GENOMIC TESTING

<em>FLT3</em> mutation analysis in laboratories has brought on reimbursement barriers in clinical oncology. Jordan Clark, chief commercial officer, Diaceutics, a diagnostic development and commercialization company, spoke to <em>Targeted Oncology</em> about the cause of reimbursement issues and how the problem affects all parties involved.

A new study shows comparability between liquid biopsy and tissue biopsy in both diagnostics and monitoring of non&ndash;small cell lung cancer (NSCLC). However, based on the results, liquid biopsies may be preferable to help oncologists make swifter decisions that help manage the disease.<br /> &nbsp;

Charles G. Mullighan, MBBS, MSc, MD, discussed with&nbsp;<em>Targeted Oncology&nbsp;</em>the role of genetic variants in understanding a patient&rsquo;s predisposition to ALL. He highlighted findings in research that may help in utilizing the current understanding of these genetic variants to make treatment decisions for patients with ALL.

Timothy F. Burns, MD, PhD, discusses the value of conducting next-generation sequencing in-house for patients with lung cancer compared with sending out to an external laboratory for molecular profiling results. Burns says he conducts NGS testing on all patients with metastatic and nonsquamous lung cancers. This includes patients that are both smokers and non-smokers.

A review of patients with advanced non&ndash;small cell lung cancer treated in a community practice setting demonstrated that not all patients recommended for receiving genomic testing are being appropriately tested for potential genetic drivers of disease.<br /> &nbsp;

The development and advancements in targeted therapies and immunotherapies have dramatically changed drug development and clinical practice. With access to widespread genomic research and next-generation sequencing, details about somatic and germline mutations in solid tumors can better inform the treatment plan,&nbsp;Howard &ldquo;Skip&rdquo; Burris III, MD, explains.

Olga K. Weinberg, MD, discusses how genomic testing has evolved over the years and how she envisions the role of NGS will change as more is learned about genetic mutations.&nbsp;

Jennifer Geurts, MS, CGC,&nbsp;discusses the current role of genetic testing, both in patients diagnosed with cancer, as well as family members that could be at risk of developing cancer. She also highlights how genetic counseling can impact treatment decisions in patients with pancreatic, breast, and ovarian cancers.

In the first precision oncology trial for pediatric patients with cancer, a larger percentage of patients than expected who underwent screening for targetable alterations in their tumors were able to be assigned to a treatment targeted to that alteration or pathway.

In an interview with&nbsp;<em>Targeted Oncology</em>, Banu Arun, MD, discussed the role of genetic testing in patients with metastatic breast cancer. She highlighted the importance of identifying various mutations, including&nbsp;<em>BRCA1/2&nbsp;</em>mutations in light of the approval of PARP inhibitors. In addition, she spoke to how the role of genomic testing is evolving in this field with the development of new targeted agents.

A new single-center report has found that the results of next-generation sequencing&ndash;based molecular profiling for non&ndash;GI stromal tumor sarcomas provided information used to effectively guide clinical management.

Significantly higher response rates were seen in patients with&nbsp;<em>ALK</em>-positive non&ndash;small cell lung cancer who had been treated with at least 1 prior ALK tyrosine kinase inhibitor &nbsp;before receiving lorlatinib and who harbored an&nbsp;<em>ALK&nbsp;</em>resistance mutation compared with those who did not have an&nbsp;<em>ALK&nbsp;</em>mutation.

A new phase III trial has demonstrated that a novel extended-release formulation of anagrelide (Thromboreductin) is noninferior to immediate-release anagrelide in reducing platelet counts in patients with essential thrombocythemia.

At the 2019 American Society of Clinical Oncology&ndash;Society for Immunotherapy of Cancer Clinical Immuno-Oncology Symposium, Natalie Vokes, MD, MPhil, reviews the latest evidence linking tumor mutational burden to outcome in patients treated with immune checkpoint blockade as well as genomic correlates of response within the tumor immunity cycle.

An analysis of the genotyping of tumor tissue samples from patients with hepatocellular carcinoma identified frequent alterations and potentially actionable mutations in cases of HCC, and helped to confirm the clinical utility of next-generation sequencing testing for matching patients to targeted therapies and immunotherapies.

Genomic testing could increasingly be utilized to guide treatment decisions for Veteran patients with cancer. Two recent announcements confirm an emerging focus from Veterans Affairs on genetic testing that provides more informed and tailored cancer care for US Veterans.

Lung Cancer

Over 60 healthcare organizations are pressing the Center for Medicare and Medicaid Services to revise its current interpretation of the National Coverage Determination, which they say wrongly excludes germline next-generation sequencing-based testing from Medicare coverage for patients with early-stage cancers.<br /> &nbsp;

General Cancer

Increasing clinical relevance of less common gene signatures and alterations is leading to a benefit from broad-panel next-generation sequencing testing for patients with metastatic non&ndash;small cell lung cancer, according to an expert at Memorial Sloan Kettering Cancer Center.