How to read a next-generation sequencing report-what oncologists need to know.

Next-generation sequencing (NGS) of tumor cell-derived DNA/RNA to screen for targetable genomic alterations is now widely available and has become part of routine practice in oncology. NGS testing strategies depend on cancer type, disease stage and the impact of results on treatment selection. The European Society for Medical Oncology (ESMO) has recently published recommendations for the use of NGS in patients with advanced cancer. We complement the ESMO recommendations with a practical review of how oncologists should read and interpret NGS reports. A concise and straightforward NGS report contains details of the tumor sample, the technology used and highlights not only the most important and potentially actionable results, but also other pathogenic alterations detected. Variants of unknown significance should also be listed. Interpretation of NGS reports should be a joint effort between molecular pathologists, tumor biologists and clinicians. Rather than relying and acting on the information provided by the NGS report, oncologists need to obtain a basic level of understanding to read and interpret NGS results. Comprehensive annotated databases are available for clinicians to review the information detailed in the NGS report. Molecular tumor boards do not only stimulate debate and exchange, but may also help to interpret challenging reports and to ensure continuing medical education.

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Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Disclosure SS: grants: Swiss National Cancer Foundation (fellowship), Fill the Gap (Career development grant), Von Tobel Foundation (research funding), Bristol Myers Squibb (BMS) (research funding), AstraZeneca (research funding), Janssen (research funding); consulting fees/advisory boards (all institutional): BMS, Merck Sharp & Dohme (MSD), Boehringer Ingelheim, AstraZeneca. Travel support: Takeda, MSD, Boehringer-Ingelheim. WJ: grants: AstraZeneca; honoraria: Bayer, Janssen; consulting fees: GlaxoSmithKline (GSK); advisory board: GSK, Janssen, MSD. CB: advisory board: AstraZeneca, Pfizer, Roche, Takeda, Boehringer Ingelheim, Janssen; travel support: AstraZeneca, Takeda. MM: Swiss National Science Foundation grant; consulting fees, payment or honoraria for lectures etc. (all institutional): Merck, GlaxoSmithKline, Roche, Novartis, ThermoFisher. SR: grants (all research funding): AstraZeneca, Merck, Roche, Amgen; consulting fees/payment or honoraria for lectures, expert testimony etc. (all institutional): Amgen, AstraZeneca, Bayer, BMS, Boehringer-Ingelheim, Eli Lilly, Janssen, Merck, MSD, Novartis, Otsuka, Pfizer, PharmaMar, Roche Pharma and Roche Diagnostics, Sanofi, Takeda; travel support (institutional): Roche, Eli Lilly, BMS, Amgen, AstraZeneca, MSD; participation on data safety monitoring board or Advisory board; Roche (institutional); other: vice president of SAKK; elected member of the Swiss Federal Drug Commission. AO: advisory role (compensated, institutional): AstraZeneca, Astellas, Bayer, Janssen, Molecular Partners, MSD, Pfizer, Roche, Sanofi Aventis (compensated, institutional) Novartis, Janssen, Bayer, MSD, AstraZeneca (compensated); research support (institutional): TEVA, Janssen; travel support: Astellas, Bayer, Janssen, Sanofi Aventis; speakers bureau (compensated, institutional): Astellas, Bayer, Janssen. MJ: advisory role (institutional): Novartis, AstraZeneca, Basilea Pharmaceutica, Bayer, BMS, Debiopharm, MSD, Roche, Sanofi; research funding: Swiss Cancer Research; travel grants: Roche, Sanofi, Takeda. All other authors have declared no conflicts of interest.