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- Dec 4, 2019
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I finished fellowship and an unanswered question I had was how to incorporate NGS tumor origin into clinical practice. At the beginning it was something we used if there was a discrepancy between histopathology and NGS to revisit. However the standard of care for poorly differentiated carcinomas was to seek out histopathological diagnosis either through rebiopsy or NCCN pathway for occult malignancy. Towards the end of my fellowship the temptation to utilize tumor of origin in the poorly differentiated carcinomas grew.
Is this now an acceptable standard of care to utilize tumor of origin from a NGS panel if there's a high degree of certainty of primary site for otherwise poorly differentiated carcinomas? NCCN guidelines for occult malignancy still says to avoid using NGS but ESMO seems more permissive. I think as a field we will probably move to using it especially with high degrees of certainty associated with the primary. I just wanted to see what other's practice patterns are wrt using NGS tumor of origin in otherwise unknown primary.
Is this now an acceptable standard of care to utilize tumor of origin from a NGS panel if there's a high degree of certainty of primary site for otherwise poorly differentiated carcinomas? NCCN guidelines for occult malignancy still says to avoid using NGS but ESMO seems more permissive. I think as a field we will probably move to using it especially with high degrees of certainty associated with the primary. I just wanted to see what other's practice patterns are wrt using NGS tumor of origin in otherwise unknown primary.
