Recommendations for the use of NGS in patients with metastatic cancer

Fernanda Mosele discusses the recommendations for the use of next-generation sequencing (NGS) for patients with advanced cancer in 2024: a report from the ESMO Precision Medicine Working Group published in the Annals of Oncology.

The recommendations feature the clinical impact of tumour NGS in guiding treatment decision using the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) considering cost-effectiveness and accessibility. As for previous 2020 recommendations, ESMO recommends running tumour NGS in advanced non-squamous non-small cell lung cancer, prostate cancer, colorectal cancer, cholangiocarcinoma, and ovarian cancer. Moreover, it is recommended to perform tumour NGS in clinical research centres and under specific circumstances discussed with patients. In this updated report, the consensus within the group has led to an expansion of the recommendations to encompass patients with advanced breast cancer and rare tumours such as gastrointestinal stromal tumours, sarcoma, thyroid cancer, and cancer of unknown primary. Finally, ESMO recommends performing tumour NGS to detect tumour-agnostic alterations in patients with metastatic cancers where access to matched therapies is available.

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