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Point of Care Molecular Testing: Community-Based Rapid Next-Generation Sequencing to Support Cancer Care

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Department of Laboratory Medicine, William Osler Health System, Brampton, ON L6R 3J7, Canada
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Division of Medical Oncology, William Osler Health System, Brampton, ON L6R 3J7, Canada
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Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(3), 1326-1334; https://doi.org/10.3390/curroncol29030113
Received: 17 January 2022 / Revised: 21 February 2022 / Accepted: 22 February 2022 / Published: 23 February 2022
Purpose: Biomarker data are critical to the delivery of precision cancer care. The average turnaround of next-generation sequencing (NGS) reports is over 2 weeks, and in-house availability is typically limited to academic centers. Lengthy turnaround times for biomarkers can adversely affect outcomes. Traditional workflows involve moving specimens through multiple facilities. This study evaluates the feasibility of rapid comprehensive NGS using the Genexus integrated sequencer and a novel streamlined workflow in a community setting. Methods: A retrospective chart review was performed to assess the early experience and performance characteristics of a novel approach to biomarker testing at a large community center. This approach to NGS included an automated workflow utilizing the Genexus integrated sequencer, validated for clinical use. NGS testing was further integrated within a routine immunohistochemistry (IHC) service, utilizing histotechnologists to perform technical aspects of NGS, with results reported directly by anatomic pathologists. Results: Between October 2020 and October 2021, 578 solid tumor samples underwent genomic profiling. Median turnaround time for biomarker results was 3 business days (IQR: 2–5). Four hundred eighty-one (83%) of the cases were resulted in fewer than 5 business days, and 66 (11%) of the cases were resulted simultaneously with diagnosis. Tumor types included lung cancer (310), melanoma (97), and colorectal carcinoma (68), among others. NGS testing detected key driver alterations at expected prevalence rates: lung EGFR (16%), ALK (3%), RET (1%), melanoma BRAF (43%), colorectal RAS/RAF (67%), among others. Conclusion: This is the first study demonstrating clinical implementation of rapid NGS. This supports the feasibility of automated comprehensive NGS performed and interpreted in parallel with diagnostic histopathology and immunohistochemistry. This novel approach to biomarker testing offers considerable advantages to clinical cancer care. View Full-Text
Keywords: NGS; precision medicine; targeted therapy NGS; precision medicine; targeted therapy
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MDPI and ACS Style

Sheffield, B.S.; Beharry, A.; Diep, J.; Perdrizet, K.; Iafolla, M.A.J.; Raskin, W.; Dudani, S.; Brett, M.A.; Starova, B.; Olsen, B.; Cheema, P.K. Point of Care Molecular Testing: Community-Based Rapid Next-Generation Sequencing to Support Cancer Care. Curr. Oncol. 2022, 29, 1326-1334. https://doi.org/10.3390/curroncol29030113

AMA Style

Sheffield BS, Beharry A, Diep J, Perdrizet K, Iafolla MAJ, Raskin W, Dudani S, Brett MA, Starova B, Olsen B, Cheema PK. Point of Care Molecular Testing: Community-Based Rapid Next-Generation Sequencing to Support Cancer Care. Current Oncology. 2022; 29(3):1326-1334. https://doi.org/10.3390/curroncol29030113

Chicago/Turabian Style

Sheffield, Brandon S., Andrea Beharry, Joanne Diep, Kirstin Perdrizet, Marco A.J. Iafolla, William Raskin, Shaan Dudani, Mary A. Brett, Blerta Starova, Brian Olsen, and Parneet K. Cheema. 2022. "Point of Care Molecular Testing: Community-Based Rapid Next-Generation Sequencing to Support Cancer Care" Current Oncology 29, no. 3: 1326-1334. https://doi.org/10.3390/curroncol29030113

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