- From the public health perspective, the authors recommend NGS should be used routinely in patients with metastatic lung adenocarcinoma, prostate cancer, ovarian cancer, and cholangiocarcinoma. In these tumours, large multigene panels could be used if they add acceptable extra cost compared with small panels. Additionally, based on the KN158 trial it is recommended to test tumour mutational burden (TMB) in well-and moderately-differentiated neuroendocrine tumours (NETs), cervical, salivary, thyroid and vulvar cancers, as TMB predicts response to the anti-PD-1 antibody pembrolizumab in these cancers.
- From the clinical research perspective, centres should perform NGS to generate more evidence about use of this method and accelerate drug development.
- From the patient-centric perspective, patients with other cancers can decide with their doctors to order NGS on a large panel of genes – providing there is no extra cost for the public healthcare system and the patient is informed about the relative likelihood of benefit.
ESMO provides first recommendations on use of next-generation sequencing in metastatic cancer
