The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System
Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Study Design
- When send-out testing was conducted, to carry out a comparison of time from biopsy to results and biopsy to treatment between patients with comprehensive send-out testing and select send-out panels.
- Whether reflexive NGS was associated with differences in mutational status, treatment allocations, and survival compared with send-out testing at CDH + D.
2.2. Setting and Subjects
2.3. Data Collection
- Patient data, including smoking status, stage of disease, PDL1 status, NGS results on tissue, NGS results from blood, and whether the patient was enrolled on a clinical trial.
- Clinical information, including pathologic diagnosis, first-line systemic treatment chosen for each patient, date of initiation of therapy (defined as the first date that the patient received therapy), date of disease progression, specific therapies chosen beyond first-line treatment, and date of death or last follow-up.
- The system’s information, including hospital of diagnosis and treatment, date of biopsy for new diagnosis of lung cancer, date of ordering NGS, date of NGS results, whether “insufficient tissue” was identified on biopsy and a repeat biopsy was needed, and the method of NGS sequencing (whether in-house or sent out).
- Among the biopsies sent out (CDH + D), the team reviewed whether NGS was comprehensive or limited. Limited panels were defined as those requiring a clinician to select certain oncogenic drivers, while comprehensive included sending for a panel designated by the vendor.
2.4. Power Analysis
2.5. Data Analysis
2.6. Limitations
3. Results
3.1. Demographics
3.2. Time to Treatment
3.3. NGS Testing Outcomes
3.4. Overall Survival
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | n = 191 1 | NMH, n = 85 1 | CDH + Delnor, n = 106 1 |
---|---|---|---|
Age | 70 (62, 78) | 68 (61, 79) | 71 (63, 78) |
Missing | 3 | 2 | 1 |
Gender | |||
Female | 107 (56.0%) | 51 (60.0%) | 56 (52.8%) |
Male | 84 (44.0%) | 34 (40.0%) | 50 (47.2%) |
Race | |||
Asian | 12 (6.3%) | 8 (9.4%) | 4 (3.8%) |
Black or African American | 22 (11.5%) | 18 (21.2%) | 4 (3.8%) |
Other | 14 (7.3%) | 8 (9.4%) | 6 (5.7%) |
White | 143 (74.9%) | 51 (60.0%) | 92 (86.8%) |
Smoking Status | |||
Never | 41 (21.5%) | 19 (22.4%) | 22 (20.8%) |
Former | 113 (59.2%) | 54 (63.5%) | 59 (55.7%) |
Current | 37 (19.4%) | 12 (14.1%) | 25 (23.6%) |
Site | |||
CDH | 86 (45.0%) | ||
Delnor | 20 (10.5%) | ||
NMH | 85 (44.5%) | ||
Time from first biopsy to actionable NGS results (days) | 21 (15, 29) | 19 (14, 25) | 24 (18, 34) |
Missing | 20 | 4 | 16 |
Time from first biopsy to initiation of treatment (days) | 35 (24, 49) | 30 (22, 46) | 37 (28, 49) |
Missing | 43 | 14 | 29 |
Variable | CDH + Delnor, n = 106 1 | NMH, n = 85 1 | p-Value 2 |
---|---|---|---|
Time from first biopsy to actionable NGS results | 24 (18, 34) | 19 (14, 25) | <0.001 |
Time from first biopsy to initiation of treatment | 37 (28, 49) | 30 (22, 46) | 0.092 |
Variable | Comprehensive, N = 29 1 | Non-Comprehensive, N = 61 1 | p-Value 2 |
---|---|---|---|
Time from first biopsy to actionable NGS results | 26 (21, 35) | 22 (15, 33) | 0.033 |
Time from first biopsy to initiation of treatment | 37 (28, 49) | 38 (29, 50) | 0.6 |
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Vakkalagadda, C.V.; Dressler, D.B.; Sun, Z.; Fuchs, J.; Liu, Y.; Silberman, P.; Ragam, A.; Kircher, S.; Patel, J.D.; Mohindra, N.A. The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System. Cancers 2024, 16, 3654. https://doi.org/10.3390/cancers16213654
Vakkalagadda CV, Dressler DB, Sun Z, Fuchs J, Liu Y, Silberman P, Ragam A, Kircher S, Patel JD, Mohindra NA. The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System. Cancers. 2024; 16(21):3654. https://doi.org/10.3390/cancers16213654
Chicago/Turabian StyleVakkalagadda, Chetan V., Danielle B. Dressler, Zequn Sun, Joseph Fuchs, Yingzhe Liu, Philip Silberman, Avanthi Ragam, Sheetal Kircher, Jyoti D. Patel, and Nisha A. Mohindra. 2024. "The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System" Cancers 16, no. 21: 3654. https://doi.org/10.3390/cancers16213654
APA StyleVakkalagadda, C. V., Dressler, D. B., Sun, Z., Fuchs, J., Liu, Y., Silberman, P., Ragam, A., Kircher, S., Patel, J. D., & Mohindra, N. A. (2024). The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System. Cancers, 16(21), 3654. https://doi.org/10.3390/cancers16213654