There is a new diagnostic weapon to fight lung cancer, which in Italy is in third place for diffusion (41 thousand cases registered in 2020) and first as a cause of death (34 thousand deaths per year): the innovative Ngs tests ( Next Generation Sequencing), which allow for simultaneous evaluation of dozens of genetic alterations on non-small cell lung cancers (Nsclc). In the case of lung cancer, these NGS tests are twice as important, both because it is the tumor with the highest number of identifiable mutations, and because it is difficult to take tissue samples in the lung area to reveal the different genetic mutations. which represent the first step in developing targeted therapies.
Research has uncovered genetic mutations that can be present in 60% of Nsclc-type lung cancers; and for these it is potentially possible to set up targeted therapies in 4 out of 10 cases, capable of improving the quality and life expectancy of patients. This is why an increasingly innovative and effective diagnosis makes a difference in the therapeutic approach of patients with lung cancer. On the occasion of the meeting “New strategies for the fight against lung cancer”, promoted by The European House Ambrosetti with the non-conditioning contribution of Amgen, experts and representatives of the institutions discussed the need to homogenize the use of Ngs tests from part of public health, taking into account how in our country one adenocarcinoma out of two is not yet genetically “photographed” as it would be possible.
“Less than 40% of our molecular biology laboratories currently use Ngs in the daily diagnostic routine of lung tumors, confirmed Marcello Tiseo, associate professor of Oncology at the University of Parma, head of the Uo ‘Management of complex oncological outpatient activities’ and Pdta coordinator of thoracic oncology Auo of Parma – in the majority of the structures a basic molecular study is performed, compared to what is possible with Next Generation Sequencing technology. So over 50% of non-small cell lung cancers risk not being adequately characterized from a molecular point of view: an aspect that is anything but secondary, considering that 5-year survival (currently 16%) is increasing. precisely because of the treatments with targeted drugs, which are more effective and better tolerated by patients than chemotherapy, alone or in combination with immunotherapy “.
Although at the moment a reimbursement rate has not yet been defined by the Ministry of Health for Ngs tests, these can also represent a saving for the NHS. This is confirmed by a study on two Italian structures, said Carmine Pinto, president of the Federation of groups of Italian oncological cooperatives (Ficog): “The average cost for NGS tests with medium-small panels is about 1,150 euros. These panels allow to obtain the information necessary for the use in clinical practice of the molecularly targeted drugs already available “.
The overall expenditure for the individual tests performed in sequence, on the other hand, is difficult to quantify because they vary greatly in number and type. “Precisely for the non-coded management of traditional tests it is correct to assume that Next Generation Sequencing also allows a net saving for the NHS – continued the specialist -. For a more sustainable use of public resources, effective management of the distribution of laboratories is needed. with adequate technologies and professional resources in the area: the ideal would be to have one for every 700-800 thousand inhabitants, with a logistics that allows biological samples to be run and not patients, as part of the programming of regional oncological networks to collect the greatest number of data useful for care and research “.