The transformative impact of rapid in-house next-generation sequencing (NGS) technology on cancer treatment is becoming increasingly evident. This advancement is particularly significant in enabling personalized medicine and improving patient outcomes. With the progress in molecular testing and the growing number of identifiable biomarkers associated with targeted therapies, early and effective cancer intervention is now more achievable. However, gaps in clinical implementation and the delivery of genomic profile data have historically posed significant barriers to patients accessing personalized treatments.
The Shift from Traditional Testing Methods
Inefficiency of Sequential Single-Gene Testing
In recent years, the relevance of molecular biomarkers for precision oncology research has accelerated, rendering traditional sequential single-gene testing methods inefficient and insufficient. Despite the challenges, hospitals can now adopt highly automated NGS in-house, allowing for faster, cost-effective, and more efficient testing processes compared to traditional outsourced methods.
NGS technology revolutionizes genomics by allowing the rapid sequencing of numerous genes simultaneously from a single test. This integration in Malaysian hospitals means they can perform NGS tests in-house, significantly reducing the turnaround time for results, which can now be obtained in as little as 24 hours. This rapid pace facilitates quicker decision-making and timely initiation of optimized and targeted treatment therapies for cancer patients.
Advantages of Multigene NGS Assays
One major advantage of in-house NGS is the reduced need for tissue samples while providing more actionable biomarker insights. Modern cancer care heavily depends on biomarker testing for diagnosis and therapy decisions. The ever-growing list of actionable biomarkers has rendered single or sequential biomarker testing impractical. Traditional single-gene testing methods are prone to rapidly depleting precious tissue samples, driving up costs, and extending the time to get results for all actionable biomarkers being tested. On the contrary, a single multi-gene NGS test demands less tissue compared to multiple rounds of single-gene testing. Importantly, sequential single-gene testing can sometimes be as costly or even more costly than an NGS multigene assay.
Especially in cases where biopsied samples are scarce and difficult to retrieve, multiple tests may not be an option if the initial testing fails. NGS enables parallel sequencing of multiple genes, resulting in more patients being successfully tested promptly without re-biopsies. Additionally, advancements in bioinformatics and reporting capabilities ensure clinicians can easily access vital information, including tumor mutational burden annotations. This facilitates a comprehensive contextual investigation of sample-specific variants with respect to labels, guidelines, current clinical trials, and peer-reviewed literature.
Enhancing Patient Outcomes with Rapid NGS
Timely Genomic Testing and Improved Survival Rates
Studies have demonstrated better cancer survival rates with rapid NGS genomic profiling. Limited single-gene testing followed by outsourced NGS testing often leads to extended delays, up to 33 days, for results. Consequently, oncologists might initiate conventional therapies while awaiting molecular reports, potentially leading to suboptimal outcomes. Timely access to genomic testing significantly enhances patient outcomes and survival rates. A real-world study presented at the 2023 American Society of Clinical Oncology (ASCO) annual meeting indicated a 95% median overall survival rate in cancer cases with genomic testing results.
Case Studies in Non-Small Cell Lung Cancer (NSCLC)
In another study of 525 non-small cell lung cancer (NSCLC) cases, patients who underwent biomarker testing and received biomarker-directed first-line treatment with a tyrosine kinase inhibitor (TKI) exhibited up to 35% higher survival probability after two years compared to those on first-line chemotherapy and/or immunotherapy regimens without genomic profiling results. Furthermore, patients initially on chemotherapy and/or immunotherapy who later switched to second-line TKI therapy after genomic profiling displayed a 22% higher survival probability after two years relative to those who did not switch.
These findings underscore the importance of timely genomic profile results, which offer clinicians the chance to select optimal first-line therapies for patients with tumors harboring actionable genomic alterations. Integrating in-house NGS testing enables multidisciplinary teams to improve care coordination and tailor patient treatments for better outcomes. By offering detailed genomic data from a single test, rapid NGS helps to avoid generic treatments, ensuring that patients receive the most effective, personalized therapies from the outset. This reduction in diagnosis time also potentially decreases hospital stay duration, translating to cost savings for both patients and the healthcare system while freeing up hospital beds for other patients.
Practical Benefits of In-House NGS
Streamlined Testing and Reduced Costs
Integrating in-house NGS testing enables multidisciplinary teams to improve care coordination and tailor patient treatments for better outcomes. By offering detailed genomic data from a single test, rapid NGS helps to avoid generic treatments, ensuring that patients receive the most effective, personalized therapies from the outset. This reduction in diagnosis time also potentially decreases hospital stay duration, translating to cost savings for both patients and the healthcare system while freeing up hospital beds for other patients.
The consideration of cost savings is paramount in healthcare systems where resources are limited. By conducting NGS tests in-house, hospitals can dodge the costs related to outsourcing these tests, including shipping and excessive turnaround times. Furthermore, in-house NGS minimizes the dependency on repeat biopsies, thereby preserving valuable tissue samples and reducing additional procedural costs. This streamlined approach also facilitates more consistent and rapid updates to a patient’s treatment plan based on the latest genomic data, contributing to better overall patient care.
Democratization of NGS in Malaysia
The transformative potential of rapid in-house next-generation sequencing (NGS) technology on cancer treatment is becoming increasingly clear. This advancement is particularly relevant for enabling personalized medicine, greatly enhancing patient outcomes. With the strides made in molecular testing and the increasing number of identifiable biomarkers linked to targeted therapies, early and effective cancer intervention is now more attainable than ever. NGS allows for the precise identification of genetic mutations, enabling tailored treatments that are specific to each patient’s cancer type. This is crucial for optimizing therapy efficacy and minimizing adverse effects. However, challenges remain in the clinical implementation and timely delivery of genomic profile data, which have historically hindered patients’ access to personalized treatments. Addressing these gaps is essential to fully realize the benefits of NGS technology in the fight against cancer, ensuring that all patients have the opportunity to benefit from the advances in personalized oncology care.
