Next-Generation Sequencing (NGS)

Next-Generation Sequencing is a high-speed laboratory technology that reads the DNA (and sometimes RNA) of many genes at once, often hundreds or thousands in a single test. In cancer care, NGS is performed on a tumor tissue sample or sometimes a blood sample to find genetic mutations that may guide treatment decisions, clinical trial eligibility, or prognosis.

Origin

NGS emerged in the mid-2000s as a successor to older Sanger sequencing methods, which read DNA one fragment at a time. The first commercial NGS platforms (Roche/454, Illumina/Solexa) launched between 2005 and 2007, and the technology has since become standard in oncology pathology labs.

Significance in Asbestos Context

For patients with mesothelioma or asbestos-related lung cancer, NGS of the tumor can identify mutations such as BAP1, NF2, CDKN2A, TP53, and others that shape prognosis and may open the door to targeted therapies or clinical trials. NGS results are increasingly part of the pathology workup and can influence which systemic treatments a medical oncologist recommends. In a legal claim, the molecular profile from NGS can also support diagnostic certainty, confirming that a tumor is mesothelioma rather than a mimicking cancer, and germline BAP1 testing (a separate test) may matter for family members. Patients should know that NGS does not identify the cause of the cancer; even when a mutation is found, asbestos exposure remains the established cause for mesothelioma in the vast majority of cases.

Example Sentence

After her pleural mesothelioma diagnosis, the oncologist ordered next-generation sequencing on the biopsy tissue to check for mutations that might qualify her for a clinical trial.

Related Terms

BAP1, CDKN2A, Immunohistochemistry, Tumor Biomarkers, Targeted Therapy, Liquid Biopsy

Notes

• Ask your oncologist or pathologist whether NGS has been performed on your tumor and request a copy of the molecular pathology report for your records and your legal file.
• If a BAP1 mutation is found in the tumor, ask whether germline (inherited) BAP1 testing is appropriate. This can have implications for blood relatives who may need cancer screening.
• Confirm that enough tumor tissue was preserved at biopsy for NGS; if not, a repeat biopsy or liquid biopsy (blood-based NGS) may be options worth discussing.
• Bring NGS results when seeking a second opinion at a mesothelioma specialty center, as some targeted therapies and trials are only available at high-volume programs.
• Preserve all pathology and molecular reports. These documents serve both your treatment planning and your legal claim's diagnostic record.