14/03/2026
What do NCCN guidelines say about NGS in 2026?
If you’re an oncologist wondering whether NGS is “recommended” or just “nice to have," let the guidelines speak.
Here’s a summary of current NCCN recommendations for comprehensive genomic profiling:
NSCLC (Non-Small Cell Lung Cancer):
“Broad molecular profiling is recommended for all patients with advanced NSCLC.”
That means NGS is not a sequential single-gene testing.
Breast Cancer:
Germline BRCA1/2 testing for all eligible patients. Somatic PIK3CA, ESR1, and HER2 testing for advanced disease. NGS panels capture all of these in one test.
Colorectal Cancer:
Universal MMR/MSI testing. RAS and BRAF testing for metastatic disease. HER2 amplification assessment. NGS covers the full panel.
Ovarian Cancer:
Germline and somatic BRCA + HRD testing for all patients with epithelial ovarian cancer. This testing is crucial in making decisions about PARP inhibitors.
Hematological Malignancies:
AML: FLT3, IDH1/2, NPM1, TP53 at diagnosis. ALL: Broad molecular characterization. CML: BCR-ABL monitoring.
The message from global guidelines is clear: comprehensive genomic testing is no longer optional for quality cancer care. It's a must.