Recommendations for the use of next-generation sequencing (NGS) for patients with advanced cancer in 2024: a report from the ESMO Precision Medicine Working Group
- Study type
- Clinical guideline
- Study name
- ESMO NGS 2024
- Design
- Consensus-based recommendations (clinical guideline) from the European Society for Medical Oncology (ESMO) Precision Medicine Working Group
- Source
- Annals of Oncology · 2024
In plain words
In this guideline, European experts recommend that for some patients with advanced cancer, a sample of the tumour should be checked with a broad genetic test called next-generation sequencing (NGS). The aim is to find changes in the tumour's genes so that, if a suitable targeted treatment exists, treatment can be chosen more precisely. In this update, the list of cancers for which this test is recommended has been widened, including advanced breast cancer. Whether you need this test should be discussed with your treating doctor.
Key points
Key guideline recommendations
- Level of evidence not stated in the abstract
As in the 2020 recommendations, ESMO recommends tumour NGS in advanced non-squamous non-small-cell lung cancer, prostate cancer, colorectal cancer, cholangiocarcinoma and ovarian cancer.
- Level of evidence not stated in the abstract
Tumour NGS is recommended in clinical research centres and in specific circumstances discussed with patients.
- Level of evidence not stated in the abstract
The recommendations have been widened to include patients with advanced breast cancer and rare tumours such as gastrointestinal stromal tumours, sarcoma, thyroid cancer and cancer of unknown primary.
- Level of evidence not stated in the abstract
ESMO recommends tumour NGS to detect tumour-agnostic alterations in patients with metastatic cancers wherever access to matched therapies exists.
Study population
Patients with advanced cancer for whom tumour next-generation sequencing (NGS) is being considered in routine clinical practice.
Endpoints
The working group assessed the clinical impact of tumour NGS in guiding treatment decisions using the ESCAT scale (ESMO Scale for Clinical Actionability of molecular Targets), taking cost-effectiveness and accessibility into account.
Clinical significance and place in guidelines
This report updates the 2020 ESMO recommendations and widens the list of advanced cancers in which tumour NGS is recommended, including advanced breast cancer, GIST, sarcoma, thyroid cancer and cancer of unknown primary. NGS is also recommended to detect tumour-agnostic alterations in metastatic cancers, provided that access to matched therapy exists. Practical implementation depends on the availability of testing and targeted drugs at each centre. Details of the level of evidence (ESCAT) for each cancer should be checked in the full text of the guideline.
Limitations
The abstract gives no information on the level of evidence of each recommendation, details of the consensus method or the full list of actionable alterations; these should be read in the full text. The recommendations were drawn up with cost-effectiveness and accessibility in mind and may not be equally applicable in all health systems. An erratum has been published for this article (Ann Oncol. 2025;36(4):472).
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.