Dr Howard Burris on Determining Which Patients Will Benefit From Next-Generation Sequencing

Howard A. "Skip" Burris, III, MD, FACP, FASCO, president, clinical operations, and chief medical officer of Sarah Cannon Research Institute, discusses differentiating which patients will benefit from next-generation sequencing (NGS) and the role of NGS testing for matching patients to clinical trials.

Transcript

While next-generation sequencing can benefit patients who can be matched to a targeted therapy, not every patient receives this benefit. How can you differentiate which patients should receive this testing?

I think that gets to one of the challenges around education on molecular profiling and next-generation sequencing (NGS). There’s a lot of discussion on should I profile this patient? And my answer to that for where we sit today is we don’t know, We want to think of the stereotypical patient that needs it or an aggressive patient that needs it, and we really need to profile all or current relapsed patients. We don’t know about utilizing these tests in the adjuvant, post-surgery setting, but once someone’s had standard of care or once someone has metastatic disease, I urge my colleagues to profile at that point and understand the biology of the tumor.

Sometimes, it will give you a direct match to a therapy, and other times it will give you a sense of just how aggressive that tumor is or whether the patient’s appropriate for immunotherapy.

Does NGS also have a role for matching patients to a clinical trial is there is no approved drug for their disease?

NGS testing is absolutely a driver for enrollment in clinical trials. Just one anecdote that we presented last year at ASCO [American Society of Clinical Oncology] was that if a case was presented at one of our molecular cancer conferences—so the patient had been profiled and brought to this molecular tumor board—there was a more than 2-fold improvement in the odds of that patient going on a clinical trial, up from about 5% to 8% for our group as a whole to 18% to 20%. So, creating the conversation, being educated as to the aberration that are found, and then thinking about what trials might be appropriate, maybe not always the exact match of the target, but really the conversation about what type of trials might be a good fit for the patient.