Comparison of Next-Generation Sequencing Platforms for Clinical Testing of Non-Small Cell Lung Cancer.
Lung cancer remains the leading cause of cancer-related death worldwide, accounting for 1.59 million of the 8.2 million total cancer deaths each year. Non-small cell lung cancer accounts for ~80% of all lung cancers and adenocarcinoma, the main histological subtype, has frequently already metastasised when detected.
As standard single-site biopsy of the primary tumor may not capture intratumor heterogeneity or the genetic makeup of metastatic lesions, such testing can lead to inaccurate prognosis and treatment strategies.
Availability of tissue biopsy in the majority of cases is limited and in some cases cannot be performed, thus reducing the likelihood of successfully monitoring therapeutic response.
The use of alternative sources of biopsy material that reflect tumor heterogeneity and the metastatic state, such as readily available blood or Pleural Effusions, may provide valuable information.
There is an urgent need for sensitive methods for assessing mutational status from small biopsy samples for prognosis and
predicting response to therapy as well as progression of lung adenocarcinoma.
Next generation sequencing offers attractive prospects, including the ability to simultaneously interrogate hundreds of mutational hotspots with high accuracy and sensitivity from limited amounts of genomic DNA from a variety of tumor sources.
Major improvements in sequencing technology such as increased read length and accuracy have resulted
in dramatic cost reductions, making NGS more affordable. Protocols for isolation of amplifiable DNA from Formalin-fixed
paraffin-embedded samples and the small amount of DNA available from fine-needle aspirates have also improved.
Pulm Res Respir Med Open J. 2015; 2(3): 97-108. doi: 10.17140/PRRMOJ-2-116