Value-based genomics

Jun Gong, Kathy Pan, Marwan Fakih, Sumanta Pal and Ravi Salgia _

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Oncotarget. 2018; 9:15792-15815. https://doi.org/10.18632/oncotarget.24353

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Jun Gong1, Kathy Pan2, Marwan Fakih1, Sumanta Pal1 and Ravi Salgia3

1Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA

2Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA

3Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA

Correspondence to:

Ravi Salgia, email: [email protected]

Keywords: next-generation sequencing; precision oncology; pathways; cost-effectiveness; value-based care

Received: November 30, 2017     Accepted: January 19, 2018     Epub: January 30, 2018     Published: March 20, 2018


Advancements in next-generation sequencing have greatly enhanced the development of biomarker-driven cancer therapies. The affordability and availability of next-generation sequencers have allowed for the commercialization of next-generation sequencing platforms that have found widespread use for clinical-decision making and research purposes. Despite the greater availability of tumor molecular profiling by next-generation sequencing at our doorsteps, the achievement of value-based care, or improving patient outcomes while reducing overall costs or risks, in the era of precision oncology remains a looming challenge. In this review, we highlight available data through a pre-established and conceptualized framework for evaluating value-based medicine to assess the cost (efficiency), clinical benefit (effectiveness), and toxicity (safety) of genomic profiling in cancer care. We also provide perspectives on future directions of next-generation sequencing from targeted panels to whole-exome or whole-genome sequencing and describe potential strategies needed to attain value-based genomics.

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