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Gregory J. Riely, MD, PhD


Streamlining the Process for Obtaining Next-Generation Sequencing Results in NSCLC

By: Amy MacDonald, MS
Posted: Wednesday, February 8, 2023

It is in the best interest of patients with newly diagnosed metastatic non–small cell lung cancer (NSCLC) to receive next-generation sequencing results for their tumors in a timely fashion. Although such results are needed to inform first-line treatment decisions, they may be delayed for a variety of reasons. Raymond Liu, MD, of The Permanente Medical Group, San Francisco, and colleagues identified steps to improve the wait time to receipt of next-generation sequencing results. Published in JCO Oncology Practice, these data demonstrate that improved communication with both external next-generation sequencing vendors and internal departments may prove to be keys to solving this issue.

A preintervention cohort of 42 patients with metastatic NSCLC (diagnosed at Kaiser Permanente San Francisco’s 21 cancer centers between December 2018 and August 2021) was identified. Electronic medical data revealed that these patients received their next-generation sequencing results an average of 27 (standard deviation [SD] = 9) days after pathologic diagnosis.

To reduce this time lag, researchers implemented several new initiatives, including earlier oncologist review of pathology results, improved next-generation sequencing vendor availability, and prioritization of next-generation sequencing testing. In addition, automated electronic weekly pathology reports were created to provide earlier identification of actionable patients with NSCLC.

The researchers’ interventions reduced the mean time from pathologic diagnosis to next-generation sequencing results from 27 (SD = 9) days to 17 (SD = 6) days. The median time from biopsy results to next-generation sequencing order was reduced from 7 days to 1 day. Total time from pathologic diagnosis to treatment was also reduced from 33 (SD = 18) days to 22 (SD = 8) days. The researchers concluded that processing time for tissue next-generation sequencing may be effectively reduced in an integrated health-care system.

Disclosure: For full disclosure of study authors visit

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