Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group

被引：832

作者：

Mosele, F. ^{[1
]}

Remon, J. ^{[2
]}

Mateo, J. ^{[3
,4
]}

Westphalen, C. B. ^{[5
,6
]}

Barlesi, F. ^{[1
]}

Lolkema, M. P. ^{[7
]}

Normanno, N. ^{[8
]}

Scarpa, A. ^{[9
,10
]}

Robson, M. ^{[11
]}

Meric-Bernstam, F. ^{[12
]}

Wagle, N. ^{[13
,14
]}

Stenzinger, A. ^{[15
]}

Bonastre, J. ^{[16
,17
]}

Bayle, A. ^{[1
,16
,17
]}

Michiels, S. ^{[16
,17
]}

Bieche, I ^{[18
]}

Rouleau, E. ^{[19
]}

Jezdic, S. ^{[20
]}

Douillard, J-Y ^{[20
]}

Reis-Filho, J. S. ^{[21
]}

Dienstmann, R. ^{[22
]}

Andre, F. ^{[1
,23
,24
]}

机构：

[1] Gustave Roussy, Dept Med Oncol, Villejuif, France

[2] HM Hosp, Hosp HM Delfos, Ctr Integral Oncol Clara Campal HM CIOCC, Dept Med Oncol, Barcelona, Spain

[3] Vall Hebron Inst Oncol VHIO, Clin Res Program, Barcelona, Spain

[4] Vall dHebron Univ Hosp, Barcelona, Spain

[5] Ludwig Maximilians Univ Munchen, Comprehens Canc Ctr Munich, Univ Hosp, Munich, Germany

[6] Ludwig Maximilians Univ Munchen, Dept Med 3, Univ Hosp, Munich, Germany

[7] Erasmus MC Canc Ctr, Dept Med Oncol, Rotterdam, Netherlands

[8] Fdn G Pascale IRCCS, Cell Biol & Biotherapy Unit, Ist Nazl Tumori, Naples, Italy

[9] Univ Verona, ARC Net Res Ctr, Verona, Italy

[10] Univ Verona, Dept Diagnost & Publ Hlth, Sect Pathol, Verona, Italy

[11] Mem Sloan Kettering Canc Ctr, Dept Med, Breast Med & Clin Genet Serv, 1275 York Ave, New York, NY 10021 USA

[12] Univ Texas MD Anderson Canc Ctr, Dept Invest Canc Therapeut, Houston, TX 77030 USA

[13] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA

[14] Harvard Med Sch, Boston, MA 02115 USA

[15] Univ Hosp Heidelberg, Inst Pathol, Heidelberg, Germany

[16] Univ Paris Saclay, Gustave Roussy, Dept Biostat & Epidemiol, Villejuif, France

[17] Univ Paris Saclay, Oncostat Inserm U1018, Labeled Ligue Canc, Villejuif, France

[18] Paris Descartes Univ, Inst Curie, Dept Genet, Paris, France

[19] Dept Med Biol & Pathol, Canc Genet Labs, Gustave Roussy Canc Campus, Villejuif, France

[20] European Soc Med Oncol, Sci & Med Div, Lugano, Switzerland

[21] Mem Sloan Kettering Canc Ctr, Dept Pathol, 1275 York Ave, New York, NY 10021 USA

[22] Vall dHebron Inst Oncol, Mol Prescreening Program, Oncol Data Sci Grp, Barcelona, Spain

[23] INSERM, UMR981, Gustave Roussy Canc Campus, Villejuif, France

[24] Paris Saclay Univ, Orsay, France

来源：

ANNALS OF ONCOLOGY | 2020年 / 31卷 / 11期

关键词：

next-generation sequencing (NGS); genomic alterations; metastatic cancers; CELL LUNG-CANCER; DABRAFENIB PLUS TRAMETINIB; POSITIVE SOLID TUMORS; PHASE-II TRIAL; OPEN-LABEL; COLORECTAL-CANCER; BREAST-CANCER; RAS MUTATIONS; TRASTUZUMAB EMTANSINE; MONOCLONAL-ANTIBODY;

D O I：

10.1016/j.annonc.2020.07.014

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Next-generation sequencing (NGS) allows sequencing of a high number of nucleotides in a short time frame at an affordable cost. While this technology has been widely implemented, there are no recommendations from scientific societies about its use in oncology practice. The European Society for Medical Oncology (ESMO) is proposing three levels of recommendations for the use of NGS. Based on the current evidence, ESMO recommends routine use of NGS on tumour samples in advanced non-squamous non-small-cell lung cancer (NSCLC), prostate cancers, ovarian cancers and cholangiocarcinoma. In these tumours, large multigene panels could be used if they add acceptable extra cost compared with small panels. In colon cancers, NGS could be an alternative to PCR. In addition, based on the KN158 trial and considering that patients with endometrial and small-cell lung cancers should have broad access to anti-programmed cell death 1 (anti-PD1) antibodies, it is recommended to test tumour mutational burden (TMB) in cervical cancers, well- and moderately-differentiated neuroendocrine tumours, salivary cancers, thyroid cancers and vulvar cancers, as TMB-high predicted response to pembrolizumab in these cancers. Outside the indications of multigene panels, and considering that the use of large panels of genes could lead to few clinically meaningful responders, ESMO acknowledges that a patient and a doctor could decide together to order a large panel of genes, pending no extra cost for the public health care system and if the patient is informed about the low likelihood of benefit. ESMO recommends that the use of off-label drugs matched to genomics is done only if an access programme and a procedure of decision has been developed at the national or regional level. Finally, ESMO recommends that clinical research centres develop multigene sequencing as a tool to screen patients eligible for clinical trials and to accelerate drug development, and prospectively capture the data that could further inform how to optimise the use of this technology.

引用

页码：1491 / 1505

页数：15

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