Rapid In-House NGS Is Closing the Gap in Precision Cancer Therapy

For patients newly diagnosed with cancer, the time from initial detection to molecular testing and start of therapy is critical, and every moment matters. In this context, the integration of companion diagnostics (CDx) into testing workflows, especially those utilizing next-generation sequencing (NGS), has become central to precision oncology by enabling the identification of actionable alterations, and the subsequential selection of targeted therapies. 

NGS-based assays are now considered standard for optimal treatment planning in many tumor types, and their value is maximized when results are delivered rapidly. Indeed, prolonged turnaround times (TAT), from sample collection through reporting, can compromise outcomes, whereas shorter TAT is consistently associated with earlier therapy initiation and improved prognosis. The American Cancer Society National Lung Cancer Roundtable has identified reducing TAT for biomarker testing as a key priority in non-small cell lung cancer (NSCLC), a principle that extends across oncology. 

Globally, the majority of cancer care is delivered in community rather than academic settings, with approximately 85 percent of patients in the United States receiving initial treatment in community hospitals. These institutions often lack infrastructure and specialized personnel for onsite genomic testing, relying instead on external service laboratories. This dependency can add days to weeks to the diagnostic timeline, creating uncertainty for patients and delaying treatment decisions.

But the latest technological advances are beginning to close this gap. The U.S. Food and Drug Administration (FDA) has recently cleared a fully automated NGS system capable of generating actionable results within 24 hours, enabling rapid molecular profiling of cancer specimens. Such a platform minimizes the need for highly specialized staff, can be easily integrated into existing laboratory workflows, and provides streamlined bioinformatics and reporting solutions. By reducing operational complexity and cost, automated NGS makes it feasible for community hospitals to expand testing capacity without significant infrastructure investments. This democratization of testing helps ensure that access to precision oncology is not limited by geography or institutional resources. Nonetheless, for complex cases where more comprehensive molecular testing is needed, large academic and NCI designed centers remain a pillar of cancer care.

Equally important to underline, in-house NGS testing can improve communication and coordination among HCPs and care teams. When results are integrated directly into electronic health records and tumor board discussions, treatment planning is faster and better informed, supporting evidence-based decision-making. Lastly, operational efficiencies, resulting in fewer hospital visits and optimized personnel resource utilization, further contribute to cost-effectiveness while improving the patient experience.

As cancer therapies grow increasingly targeted and molecular profiles more complex, the need for rapid, reliable, and broadly accessible NGS-based companion diagnostics will only intensify. The American Society of Clinical Oncology (ASCO) highlights that integrating somatic genomic testing into routine clinical practice is now essential for guiding therapy in metastatic and advanced cancers, and its use will shortly expand as well into earlier stages to inform treatment decisions. The road is paved to broader adoption of local automated NGS testing, ultimately to enhance patient outcomes by enabling timely identification of actionable mutations, expanding access to precision medicine, and ensuring more equitable delivery of high-quality cancer care.