Use of dedicated gene panel sequencing using next generation sequencing to improve the personalized care of lung cancer.

Abstract

Advances in Next Generation Sequencing (NGS) technologies have improved the ability to detect potentially targetable mutations. However, the integration of NGS into clinical management in an individualized manner remains challenging. In this single-center observational study, we performed a dedicated NGS panel studying 41 cancer-related genes in 50 consecutive patients with metastatic non-small-cell lung cancer between May 2012 and October 2014. Molecular analysis could be performed in 48 patients with a good quality check. One hundred and thirty-three mutations, whose twenty-four unique mutations, were detected. At least one mutation was found in 46 patients. In 58% of cases, the Molecular Tumor Board (MTB) was able to recommend treatment with a targeted agent based on the evaluation of the tumor genetic profile and treatment history. Nine patients (18%) were subsequently treated with a MTBrecommended targeted therapy; four patients experienced a clinical benefit with a partial response or stabilization lasting more than 4 months. In this case series involving patients with metastatic non-small cell lung cancer, we show that including integrative clinical sequencing data into routine clinical management was feasible and could impact on patient therapeutic proposal.

Characterization of driver mutations in Chinese non-small cell lung cancer patients using a novel targeted sequencing panel

“…Specifically, our panel were composed of 21 genes including ALK, AKT1, BRAF, CDKN2A, DDR2, ERBB2, EGFR, FGFR1, FGFR2, IDH1, KRAS, MAP2K1, MET, NRAS, PDGFRA, PIK3CA, PTEN, RET, ROS1, STK11 and TP53, which had mutation frequency above 1% in the lung cancer samples of COSMIC database, and 17 genes of them were identified as oncogenes and the other 4 genes were identified as tumor suppressor genes by OncoKB database (Figure 1). Moreover, we overlapped the 21-gene panel with other 4 previously published NSCLC sequencing panel which have similar size to ours (24)(25)(26)(27), the overlapping results indicated that our panel has not only shared core driver genes (TP53, EGFR, PIK3CA, etc.) with them, but also uniquely covered some clinically important genes (DDR2, ROS1, IDH1, etc.…”

Molecular Tumor Board Review and Improved Overall Survival in Non–Small-Cell Lung Cancer

“…Molecular tumor boards (MTBs) have been developed at multiple academic medical centers to address physician barriers to precision medicine, providing guidance on the use of NGS reports. [18][19][20][21][22] Importantly, availability of an MTB increases physician willingness to order and use NGS testing. 23 MTBs are generally composed of a multidisciplinary team including medical oncologists, surgical oncologists, genetic counselors, pathologists, pharmacists, radiologists, and basic scientists, 19,21 working together to provide recommendations to clinicians for targeted therapy and clinical trials on the basis of each patient's diagnosis and NGS results.…”

Precision medicine‐based therapies in advanced colorectal cancer: The University of California San Diego Molecular Tumor Board experience

“…The idea of the MTB has been a growing treatment paradigm in the field of precision oncology with variable success in clinical practice [21,22,24,25]. For example, some MTBs have demonstrated objective response rates as high as 44–67% in patients with non‐small cell lung cancer [26,27]. However, other MTBs treating various solid and hematologic cancers have shown objective response rates from 0–13% [28,29].…”