Abstract 503P
Background
Next generation sequencing (NGS) has revolutionized the traditional approach to cancer management of one-size-fits-all to a more personalized, proactive and precise treatment model over the years. However, implementation of NGS in developing countries imposes significant challenges. The real-world experience of implementing NGS in clinical practice would confer invaluable insights into practical challenges and strategies needed to successfully integrate NGS in developing Asian countries.
Methods
This study retrospectively analyzed the usefulness of NGS testing done as per ESCAT among new patients that was seen in a private Oncology Clinic in an urban setting in Malaysia from January 2024 till June 2024 irrespective of patient demographics, tumor sites, clinical staging and types of NGS testing done.
Results
Among 67 new cases seen, 35 (52.2%) patients underwent NGS testing out of which 29 patients underwent NGS on tumour tissue and six on ctDNA. Only eight patients (22.9%) had clinically meaningful results of either ESCAT evidence Tier I or Tier II followed by 16 patients (45.7%) with results equivalent to ESCAT evidence Tier III to Tier X and 11 patients (31.4%) revealed negative results. There were no significant difference in terms of clinically meaningful outcome between tumour tissue and ctDNA testing (CI: 0.0764-3.5607, OR:0.5217,P-Value : 0.5067). The most common types of mutations detected were TP53 (33.3%) and PIK3A (33.3%) followed by APC gene (20.8%), KRAS (16.6%), ATM (16.6%) and EGFR (8.3%) respectively. One patient each revealed high and intermediate tumour burden (TMB) whereas six patients (25%) noted to have low TMB. Besides, 62.4% of patients revealed MS stable status and One patient with Lynch Syndrome detected. Common tumour site distributions were colon (40%), lung (22.9%) and liver (11.4%).
Conclusions
Implementation of NGS in an already constraint developing Asian countries presents unique challenges that require pragmatic consideration, strategic planning as well as population targeted research and intervention in order to bridge gap in clinical relevance which would enhance its outcome in Clinical Oncology field.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.