Impact of next-generation sequencing (NGS) on treatment selection in acute myeloid leukemia (AML).

103Background: Until recently, therapy options for AML patients (pts) were limited. The advent of NGS and novel targeted agents raise the question of how broader use of testing will impact treatment and outcomes. Methods: From October 2012 to June 2016, we included 1470 AML pts with available NGS-based detection of somatic mutations. 17 genes (ALK, CSF1R, FGFR1/2/3, FLT3, IDH1/2, JAK2, KDR, KRAS/NRAS, NPM1, PDGFRA, PTPN11, RET and TP53) were considered potentially actionable due to the possibility to be directly or indirectly targeted with standard or investigational agents. Results: of the 1271 treated pts, 982 (77%) had a median of 2 actionable mutations (AMs) (1-5): TP53 (n = 241; 16%), IDH2 (n = 240; 16%), IDH1 (n = 238; 16%), FLT3 (200; 14%), NPM1 (n = 195; 13%), NRAS (n = 175; 12%), JAK2 (103; 7%), KRAS (n = 82; 6%). 41% (271/518) of pts started new therapy after NGS results availability. NGS guided targeted therapy in 36% of pts: 53% of these enrolled on clinical trials (CT) and 6% received off-lab...