Luis G. Paz-Ares, MD, PhD, chair, the Medical Oncology Department, the Hospital Universitario 12 de Octubre, associate professor, the Universidad Complutense de Madrid, head, the Lung Cancer Unit, the National Oncology Research Center, discusses the importance of next-generation sequencing (NGS) and highlights current challenges with NGS for patients with non–small cell lung cancer (NSCLC).

NGS is used to detect if patients with NSCLC have specific molecular abnormalities that require a specific treatment, Paz-Ares begins. Previously, multiple genomic tests would be used to detect individual abnormalities; however, the ideal approach in the current treatment space it to complete a complex genomic test that detect a wide range of abnormalities, Paz-Ares explains. Using comprehensive NGS is more cost effective, faster, and requires less tissue from the patient, he adds. 

Although NGS has improved genomic testing for patients with NSCLC, current methods still have challenges, Paz-Ares says. Access to NGS technology remains an unmet need in some areas. In order to conduct NGS, institutions need to have the infrastructure to complete the tests, or NGS needs to be outsourced to another lab, Paz-Ares adds.

Along with completing NGS, being able to interpret the results and translate them into treatment decisions is crucial, Paz-Ares continues. A tumor molecular board consisting of a multidisciplinary team of specialists, including oncologists, molecular biologists, geneticists, and pathologists, is essential to interpret each test accurately, Paz-Ares adds. Results from NGS are not always clear, and a deeper investigation into the findings and how they relate to optimal treatment patterns could help inform a decision for a given patient, Paz-Ares concludes.

Videos

Luis G. Paz-Ares, MD, PhD, discusses the importance of next-generation sequencing and highlights current challenges with NGS for patients with non–small cell lung cancer.


Dr Paz-Ares on the Challenges of NGS in NSCLC

Luis G. Paz-Ares, MD, PhD, chief physician at the Hospital Universitario Doce De Octubre, discusses results from an integrated analysis of patients with 

 fusion—positive non–small cell lung cancer (NSCLC) enrolled in the STARTRK-2 (NCT02568267), STARTRK-1 (NCT02097810), and ALKA-372-001 (EudraCT 2012-000148-88) trials, which evaluated the safety and efficacy of entrectinib in patients with solid tumors.

The trials enrolled a total of 54 patients with 

 fusions in solid tumors across a variety of histologies, but the analysis conducted by Paz-Ares and his colleagues focused on the 10 patients with NSCLC. Results from the analysis were presented at the 2019 European Lung Cancer Congress.

In these patients, the response rate with entrectinib was 70%. In the 6 patients with NSCLC who also had brain metastases, 4 experienced an intracranial response. The safety profile for entrectinib in this patient population was also similar to that of the overall population.

These findings, says Paz-Ares, led the investigators to conclude that not only is entrectinib active in a variety of tumor types, it is particularly effective in 

 fusion—positive NSCLC and in patients who also have central nervous system disease.

Luis G. Paz-Ares, MD, PhD, chief physician at the Hospital Universitario Doce De Octubre, discusses an integrated analysis of patients with NTRK fusion–positive non–small-cell lung cancer enrolled in the STARTRK-2, STARTRK-1, and ALKA-372-001 trials, which evaluated the safety and efficacy of entrectinib in patients with solid tumors.
 

Luis G. Paz-Ares, MD, PhD

Articles

Dr Paz-Ares on the Challenges of NGS in NSCLC

Dr. Paz-Ares on Entrectinib in NTRK Fusion-Positive NSCLC