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Brief Report

Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer

1
Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, Canada
2
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, Canada
3
Department of Laboratory Medicine & Pathology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2M9, Canada
4
Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
T.L.S. and N.B.L. are co-principal investigators.
Curr. Oncol. 2022, 29(7), 4428-4437; https://doi.org/10.3390/curroncol29070352
Received: 14 May 2022 / Revised: 17 June 2022 / Accepted: 20 June 2022 / Published: 22 June 2022
(This article belongs to the Section Thoracic Oncology)
In advanced non-small cell lung cancer (NSCLC), patients with actionable genomic alterations may derive additional clinical benefit from targeted treatment compared to cytotoxic chemotherapy. Current guidelines recommend extensive testing with next generation sequencing (NGS) panels. We investigated the impact of using a targeted NGS panel (TruSight Tumor 15, Illumina) as reflex testing for NSCLC samples at a single institution. Molecular analysis examined 15 genes for hotspot mutation variants, including AKT1, BRAF, EGFR, ERBB2, FOXL2, GNA11, GNAQ, KIT, KRAS, MET, NRAS, PDGFRA, PIK3CA, RET and TP53 genes. Between February 2017 and October 2020, 1460 samples from 1395 patients were analyzed. 1201 patients (86.1%) had at least one variant identified, most frequently TP53 (47.5%), KRAS (32.2%) or EGFR (24.2%). Among these, 994 patients (71.3%) had clinically relevant variants eligible for treatment with approved therapies or clinical trial enrollment. The incremental cost of NGS beyond single gene testing (EGFR, ALK) was CAD $233 per case. Reflex upfront NGS identified at least one actionable variant in more than 70% of patients with NSCLC, with minimal increase in testing cost. Implementation of NGS panels remains essential as treatment paradigms continue to evolve. View Full-Text
Keywords: lung cancer; next generation sequencing; genomic alterations; Canada lung cancer; next generation sequencing; genomic alterations; Canada
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MDPI and ACS Style

Kuang, S.; Fung, A.S.; Perdrizet, K.A.; Chen, K.; Li, J.J.N.; Le, L.W.; Cabanero, M.; Karsaneh, O.A.A.; Tsao, M.S.; Morganstein, J.; Ranich, L.; Smith, A.C.; Wei, C.; Cheung, C.; Shepherd, F.A.; Liu, G.; Bradbury, P.; Pal, P.; Schwock, J.; Sacher, A.G.; Law, J.H.; Stockley, T.L.; Leighl, N.B. Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer. Curr. Oncol. 2022, 29, 4428-4437. https://doi.org/10.3390/curroncol29070352

AMA Style

Kuang S, Fung AS, Perdrizet KA, Chen K, Li JJN, Le LW, Cabanero M, Karsaneh OAA, Tsao MS, Morganstein J, Ranich L, Smith AC, Wei C, Cheung C, Shepherd FA, Liu G, Bradbury P, Pal P, Schwock J, Sacher AG, Law JH, Stockley TL, Leighl NB. Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer. Current Oncology. 2022; 29(7):4428-4437. https://doi.org/10.3390/curroncol29070352

Chicago/Turabian Style

Kuang, Shelley, Andrea S. Fung, Kirstin A. Perdrizet, Kaitlin Chen, Janice J.N. Li, Lisa W. Le, Michael Cabanero, Ola A.A. Karsaneh, Ming S. Tsao, Josh Morganstein, Laura Ranich, Adam C. Smith, Cuihong Wei, Carol Cheung, Frances A. Shepherd, Geoffrey Liu, Penelope Bradbury, Prodipto Pal, Joerg Schwock, Adrian G. Sacher, Jennifer H. Law, Tracy L. Stockley, and Natasha B. Leighl. 2022. "Upfront Next Generation Sequencing in Non-Small Cell Lung Cancer" Current Oncology 29, no. 7: 4428-4437. https://doi.org/10.3390/curroncol29070352

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