Sucharu Prakash, Director of Quality Services at Texas Oncology, shared a post on LinkedIn:
“I get this question often: ‘What’s the Best NGS Assay for my patient?’
The honest answer-It depends. There is no single ‘best’ NGS approach for every case. The right test is dictated by the clinical context – are you aiming for comprehensive profiling, rapid treatment decisions, or non-invasive monitoring?
That said, Comprehensive Genomic Profiling (CGP) is what you need- this involves DNA panels paired with RNA sequencing. This approach captures all major alteration classes: substitutions, indels, copy number changes, gene rearrangements, fusions. Additionally, IHC for several biomarkers (immune as well as others) is now standard.
There are numerous labs offering CGP– so how does one choose? Often the choice of laboratory comes down to ease of ordering, turnaround time, timely access to tissue and transport, easy to read report, EMR integration and customer support.
Liquid Biopsy (NGS on ctDNA) is fast and easy and has high concordance rates with tissue. Increasingly, concurrent somatic and liquid testing is endorsed by guidelines.
It also helps if one lab can perform all – somatic, liquid, germline and MRD testing.
In Texas Oncology, we do not endorse one lab over another- rather, we encourage ordering through Trapelo, our online tool.
Ultimately, this isn’t just a technology decision – it’s a clinical one.
The real challenge (and opportunity) ahead isn’t picking the ‘best’ test – it’s ensuring the right test is used at the right time for every patient.
So proud of my team at Texas Oncology for the success of our testing initiative- we now test almost every patient with CGP. Testing is the first and critical step, but interpretation of results and timely intervention ultimately improves outcomes- this is still a work in progress.”
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