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Evidence to Improve Care

Plasma-Based Comprehensive Genomic Profiling DNA Assays for Non-Small Cell Lung Cancer

 

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding plasma-based comprehensive genomic profiling DNA assays (liquid biopsy testing) for individuals diagnosed with non–small cell lung cancer who have an insufficient tissue sample or difficult-to-reach tumour tissue and for those who are otherwise unable to undergo tissue biopsy.

Read the final recommendation report


Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for about 85% of all cases. Because symptoms are typically mild at first, people are often not diagnosed until an advanced stage. Treatment for NSCLC may involve surgery, systemic therapy (chemotherapy, immunotherapy, or targeted therapy), radiation therapy, or a combination of these approaches.

Some cases of NSCLC are associated with certain genomic alterations (specific genetic or molecular changes) in the DNA of the tumour. Genomic alterations are considered actionable when they predict response to treatments known as targeted therapies. For people with actionable genomic alterations, targeted therapies may be more effective than traditional chemotherapy or radiation.

A type of genetic testing called comprehensive genomic profiling can identify actionable genomic alterations in tumour DNA and thus help determine the most effective treatment for a person with NSCLC. In Ontario, this testing is currently done through tissue biopsy (extracting a piece or fragments of tumour tissue for examination); this is called tissue testing. Plasma-based comprehensive genomic profiling – or liquid biopsy testing – involves taking a blood sample (rather than a tissue sample) to assess for the presence of circulating tumour DNA in the blood. Liquid biopsy testing may offer some advantages over tissue testing.

This health technology assessment looked at the analytical validity, clinical validity, clinical utility, and cost-effectiveness of liquid biopsy testing for people with NSCLC. It also looked at the budget impact of publicly funding this technology and at the experiences, preferences, and values of people with NSCLC.

Read the full health technology assessment report for more information.

Plasma-Based Comprehensive Genomic Profiling DNA Assays for Non-Small Cell Lung Cancer: A Health Technology Assessment
November 2024

  • PDF

  • XML (accessible version to come)

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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