Retrospective evaluation of the impact of next-generation sequencing technology on treatment changes and survival in cases of metastatic solid tumors

Objective: Metastatic solid tumors represent an advanced and aggressive stage of cancer that limits treatment options. Next-Generation Sequencing Technology (NGS) allows for a more detailed analysis of cancer patients' genetic profiles, identifying targetable mutations to aid in the development of personalized treatment approaches. This study aims to retrospectively evaluate the detection rate of targetable mutations via NGS, the initiation rate of treatment in cases with detected targetable mutations, and the impact of treatment changes on survival. Materials and Methods: The files of a total of 882 patients with solid organ tumors treated and followed at Yeditepe University Koşuyolu Hospital, Medical Oncology Clinic between 2021 and 2023 were retrospectively reviewed. NGS tests were performed during treatment for 54 of these patients. Patients over the age of 18, with advanced stage solid tumors and histopathological diagnosis, who received at least one line of systemic treatment and consented to participate in the study were included. Demographic characteristics of the patients such as age, sex, stage, performance status, treatments received, pathological characteristics of the tumor, NGS results, and survival times were retrospectively obtained from the patients' files, and correlation analysis was performed. Results: The sex, age, stage, histopathology of the tumor, mutations detected and targetable by NGS, TMB score, MSI results, and metastasis locations of cases with metastatic solid tumors were tabulated retrospectively. In 46% of the 54 patients tested with NGS (25 patients), targetable genetic mutations were identified. Conclusion: Targetable genetic mutations were detected in 25 of the 54 patients who had not previously been identified with targetable mutations and had exhausted their treatment options, through genetic analysis with NGS. 8 patients had a chance to have new treatment according to their genetic mutations found by NGS. When survival analysis was performed, no statistically significant difference was found between the group receiving targeted therapy and the group not receiving it.