ArticleTherapeutic advances in medical oncology2025
Next-generation sequencing in the management of cancer: an evaluation of the clinical effectiveness in Jordan.
Article in Therapeutic advances in medical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The widespread use of next-generation sequencing (NGS) panels to guide targeted therapies in advanced malignancies raises questions regarding their real-world impact on clinical outcomes and affordability. Objectives: The study aims to find trends in targetable genetic alterations among late-stage cancer patients in the Jordanian population and to assess the clinical effectiveness of NGS testing in Jordan. Design: This article is a retrospective observational analysis. Data extracted from patient files were used to determine genetic alteration trends and for a comparative assessment of progression-free survival (PFS) between patients receiving NGS-guided personalized treatment compared to those receiving conventional treatment. Methods: Two hundred thirteen nonselected late-stage cancer patients from three Jordanian hospitals (2019-2024) were included in this study. Key data points included demographics, genetic variations, and treatment details. Statistical analysis involved the use of the Cox proportional hazards model to evaluate PFS between the two groups of patients. Results: Clinically significant genetic alterations were found in 89 patients (42%), with the most common genes being KRAS (20%), PIK3CA (9%), ERBB2 (7%), EGFR (6%), and BRCA1 and 2 (1.5% each). Microsatellite instability-high status was seen in 8 patients (3.7%). Out of the 89 patients with targetable genetic variations, 80.9% received their recommended NGS-guided treatments, while 19.1% did not due to cost or drug unavailability. PFS was significantly improved for patients receiving NGS-guided targeted treatment compared to conventional treatment in the general population with a hazard ratio (HR) of 0.216, the colorectal cancer population (HR of 0.185), the breast cancer population (HR of 0.239), and the lung cancer population (HR of 0.089). Conclusion: NGS testing is a very beneficial tool for patients with advanced malignancies to select targeted therapies and potentially improve survival. However, the incorporation of NGS testing in Jordan faces challenges such as high testing and treatment costs and drug unavailability.
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