A brief discussion on the value of commercially available comprehensive genomic profiling over homegrown testing.
David R. Gandara, MD: One thing I haven’t talked about is whether it’s preferable to do this testing of next-generation sequencing broad-based within your institution, and a homegrown test, or to send it to a commercial vendor. With a few exceptions, it’s better to use the commercial tests from a good, reliable company, with good sensitivity and specificity in their assay, because not only can you get the results and in a timely fashion, but all the annotation in the report is important and difficult to keep up.
I’ll give you an example. Let’s say a patient is found to have a ROS1 fusion in their cancer, and the good next-generation sequencing comprehensive genomic profiling reports tells you that we found this. It tells you what the allele frequency is and how much is there. It tells you if it’s functional or not. If it’s not, it tells you that it’s a variant of unknown significance. It’s not actionable, not treatable. It tells you what drugs the abnormality is sensitive to. It tells you what clinical trials are available for that patient against this target, and it gives all the references.
If you have a test like this, you need an army of people updating the report. New drugs come on board, new clinical trials open or close. Although you can do this in your own institution, it’s quite laborious. At UC [University of California], Davis, we have our own next-generation sequencing platform. We use it only for research, and the reason is because otherwise, you have to have this rapid turnaround time and you have to have all the annotation that a clinician needs. This differentiates the commercial next-generation sequencing from most institutional platforms.
Transcript edited for clarity.