@article{7fbb66539bc54802a83a4776653093a9,
title = "Application of next-generation sequencing in gastrointestinal and liver tumors",
abstract = "Malignant transformation of normal cells is associated with the evolution of genomic alterations. This concept has led to the development of molecular testing platforms to identify genomic alterations that can be targeted with novel therapies. Next generation sequencing (NGS) has heralded a new era in precision medicine in which tumor genes can be studied efficiently. Recent developments in NGS have allowed investigators to identify genomic predictive makers and hereditary mutations to guide treatment decision. The application of NGS in gastrointestinal cancers is being extensively studied but continues to face substantial challenges. In our review, we discuss various NGS platforms and highlight their role in identifying familial mutations and markers of response or resistance to cancer therapy. We also provide a balanced discussion of the challenges that limit the routine use of NGS in clinical practice.",
keywords = "Challenges, Clinical application, Gastrointestinal cancer, Next generation sequencing, Predictive markers",
author = "Sameh Mikhail and Bishoy Faltas and Salem, {Mohamed E.} and Tanios Bekaii-Saab",
note = "Funding Information: Research in NGS requires a commitment to providing funding and philanthropic support to continue the progress that has been already achieved and help transition NGS from the bench to the bedside. Improving turnaround time is crucial to provide clinical data in a timely fashion to guide clinical decisions. We believe that repeating biopsies to detect molecular evolution of tumors may be necessary. This approach will be facilitated by advances such as testing circulating tumor cells or circulating tumor DNA by NGS without obtaining a tissue biopsy. Several issues will need to be resolved such as the interplay between tumor histology and the various genomic alterations. This will require accurate characterization of feedback and resistance loops of the various molecular abnormalities based on tissue histology and better study their response to targeted therapy. Such progress can be potentially made through clinical trials with adaptive designs that aim to identify mutations and tumor types that have exceptional responses to targeted therapies. The National Cancer institute MATCH trial [36] represents a step in this direction and more trials are likely to follow to help define the role of NGS in clinical oncology. The advances in molecular diagnostics will not result in meaningful clinical benefits unless they are paralleled with advances in developing novel therapeutics that are both clinically effective and safe. Although the challenges remain substantial, the progress that has been made is enormous and the opportunity to continue this progress has never been greater. Publisher Copyright: {\textcopyright} 2016 Published by Elsevier Ireland Ltd.",
year = "2016",
month = may,
day = "1",
doi = "10.1016/j.canlet.2016.02.029",
language = "English (US)",
volume = "374",
pages = "187--191",
journal = "Cancer Letters",
issn = "0304-3835",
publisher = "Elsevier Ireland Ltd",
number = "2",
}