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Recommendations for the use of next-generation sequencing in patients with metastatic cancer in the Asia-Pacific region: a report from the APODDC working group

Loong HH 1 , Shimizu T 2 , Prawira A 3 , Tan AC 4 , Tran B 5 , Day D 6 Show all authors , Tan DSP 7 , Ting FIL 8 , Chiu JW 9 , Hui M 10 , Wilson MK 11 , Prasongsook N 12 , Koyama T 13 , Reungwetwattana T 14 , Tan TJ 4 , Heong V 15 , Voon PJ 16 , Park S 17 , Tan IB 4 , Chan SL 1 , Tan DSW 18

Affiliations 

  • 1 Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
  • 2 Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
  • 3 Cancer Trials and Research Unit, Prince of Wales Hospital, Sydney, Australia
  • 4 Division of Medical Oncology, National Cancer Centre Singapore, Singapore
  • 5 Department of Oncology, Peter MacCallum Cancer Centre, Melbourne
  • 6 Department of Oncology, Monash Health and Monash University, Australia
  • 7 Department of Haematology-Oncology, National University Cancer Institute, Singapore
  • 8 Department of Medicine, Dr. Pablo O. Torre Memorial Hospital, Bacolod, Philippines
  • 9 Department of Medicine, The University of Hong Kong, HKSAR, Pok Fu Lam, Hong Kong, China
  • 10 Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, Australia
  • 11 Department of Medical Oncology, Auckland City Hospital, Auckland, New Zealand
  • 12 Division of Medical Oncology, Phramongkutklao Hospital, Bangkok, Thailand
  • 13 Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
  • 14 Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 15 Department Medical Oncology, Tan Tock Seng Hospital, Singapore
  • 16 Radiotherapy and Oncology Department, Hospital Umum Sarawak, Kuching, Malaysia
  • 17 Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • 18 Division of Medical Oncology, National Cancer Centre Singapore, Singapore. Electronic address: daniel.tan.s.w@singhealth.com.sg
ESMO Open, 2023 Aug;8(4):101586.
PMID: 37356359 DOI: 10.1016/j.esmoop.2023.101586

Abstract

INTRODUCTION: Next-generation sequencing (NGS) diagnostics have shown clinical utility in predicting survival benefits in patients with certain cancer types who are undergoing targeted drug therapies. Currently, there are no guidelines or recommendations for the use of NGS in patients with metastatic cancer from an Asian perspective. In this article, we present the Asia-Pacific Oncology Drug Development Consortium (APODDC) recommendations for the clinical use of NGS in metastatic cancers.

METHODS: The APODDC set up a group of experts in the field of clinical cancer genomics to (i) understand the current NGS landscape for metastatic cancers in the Asia-Pacific (APAC) region; (ii) discuss key challenges in the adoption of NGS testing in clinical practice; and (iii) adapt/modify the European Society for Medical Oncology guidelines for local use. Nine cancer types [breast cancer (BC), gastric cancer (GC), nasopharyngeal cancer (NPC), ovarian cancer (OC), prostate cancer, lung cancer, and colorectal cancer (CRC) as well as cholangiocarcinoma and hepatocellular carcinoma (HCC)] were identified, and the applicability of NGS was evaluated in daily practice and/or clinical research. Asian ethnicity, accessibility of NGS testing, reimbursement, and socioeconomic and local practice characteristics were taken into consideration.

RESULTS: The APODDC recommends NGS testing in metastatic non-small-cell lung cancer (NSCLC). Routine NGS testing is not recommended in metastatic BC, GC, and NPC as well as cholangiocarcinoma and HCC. The group suggested that patients with epithelial OC may be offered germline and/or somatic genetic testing for BReast CAncer gene 1 (BRCA1), BRCA2, and other OC susceptibility genes. Access to poly (ADP-ribose) polymerase inhibitors is required for NGS to be of clinical utility in prostate cancer. Allele-specific PCR or a small-panel multiplex-gene NGS was suggested to identify key alterations in CRC.

CONCLUSION: This document offers practical guidance on the clinical utility of NGS in specific cancer indications from an Asian perspective.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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