OBJECTIVES In the era of personalized medicine, there is a need of a more consistent understanding of cancer and optimizing its diagnosis. With the introduction of Next Generation Sequencing (NGS), which enables the parallel sequencing of multiple DNA fragments across hundreds of genes, the assessment of differences in tumor profiling methods has become increasingly important as it facilitates the application of novel, targeted therapies. The aim of this review was to assess and compare the efficacy of NGS versus standard diagnostic testing in patients with non-small cell lung cancer (NSCLC).

METHODS : A literature search in the PubMed and Cochrane databases undertaken in September 2019 resulted in the identification of relevant clinical trials and real world data. The findings on the comparative efficacy of NGS are included in the subsequent analysis.

RESULTS : Studies have shown NGS has greater sensitivity, specificity, and efficacy than standard tests. NGS enables identification of clinically relevant alterations even in patients who tested negative in prior non-NGS testing. By accurate identification of genomic alterations associated with NSCLC, NGS delivers clinical utility and improves matching of patients with approved targeted therapies in comparison with standard diagnostic methods. Besides influencing therapeutic strategy, NGS has higher predictive value for determining the response to treatment since it enables the assessment of Tumor Mutation Burden (TMB) and Microsatellite Instability.

CONCLUSIONS : Not only does the technology give new knowledge of the genetic architecture of NSCLC but it also opens up possibilities for optimizing its diagnostics, the therapeutic decision-making process, as well as for improving the survival of patients and their quality of life.