Dr. Wakelee on Importance of NGS Testing in NSCLC

Heather Wakelee, MD
Published: Tuesday, Mar 12, 2019



Heather Wakelee, MD, associate professor of medicine, Stanford University Medical Center, discusses the importance of next-generation sequencing (NGS) testing in the treatment of patients with non–small cell lung cancer (NSCLC).

The use of NGS testing is critical in patients with advanced-stage disease—especially in those with adenocarcinoma, Wakelee says. However, there are also patients with squamous histology, especially if they are never-smokers, who can develop driver mutations. Investigators tend to think that the classic patient with an oncogenic driver is a never-smoker who is diagnosed with adenocarcinoma, but patients with a smoking history can also have driver mutations, Wakelee stresses.

In a practice where resources are available, NGS testing should be done in every patient upfront. If resources are limited, conversations need to be had with patients. If a driver mutation is missed in a patient, then a physician is essentially missing out on giving that patient therapy that is not only well tolerated, but one that could potentially prolong their survival. It is a travesty when that happens, says Wakelee; as such, to avoid this from happening, NGS testing should be the standard.
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Heather Wakelee, MD, associate professor of medicine, Stanford University Medical Center, discusses the importance of next-generation sequencing (NGS) testing in the treatment of patients with non–small cell lung cancer (NSCLC).

The use of NGS testing is critical in patients with advanced-stage disease—especially in those with adenocarcinoma, Wakelee says. However, there are also patients with squamous histology, especially if they are never-smokers, who can develop driver mutations. Investigators tend to think that the classic patient with an oncogenic driver is a never-smoker who is diagnosed with adenocarcinoma, but patients with a smoking history can also have driver mutations, Wakelee stresses.

In a practice where resources are available, NGS testing should be done in every patient upfront. If resources are limited, conversations need to be had with patients. If a driver mutation is missed in a patient, then a physician is essentially missing out on giving that patient therapy that is not only well tolerated, but one that could potentially prolong their survival. It is a travesty when that happens, says Wakelee; as such, to avoid this from happening, NGS testing should be the standard.

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