What to Expect with Next-Generation Sequencing
- Doctors increasingly use next-generation sequencing (NGS) to devise precise treatment plans for cancer patients.
- NGS tests cancer cells to gauge gene activity, identifying gene abnormalities that may cause lung cancer.
- NGS results pinpoint lung cancer patients who could benefit most from targeted therapy. It can be critical in helping to find the best treatment plan.
- Doctors perform NGS on previously collected tumor tissue from lung cancer diagnoses. Sometimes, they may also perform a liquid biopsy from a blood draw.
These specialized tests examine and sequence a set of genes related to lung cancer. They help your doctor at Cone Health Cancer Center to provide personalized treatment options just for you by sequencing your cancer’s unique genetic makeup and help reveal specific mutations that can be targeted with tailored therapies. This kind of testing represents a significant stride in “precision medicine.”
Read MoreHow is NGS Performed?
The preferred method for conducting NGS involves testing a sample from your tumor biopsy. This typically does not require a new biopsy. It can be taken from the tumor tissue extracted from surgery when you were first diagnosed. Newer technologies including a liquid biopsy (a blood draw) have become common practice as well. Liquid biopsy examines circulating tumor DNA (ctDNA) that is shed from dead tumor cells in the bloodstream.Liquid biopsy test results arrive much faster, typically within a day to a week, compared to the 3 to 4 weeks for a tissue biopsy. But the test is less sensitive, meaning sometimes it can turn up false-negative results.
Dr. Mohamed Momamed breaks down when liquid biopsy is used.
When is Molecular Testing Performed?
“Because of the delay in getting the test result, we establish a way of handling this situation at Cone Health’s Cancer Center,” Dr. Mohamed Mohamed, a thoracic medical oncologist at Cone Health Cancer Center, explains to SurvivorNet.
“We work with the pulmonologist and thoracic surgeon. At the moment they do the tissue biopsy, they send that tissue to be tested immediately. At the same time they collect a blood sample and send it also for molecular testing.”
“So by the time I see the patient within a week, I have some information to make the decision for these patients. That saves time because we know testing takes two or three weeks to get the results. So we move it ahead of my visit rather than waiting for me to see the patient and order it.”
“Complimenting the blood with tissue actually saves us time because in many situations you send the tissue for testing and after two or three weeks you get a note that there was not insufficient material there, to do the test. So the blood saved me time and also gave me results before I get that insufficient request from the company,” explains Dr Mohamed.
Next Generation Sequencing for Lung Cancer: The Basics
How Can NGS Help Determine Treatment?
In cancer care, a significant improvement in the past decade is the development of targeted therapies, which are identified through NGS tests searching for specific mutations in your tumor. These tests investigate the genetic changes in your cancer cells to determine the most effective treatment.
Physicians identify therapeutic targets for these mutations, enhancing survival and quality of life for lung cancer patients.
NGS has transformed the way we treat lung cancer. Unlike traditional chemotherapy, which can harm both cancer and healthy cells, leading to side effects, targeted therapies are more precise. They focus only on the mutated genes, potentially causing fewer side effects while improving outcomes for cancer patients.
Will My Insurance Cover NGS Testing?
“Most of the time it’s covered by insurance because it’s a standard testing,” says Dr. Mohamed.
“I know for sure that in our cancer center, we did not have a lot of decline payment for testing. Some of the testing companies also promise that they’ll reach out to the patient if their cost for the test will be more than a hundred dollars, to let them know before the test is run,” he adds.
If you discover that your plan does not cover the comprehensive NGS testing, talk to your cancer team about options.
They may be able to work with your insurance company to get the test approved for you. Sometimes the company that runs the test may contact your insurance company on your behalf to waive the cost. The Next Generation Sequencing (NGS) Affordability Program may also be able to help lower the cost.
Questions To Ask Your Doctor
Before your next appointment, consider coming up with a list of questions to ask your doctor. They will help you understand your treatment options and what to expect moving forward. Some questions you may want to ask:
- Will you run next-generation sequencing both in the blood and in the tissue of my tumor?
- Do I have any genetic mutation that would make me eligible for targeted therapy?
- Am I a good candidate for targeted therapy?
- What are the side effects if I do receive targeted therapy?
- What’s the long-term outcome and prognosis based on my genetic mutation?
- Will my insurance cover NGS testing at Cone Health?
- Is there a clinical trial that would be relevant for me?
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