Next‐generation sequencing (NGS)‐based diagnostics have demonstrated clinical utility in predicting improved survival benefits with targeted treatment in certain cancer types, and positive cost–benefit in several healthcare systems. However, clinical adoption in Singapore remains low despite commercial availability of these diagnostics. This expert opinion review examines the key challenges to the clinical adoption of NGS‐based diagnostics in Singapore, provides recommendations on impactful initiatives to improve adoption, and also offers practical guidance on specific cancer types in which NGS‐based diagnostics are appropriate for use in Singapore. Limited patient affordability is one major challenge to clinical adoption of NGS‐based diagnostics, which could be improved by enabling patient access to more funds for specific cancer types with clear benefits. Expert opinion based on current evidence and clinical experience supports the upfront use of hotspot panels in advanced non–small cell lung cancer (NSCLC), metastatic colorectal cancer, advanced and recurrent ovarian cancer, and acute myeloid leukemia. Comprehensive genomic profiling could be considered for upfront use in select patients with NSCLC and ovarian cancer, or in refractory patients with the four cancer types. Wider adoption of NGS‐based diagnostics will improve the delivery of cancer care in Singapore and Asia‐Pacific, and thus lead to better patient outcomes.

中文翻译：

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改善新加坡基于 NGS 的癌症诊断的临床采用的建议。


基于下一代测序（NGS）的诊断已证明在预测某些癌症类型的靶向治疗改善生存效益方面具有临床实用性，并且在多个医疗保健系统中具有积极的成本效益。然而，尽管这些诊断方法已商业化，但新加坡的临床采用率仍然很低。该专家意见审查探讨了新加坡临床采用基于 NGS 的诊断面临的主要挑战，提供了有关提高采用的有效举措的建议，并就适合在新加坡使用基于 NGS 的诊断的特定癌症类型提供了实用指导。患者负担能力有限是临床采用基于 NGS 的诊断的一大挑战，而通过让患者能够获得更多针对特定癌症类型的资金并带来明显好处，可以改善这一挑战。基于当前证据和临床经验的专家意见支持在晚期非小细胞肺癌（NSCLC）、转移性结直肠癌、晚期和复发性卵巢癌以及急性髓系白血病中预先使用热点组合。可以考虑在选定的非小细胞肺癌和卵巢癌患者或患有四种癌症类型的难治性患者中预先使用全面的基因组分析。更广泛地采用基于 NGS 的诊断将改善新加坡和亚太地区癌症护理的提供，从而带来更好的患者治疗结果。