Oncologists are increasingly incorporating NGS testing to guide targeted and immuno-oncology therapies1. Most clinical NGS testing is confined to large academic institutions and reference labs, despite the fact that most cancer patients are treated in the community settings. We therefore sought to examine molecular testing selection patterns directly from oncologists in order to better identify perceived gaps in testing and treatment paradigms

1. © 2018 Thermo Fisher Scientific Inc. All rights reserved. All trademarks are the property of Thermo Fisher Scientific and its subsidiaries unless otherwise specified. Thermo Fisher Scientific • 5781 Van Allen Way • Carlsbad, CA 92008 • thermofisher.com
INTRODUCTION
Oncologists are increasingly incorporating NGS testing to guide targeted
and immuno-oncology therapies1. Most clinical NGS testing is confined
to large academic institutions and reference labs, despite the fact that
most cancer patients are treated in the community settings. We
therefore sought to examine molecular testing selection patterns directly
from oncologists in order to better identify perceived gaps in testing and
treatment paradigms.
MATERIALS AND METHODS
A population-based survey of 100 practicing oncologists was conducted
across various practice types in the US (80%) and (19%) Europe [1%
not specified] in order to assess oncology needs in NGS testing for
clinical therapy guidance. Relevant topics regarding NGS testing queried
in this survey included: use of local versus commercial labs, turn-around
time (TAT), report information, reportable results, and actionable
variants.
CONCLUSIONS
Overall, these survey results highlight crucial oncologists’
considerations regarding NGS testing. Clinical alignment is
crucial for optimal patient care.
In this study, four out of five oncologists send out their NGS
testing, yet most oncologists (72%) would switch to in-house
testing, if it was available and met key clinical criteria.
By directly addressing Oncology/Pathology gaps (both real and
perceived), local pathology labs can play a pivotal role in
improving patient care and increasing the number of cancer
patients receiving next generation treatment modalities within
their communities.
REFERENCES
1. Moscow JA, Fojo T, Schilsky RL. The evidence framework
for precision cancer medicine. Nat Rev Clin Oncol. 2018 Mar;15(3):183-
192.
RESULTS
Juscilene S Menezes, PhD; Veena E Joy, MS, AEC; and Anagh A Vora, MD. Thermo Fisher Scientific 5781 Van Allen Way, Carlsbad, CA, 92008.
WHAT CAN WE LEARN FROM ONCOLOGISTS?
A SURVEY OF MOLECULAR TESTING PATTERNS
Patients Oncologists
1-49 1
50-199 21
200-399 39
>400 39
NR
2%
Within
institution
17%
Combination
25%
External,
within network
6%
External, third
party
50%
External or in
combination
81%
0 10 20 30 40 50
External testing is the only
option, not offered in-house.
Institution offers but
unsatisfactory
External labs provide the value;
local lab not needed
Not familiar with internal
capabilities; only external testing
Reasons Oncologists Send Samples Out
49%
26%
23%
2%
0
19
A
ctionability
Inform
ation,Easy
report
TA
T
TestSuccess
R
ateEase
ofordering
Sam
ple
input
C
osts
3-7 days
8%
No
10%
Unsure
12%
TAT
>7 days
92%
Does TAT Impact Patient Care?
No
5%
No, but open
to education
22%
Yes
73%
One hundred oncologists completed the survey with an average of 16
( 7) years of post-residency experience, managing an average of 451
( 514) patients. The respondents included a cross section of academic
(48%), private practice (25%), community hospital (20%), and non-
academic (7%) oncologists.
Overall, 98% of the oncologists surveyed used NGS testing and most
indicated that the test was either extremely (36%, 35/98) or moderately
(51%, 50/98) important to their practice.
Of the oncologists surveyed, 81% used external NGS testing (exclusively
or in combination with in-house testing).
The top three testing requirements ranked by the oncologists using NGS
were actionable mutation identification, successful result rate (QNS), and
TAT.
The majority of oncologists are supportive of their local pathologists, though
approximately 1/4 (19/82; 23%) of those sending samples to external labs
stated that their local pathology labs do not meet critical variables.
Of those sending samples out, approximately 1/4 (21/82; 26%), despite having
in-house NGS testing, reported that the local lab was unable to meet their
clinical needs (e.g., actionability, interpretable reports, TAT, etc.).
Additionally, the majority (76%, 68/90) of those receiving testing results with TAT
>7 days (92%, 90/98 of NGS users), indicated that improvement in clinical
criteria (i.e., TAT) would directly lead to improved patient care.
Nearly half of the physicians sending samples out (49%) did not have
institutional NGS testing. Most of these oncologists (73%) would
switch to in-house testing, if it was available and met key clinical
criteria.
2.8
3.5
3.8
3.9
4.5
4.7
4.8
Actionability
QNS
TAT
Information NGS panel
Sample input
Costs
Ease of ordering
Priority Rank Mean (1 to 7)
No NGS
2%
Neutral
4
Slightly
important
9
Moderately
important
50
Extremely
important
35
NGS
98%
Oncologists Using NGS & its Importance to their Practice
81% of the Oncologists Used External NGS Testing
Oncologists’ Priorities
Would Oncologists Switch to In-house Testing,
if it was Available and Met Criteria?
Reasons Local Lab was Unable to Meet Clinical Needs
Oncologists
Yes
76%
No
11%
Unsure
13%
19 from EU
80 from USA
1 not specified
100 Oncologists
Academ
ic
H
ospital
Com
m
unity
H
ospital
N
on-academ
ic
H
ospital
Private
Practice