Utility And Real-World Clinical Outcomes Of Next-Generation Sequencing In Advanced Non-Small-Cell Lung Cancer In South Indian Population.

Background: Next-generation sequencing (NGS) is an advanced sequencing technology that enables rapid sequencing of numerous DNA strands and perform simultaneous analysis of various genes and diverse genomic characteristics. While there is a lack of substantial evidence available, the extent to which NGS may improve clinical outcomes among cancer patients in a real-world scenario remain uncertain.

Objective: To investigate the clinical utility of NGS in patients treated with advanced non-small cell lung cancer (NSCLC) and its impact on real-world clinical outcomes, treated with targetable or non-targetable agents.

Materials and methods: This was a prospective observational study conducted in 322 participants distributed over two broad categories- next-generation sequencing (NGS) and non-NGS. The NGS category consisted of patients who underwent genetic mutation screening by the NGS method. This group was further categorized into two sub groups- NGS - targetable and NGS- non targetable. The non- NGS category consisted of patients who did not undergo mutation testing by the NGS method.

Results: There was a significant difference in overall survival between NGS and non-NGS groups (p=0.0038). There was a significant difference between NGS targetable and non- targetable groups in terms of PFS (p= 0.0016) and overall survival (OS) (p<0.0001). There was a significant difference between NGS- matched and non-matched groups in terms of PFS (p<0.00011) as well as OS (p<0.0001).

Conclusion: NGS significantly improved survival in advanced NSCLC. Patients who received treatments matched to their NGS results experienced significantly longer survival compared to those with non-matched treatments.