Dr Leonard B. Saltz: The Role of Next-Generation Sequencing in Advancing Precision Medicine

Leonard Saltz, MD, executive director of Clinical Value and Sustainability, head of Colorectal Oncology Section, Memorial Sloan Kettering Cancer Center, discusses the role next-generation sequencing currently plays in advancing precision medicine.


What role does next-generation sequencing currently play in advancing precision medicine?
Precision medicine is a term that we’re still working on defining, and to some degree, these next-generation sequencing (NGS) assays are what most people have in mind when we talk about precision medicine. One of the points I tried to make in the session we had this afternoon is that we’re not talking about the precision use of accepted targets. We’re talking about trying to use NGS to open a new therapeutic option for a patient that otherwise might not have it.

What we’re finding, and what the data I went through this afternoon shows, is that, unfortunately, that happens in a very small minority of patients. So, as we work to move this field forward, we have to keep a certain balance between optimism and realism and help patients understand that this is not going to help everyone. In fact, it’s not going to help a very substantial percentage of patients. Arguably, the substantial majority. There’s a limited number of people for whom it’s going to be helpful, and that’s going to be very useful.

I think it’s also going to become more important as we start to see some therapies become available that are highly effective with a very rare target, and it’s not going to be practical, I don’t believe, to go searching for multiple targets separately when we’re looking for the needle in the haystack kind of patient.

But, if we can assemble an NGS assay that looks for a lot of different rare possibilities, that may be a more practical way to bring those therapies to patients.

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