Conference Abstracts - 5th Binaytara Precision Oncology Summit: Redefining Cancer Treatment with Molecular Targeted Strategies
Vol. 5, Issue Supplement 1, 2025 · S1-2
Utilization and Timing of First Tumor Next-generation Sequencing Testing (NGS) in Patients with Five Most Common Cancers in the USA
Zeynep Irem Ozay, MD,Yeonjung Jo, PhD,Chadi Hage Chehade, MD,Micah Ostrowski, MD,Nicolas Sayegh, MD,Georges Gebrael, MD,Tanner Hardy, MD,Edwin Lin, MD, PhD,Richard Ji, BS,Roberto Nussenzveig, PhD,Ayana Srivastava, BS,Vinay Mathew Thomas, MD,Sumati Gupta, MD,Benjamin Maughan, MD,Neeraj Agarwal, MD,Umang Swami, MD, MS
Submission received: 2025-08-12 / Accepted: 2025-09-03 / Published: 2025-09-26
Abstract
Background
In the USA, the five most common advanced/metastatic solid tumors are advanced non-small cell lung cancer (aNSCLC), metastatic breast cancer (mBC), metastatic prostate cancer (mPC), advanced colorectal cancer (aCRC), and metastatic pancreatic cancer (mPanC). Life-prolonging targeted therapies are approved for patients with tumor-susceptible alterations, and guidelines recommend NGS to identify these alterations. Herein, we assessed the overall utilization of NGS and the timing of NGS in relation to the time of death in real-world patients with these cancers.
Methods
This retrospective study utilized the nationwide Flatiron Health electronic health record-derived de-identified database. Eligibility: diagnosis of aNSCLC, mBC, mPC, aCRC, mPanC, with information on receipt of NGS (blood/tissue) and recorded date of death. The time between each patient's first NGS result and date of death was measured, and patients were categorized into three groups: NGS results delivered > 3 months before death, within 3 months of death, and delivered/reported after death. Frequencies and percentages of the three categories were reported, also by the year of death and practice type.
Results
Of 86,536 patients with NSCLC, 31,375 received NGS (36.3%), of whom 19,958 had a date of death recorded. Of 36,000 patients with mBC, 11,550 were tested (32.1%), of whom 5,689 had a date of death recorded. Of 24,105 patients with mPC, 7,439 were tested (30.9%), of whom 3,397 had a date of death recorded. Of 35,702 patients with aCRC, 14,642 were tested (41%), of whom 8,553 had a recorded date of death. Of 14,964 patients with mPanC, 5,298 were tested (35.4%), of whom 3,957 had a recorded date of death. The timing of NGS relative to the time of death by cancer type is shown in Table. Across all cancers, the rate of patients receiving NGS results > 3 months before death increased over time, while the rate of those receiving results within 3 months of death or after death decreased. Baseline characteristics (race-ethnicity, insurance plan, practice type) and NGS rates by year of death in the three categories will be presented at the meeting.
Conclusions
Despite the availability of life-prolonging targeted therapies based on NGS results, a sizeable number of patients either do not undergo NGS or have their first NGS very late in the course of disease (i.e., within 3 months of death). These results warrant better utilization of tumor NGS in a timely fashion in patients with cancer to optimize survival outcomes.