Much Promise, Many Issues

OncLive Chairman,

Mike Hennessy

Whenever we talk about practicing precision medicine in oncology, next-generation sequencing quickly becomes part of the conversation. It’s difficult to imagine a treatment plan more customized than one based on a detailed molecular profile of that individual patient’s tumor.

Yet the intricacies of translating these advances in our understanding of tumor biology into daily clinical practice are daunting in their own right.

That theme is evident throughout this issue. Our cover story, “Is Next-Gen Sequencing Ready for Prime Time?”, describes a debate between two leading researchers about the clinical utility of molecular profiling in the management of patients with breast cancer, particularly in those with metastatic disease.

It is important to note that the eventual utility of genomic testing was not in question; the issue in this debate was the relevance of such testing to the treatment of patients today. The discussion turned on whether the information generated through genomic profiling is definitive enough and immediately actionable for practicing oncologists to put it to work for current patients. We’ll let you decide.

Our editor-in-chief, Maurie Markman, MD, addresses another issue in genomic tumor profiling: obtaining appropriate tissue samples for solid tumors to conduct nextgeneration sequencing. Research is under way on whether “liquid biopsies” that use blood-based biomarkers or fine-needle aspiration can provide the needed solutions.

As more next-generation testing instruments hit the market, questions about how the information that they produce will be used in the clinic are likely to become more pressing. Already, there are indications that payers are requiring that such diagnostics lead to a treatment option before they agree to cover the bill for the assays.

We plan to keep you up to date on the latest developments concerning all facets of these emerging technologies, particularly through our extensive coverage of Physicians’ Education Resource (PER) meetings, where leading researchers tackle these matters.

We encourage you to let us know what is on your mind. As always, thank you for reading.