A M Zeitlberger1, P M Putora2, S Hofer3, P Schucht4, D Migliorini5, A F Hottinger6, U Roelcke7, H Läubli8,9, P Spina10, O Bozinov1, M Weller3, M C Neidert1, T Hundsberger11,12. 1. Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland. 2. Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 3. Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland. 4. Department of Neurosurgery, University Hospital Bern, Bern, Switzerland. 5. Department of Oncology, University Hospital and University of Geneva, Geneva, Switzerland. 6. Department of Clinical Neurosciences and Department of Oncology, Lausanne University, Lausanne, Switzerland. 7. Department of Neurology, Kantonsspital Luzern, Lucerne, Switzerland. 8. Department of Theragnostics, Division of Medical Oncology, University Hospital Basel, Basel, Switzerland. 9. Cancer Immunotherapy, Department of Biomedicine, University of Basel, Basel, Switzerland. 10. Institute of Pathology, Ente Ospedalierio Cantonale Ticino, Ticino, Switzerland. 11. Department of Neurology, Kantonsspital St.Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland. thomas.hundsberger@kssg.ch. 12. Department of Hematology/Oncology, Kantonsspital St.Gallen, St. Gallen, Switzerland. thomas.hundsberger@kssg.ch.
Abstract
BACKGROUND: Glioblastoma is the most common malignant primary brain tumour in adults and driven by various genomic alterations. Next generation sequencing (NGS) provides timely information about the genetic landscape of tumours and might detect targetable mutations. To date, differences exist in the application and NGS assays used as it remains unclear to what extent these variants may affect clinical decision making. In this survey-based study, we investigated the use of NGS in adult patients with glioblastoma in Switzerland. METHODS: All eight primary care centres for Neuro-Oncology in Switzerland participated in this survey. The NGS assays used as well as the criteria for the application of NGS in newly diagnosed glioblastoma were investigated. Decision trees were analysed for consensus and discrepancies using the objective consensus methodology. RESULTS: Seven out of eight centres perform NGS in patients with newly diagnosed glioblastoma using custom made or commercially available assays. The criteria most relevant to decision making were age, suitability of standard treatment and fitness. NGS is most often used in fitter patients under the age of 60 years who are not suitable for standard therapy, while it is rarely performed in patients in poor general health. CONCLUSION: NGS is frequently applied in glioblastomas in adults in Neuro-Oncology centres in Switzerland despite seldom changing the course of treatment to date.
BACKGROUND: Glioblastoma is the most common malignant primary brain tumour in adults and driven by various genomic alterations. Next generation sequencing (NGS) provides timely information about the genetic landscape of tumours and might detect targetable mutations. To date, differences exist in the application and NGS assays used as it remains unclear to what extent these variants may affect clinical decision making. In this survey-based study, we investigated the use of NGS in adult patients with glioblastoma in Switzerland. METHODS: All eight primary care centres for Neuro-Oncology in Switzerland participated in this survey. The NGS assays used as well as the criteria for the application of NGS in newly diagnosed glioblastoma were investigated. Decision trees were analysed for consensus and discrepancies using the objective consensus methodology. RESULTS: Seven out of eight centres perform NGS in patients with newly diagnosed glioblastoma using custom made or commercially available assays. The criteria most relevant to decision making were age, suitability of standard treatment and fitness. NGS is most often used in fitter patients under the age of 60 years who are not suitable for standard therapy, while it is rarely performed in patients in poor general health. CONCLUSION: NGS is frequently applied in glioblastomas in adults in Neuro-Oncology centres in Switzerland despite seldom changing the course of treatment to date.
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