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

M F Mosele; C B Westphalen; A Stenzinger; F Barlesi; A Bayle; I Bièche; J Bonastre; E Castro; R Dienstmann; A Krämer; A M Czarnecka; F Meric-Bernstam; S Michiels; R Miller; N Normanno; J Reis-Filho; J Remon; M Robson; E Rouleau; A Scarpa; C Serrano; J Mateo; F André

doi:10.1016/j.annonc.2024.04.005

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

Ann Oncol. 2024 Jul;35(7):588-606. doi: 10.1016/j.annonc.2024.04.005. Epub 2024 May 27.

Authors

M F Mosele¹, C B Westphalen², A Stenzinger³, F Barlesi⁴, A Bayle⁵, I Bièche⁶, J Bonastre⁷, E Castro⁸, R Dienstmann⁹, A Krämer¹⁰, A M Czarnecka¹¹, F Meric-Bernstam¹², S Michiels⁷, R Miller¹³, N Normanno¹⁴, J Reis-Filho¹⁵, J Remon¹⁶, M Robson¹⁷, E Rouleau¹⁸, A Scarpa¹⁹, C Serrano²⁰, J Mateo²⁰, F André²¹

Affiliations

¹ INSERM U981, Gustave Roussy, Villejuif; Department of Cancer Medicine, Gustave Roussy, Villejuif, France.
² Comprehensive Cancer Center Munich & Department of Medicine III, University Hospital, LMU Munich, Munich.
³ Institute of Pathology, University Hospital Heidelberg and Center for Personalized Medicine (ZPM), Heidelberg, Germany.
⁴ INSERM U981, Gustave Roussy, Villejuif; Department of Cancer Medicine, Gustave Roussy, Villejuif, France; Faculty of Medicine, Université Paris-Saclay, Kremlin Bicêtre.
⁵ Faculty of Medicine, Université Paris-Saclay, Kremlin Bicêtre; Drug Development Department (DITEP), Gustave Roussy, Villejuif; Oncostat U1018, Inserm, Université Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif; Service de Biostatistique et Epidémiologie, Gustave Roussy, Villejuif.
⁶ Department of Genetics, Institut Curie, INSERM U1016, Université Paris Cité, Paris, France.
⁷ Oncostat U1018, Inserm, Université Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif; Service de Biostatistique et Epidémiologie, Gustave Roussy, Villejuif.
⁸ Department of Medical Oncology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid.
⁹ Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona; University of Vic-Central University of Catalonia, Vic, Spain; Oncoclínicas, São Paulo, Brazil.
¹⁰ Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
¹¹ Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw; Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
¹² Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA.
¹³ Department of Medical Oncology, University College London, London; Department of Medical Oncology, St Bartholomew's Hospital, London, UK.
¹⁴ Scientific Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
¹⁵ Department of Pathology, Memorial Sloan Kettering Cancer Center, New York.
¹⁶ Department of Cancer Medicine, Gustave Roussy, Villejuif, France.
¹⁷ Breast Medicine and Clinical Genetics Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.
¹⁸ Tumor Genetics Service, Medical Biology and Pathology Department, Gustave Roussy, Villejuif, France.
¹⁹ Section of Pathology, Department of Diagnostics and Public Health, University of Verona-School of Medicine, Verona, Italy.
²⁰ Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona.
²¹ INSERM U981, Gustave Roussy, Villejuif; Department of Cancer Medicine, Gustave Roussy, Villejuif, France; Faculty of Medicine, Université Paris-Saclay, Kremlin Bicêtre. Electronic address: [email protected].

PMID: 38834388
DOI: 10.1016/j.annonc.2024.04.005

Abstract

Background: Advancements in the field of precision medicine have prompted the European Society for Medical Oncology (ESMO) Precision Medicine Working Group to update the recommendations for the use of tumour next-generation sequencing (NGS) for patients with advanced cancers in routine practice.

Methods: The group discussed 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.

Results: As for 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 carry out 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 carrying out tumour NGS to detect tumour-agnostic alterations in patients with metastatic cancers where access to matched therapies is available.

Conclusion: Tumour NGS is increasingly expanding its scope and application within oncology with the aim of enhancing the efficacy of precision medicine for patients with cancer.

Keywords: ESCAT; advanced cancer; next-generation sequencing (NGS); precision medicine.

Publication types

Practice Guideline

MeSH terms

Europe
High-Throughput Nucleotide Sequencing* / methods
High-Throughput Nucleotide Sequencing* / standards
Humans
Medical Oncology / methods
Medical Oncology / standards
Neoplasms* / genetics
Neoplasms* / pathology
Neoplasms* / therapy
Precision Medicine* / methods
Precision Medicine* / standards