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Comment & Response
June 17, 2021

Is Universal Next-Generation Sequencing Testing of Patients With Advanced Cancer Ready for Prime Time?—Reply

Author Affiliations
  • 1Department of Internal Medicine, University of Michigan, Ann Arbor
  • 2Michigan Center for Translational Pathology, University of Michigan, Ann Arbor
  • 3Department of Pathology, University of Michigan, Ann Arbor
  • 4Rogel Cancer Center, University of Michigan, Ann Arbor
  • 5Department of Urology, University of Michigan, Ann Arbor
  • 6Howard Hughes Medical Institute, University of Michigan, Ann Arbor
JAMA Oncol. 2021;7(8):1246-1247. doi:10.1001/jamaoncol.2021.1907

In Reply We thank Dunn et al for their comments regarding our Original Investigation1 on the clinical benefit of next-generation sequencing (NGS) testing in patients with advanced solid tumors. In our study, we determined that 15.8% of patients had pathogenic germline variants (PGVs) identified, suggestive of potential inherited cancer predisposition. Among those with PGVs, approximately 30% were of potential therapeutic relevance, offering the opportunity to consider targeted treatments that may have greater likelihood of clinical benefit over standard therapies. With nearly 1 of every 6 patients in this cohort having a PGV identified, many of which are of therapeutic importance, we conclude that directed germline testing should be considered in all patients with advanced cancer. This recommendation is further supported by the large diversity of cancer types in which PGVs were identified, making the selection of particular patient groups for directed germline testing challenging.

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