Compared with sequential individual-gene testing and hotspot gene-panel testing, using upfront next-generation sequencing (NGS) to simultaneously identify the mutation status of multiple genes in patients with metastatic non-small cell lung cancer (mNSCLC) offers faster results and “substantial” cost savings, according to a computer model economic impact analysis funded by Novartis Pharmaceuticals and published in JCO Precision Oncology.1

“Upfront NGS testing for all relevant molecular targets in NSCLC is less costly than performing single-gene testing, no matter what testing strategy is used,” reported lead study author Nathan A. Pennell, MD, PhD, of The Cleveland Clinic in Ohio, and coauthors. “Upfront NGS testing also results in the largest number of patients with targetable genetic alterations being identified in the shortest period of time.”

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Targeted therapies significantly improve progression-free survival (PFS) times, Dr Pennell noted. But sequential single-gene testing can slow decision making.

The study is one of a nascent but growing body of research about the economic impacts of NGS in NSCLC. Previous research has suggested that NGS will more effectively identify patients with activating lung cancer mutations who can be offered targeted therapies or enrollment in clinical trials.2

“As more clinically relevant genetic targets in NSCLC emerge that require routine testing at diagnosis, it is vital to identify the molecular testing strategy that is timeliest, spares the most tissue, and is most cost-efficient, as this must be done in every new patient,” Dr Pennell and coauthors wrote.1 “Our model illustrates that moving from sequential single-gene tests or even panels of tests to broader NGS testing for patients with advanced NSCLC is already the best strategy in these areas and will only become more relevant as the list of tests grows.”