Illuminating the spectrum of genomic sequencing approaches in the precision oncology era: A UK perspective

Next-generation sequencing (NGS) offers broad molecular profiling that reveals genetic variation, gene expression and epigenetic modifications. This information is essential for identifying actionable biomarkers, enabling informed clinical decision-making and allowing therapeutic targeting of specific genetic alterations. International guidelines recommend biomarker testing in suitable patients, as targeted therapy offers greater benefits than non-specific chemotherapy. Several factors are pivotal for maximising the clinical utility and integration biomarker testing approaches in clinical practice. While utilising genomic information from NGS is becoming part of routine oncology practice, the integration of the significant complexity of the sequencing data can be challenging. Therefore, the involvement of multidisciplinary teams in precision oncology including oncologists, pathologists, radiologists, molecular biologists/geneticists and bioinformaticians is the need of the hour. Here, we highlight the complexities of NGS techniques and reporting that guide clinical decision-making in oncology, and also provide UK expert perspectives on the integration of NGS into local treatment practices.