved significantly, impacting clinical practice.
- Previous testing methods included reflex EGFR/ALK testing and limited next-generation sequencing (NGS).
Purpose of the Study:
- To evaluate the clinical impact of evolving genomic testing platforms in stage III/IV nonsquamous NSCLC.
- To assess how different NGS panel sizes affect the identification of actionable genomic alterations.
- To analyze the relationship between testing turnaround times and treatment initiation.
Main Methods:
- An ambispective review of 1028 patients with stage III/IV nonsquamous NSCLC across three distinct time periods.
- Cohort 1 (2015-2017): Reflex EGFR/ALK testing.
- Cohort 2 (2017-2020): Limited NGS (15 genes), ALK, and ROS1 testing.
- Cohort 3 (2020-2022): Comprehensive NGS (161 genes).
Main Results:
- Comprehensive NGS panels identified a greater number of actionable genomic alterations compared to earlier methods.
- However, larger NGS panels were associated with increased biopsy-to-result turnaround times.
- Fewer patients in the comprehensive NGS cohort had complete molecular results available at their first medical oncology consultation.
Conclusions:
- While comprehensive genomic profiling enhances the detection of targetable alterations in NSCLC, it can lead to delays in treatment initiation.
- The balance between testing comprehensiveness and timely results is critical for optimizing patient care in NSCLC.
- Further strategies are needed to streamline the biomarker testing process without compromising diagnostic yield.
