Dr. Drilon Discusses the Adoption of NGS in Lung Cancer

Alexander E. Drilon, MD
Published: Thursday, Feb 07, 2019



Alexander E. Drilon, MD, medical oncologist at Memorial Sloan Kettering (MSK) Cancer Center, discusses the adoption of next-generation sequencing (NGS) in lung cancer.

NGS is used more commonly now than ever before, explains Drilon; however, certain challenges remain. For example, some physicians are not familiar with the best NGS tests that are out there, of which there are many. Moreover, each test can be vastly differ from another. There are 2 major strategies for NGS, he says: amplicon-based testing and hybrid capture. At MSK, physicians use a hybrid capture-based NGS, which is most likely better at detecting a wider variety of actionable alterations.

A couple of NGS tests are authorized or approved by the FDA. For example, the test physicians use at MSK, known as MSK-IMPACT, has FDA authorization. There is also the FoundationOne assay, which can also be used as a companion diagnostic to select appropriate patients for a particular targeted therapy, says Drilon. In selecting an NGS assay, physicians have to be cautious of whether or not the test can detect fusions in addition to regular mutations and whether the assay can detect copy number changes and any other alternation outside the scope of what is found in lung cancer.
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Alexander E. Drilon, MD, medical oncologist at Memorial Sloan Kettering (MSK) Cancer Center, discusses the adoption of next-generation sequencing (NGS) in lung cancer.

NGS is used more commonly now than ever before, explains Drilon; however, certain challenges remain. For example, some physicians are not familiar with the best NGS tests that are out there, of which there are many. Moreover, each test can be vastly differ from another. There are 2 major strategies for NGS, he says: amplicon-based testing and hybrid capture. At MSK, physicians use a hybrid capture-based NGS, which is most likely better at detecting a wider variety of actionable alterations.

A couple of NGS tests are authorized or approved by the FDA. For example, the test physicians use at MSK, known as MSK-IMPACT, has FDA authorization. There is also the FoundationOne assay, which can also be used as a companion diagnostic to select appropriate patients for a particular targeted therapy, says Drilon. In selecting an NGS assay, physicians have to be cautious of whether or not the test can detect fusions in addition to regular mutations and whether the assay can detect copy number changes and any other alternation outside the scope of what is found in lung cancer.



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