Cancer is a disease of the genome that results from an accumulation of mutations that drive unregulated cell growth and differentiation.
Over the last decade, rapid advancements in next-generation sequencing (NGS) have enabled researchers to gain deep understanding of the underlying genomic alterations and biological pathways that lead to cancer development and progression.
By understanding the effect of mutations in key regions of the genome, like oncogenes and tumor suppressor genes, researchers are unlocking new possibilities for cancer therapy.
Historically, cancer treatment followed a one-size-fits-all model, where therapies were selected based on the cancer type alone. As our understanding of cancer biology has grown, therapy decisions are now increasingly based on specific cancer biomarkers, or genetic alterations present in an individual’s cancer genome.
Clinicians can prescribe drugs that directly target the biological pathways causing the disease, while avoiding sub-optimal therapies. This individualized approach to cancer care is called “precision oncology.” Using a molecular profile of a patient’s cancer, treatment plans can be uniquely tailored to help provide the best potential outcome.
Dr. Bin Wang and Dr. Tao Yang of SydPath, St. Vincent’s Hospital, Sydney, discuss their past challenges with genomic profiling, the impact of next-generation sequencing on their clinical diagnostic laboratory, and the prospective impact of NGS on patient care.
NGS has emerged as the platform of choice for tumor genomic profiling. This technology offers several advantages over traditional methods, which test for single biomarkers sequentially.
These traditional methods can take more time to produce a full genetic profile, while delaying care decisions and rapidly depleting biopsy tissue. NGS overcomes these challenges, as multiple cancer biomarkers can be assessed simultaneously in a single test to quickly reveal a full molecular profile, all while preserving tissue.
This multi-biomarker approach is increasingly being adopted for several cancer types, like non-small cell lung cancer (NSCLC). A growing set of biomarkers associated with FDA-approved therapies is now available for major cancer types, with many others in clinical trials.
Pathology laboratories are increasingly turning to NGS testing and bringing the power of molecular profiling directly into the hospital. Choosing the right in-house testing solution can help more patients to get comprehensive genomic profiling faster, with better coordinated patient care.
1. It's about time — start patients on the right treatment sooner
For cancer patients, time is of the essence. Outsourcing NGS testing to third-party labs can often lead to wait times of weeks, delaying access to treatment. With in-house NGS, pathologists can provide meaningful results in as few as four days.
2. It's about tissue — more patients get actionable results
Not all NGS tests are the same. Some require larger amounts of tissue, which can have a direct impact on the success of testing.
Similarly, with sequential single-gene testing methods, tissue requirements increase with each successive test.1 A multi-gene NGS assay with low sample requirements preserves tissue. This means that more patients can be tested without unnecessary re-biopsies, producing significantly higher test success rates and allowing greater access to targeted therapeutics.
3. It's about improved care coordination
In-house testing keeps the sample on-site and testing expertise within the care team.
This means your multi-disciplinary team has better access to the information they need to pair genomic profiling data with the latest developments in targeted therapies, which helps your team develop unique strategies for patient treatment and improved care.
4. It's about managing costs
The cost of running three or more single-gene tests can be equal or higher to the cost of running a single NGS multi-gene assay.
Plus, keeping biomarker testing in-house is less costly than sending samples out to third-party laboratories3 and reduces the turnaround time by days — an advantage for both labs and patients.
5. It’s about the future of your institution
Precision oncology is the new paradigm in cancer care. Building this expertise into your local care team empowers them to make smarter and faster therapy decisions.
To provide state-of-the-art care and grow your reputation within your local and regional market, talk with your Thermo Fisher Account Manager today.
References
1. Multiple biomarker testing tissue consumption and completion rates with single-gene tests and investigational use of Oncomine Dx Target Test for advanced non small-cell lung cancer: A Single-center analysis, Clinical Lung Cancer Month 2018
2. Clinical utility of reflex testing using focused next generation sequencing for management of patients
with advanced lung adenocarcinoma, Miller TE, et al. J Clin Pathol 2018;0:1–7. doi:10.1136/jclinpath-2018-205396
3. Clinical applicability and cost of a 46-gene panel for genomic analysis of solid tumours: Retrospective validation and prospective audit in the UK National Health Service, PLOS Medicine | DOI:10.1371/journal.pmed.1002230 February 14, 2017
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