NGS in prostate cancer – pro
The use of NGS is rapidly spreading and for most metastatic cancers it is supported by NCCN Biomarkers’ Compendium. However, it is less clear for prostate cancer because of a relative paucity of effective treatments. Some authors have expressed a conservative approach towards generalized NGS testing, and have suggested that currently NGS may be mainly useful in controlled research environments or clinical trials, where off-label administration of expensive drugs is restricted to prospective patient registry cohorts ]. Considering that only a minority of patients with cancer derive a clear benefit for matched treatments, they support that NGS for precision oncology based on emerging biomarkers remain an investigational strategy. In contrast, other authors advocate that routine upfront NGS testing should be used for all patients with metastatic cancer with limited standard of care options. ON the balance, it remains E/I for prostate cancer.
MEDICAL LITERATURE REFERENCES:
R. Colomer et al, When should we order a next generation sequencing test in a patient with cancer?
E.Clinical Medicine Lancet July 31, 2020, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30231-5/fulltext
Hovelson DH, Tomlins SA. The Role of Next-Generation Sequencing in Castration-Resistant Prostate Cancer Treatment. Cancer J. 2016;22(5):357-361. doi:10.1097/PPO.0000000000000217
NCCN Prostate Cancer 2022 and Biomarkers Compendium 2022