The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Researchers found the Percepta® Genomic Sequencing Classifier (GSC) appeared to influence clinical decision making in patients originally thought to have high-risk lung nodules. The study findings were presented in a poster at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.

The Percepta GSC can be used to risk stratify lung nodules through downclassifying malignancy risk or upclassifying it, explained Sonali Sethi, MD, from the Cleveland Clinic in Cleveland, Ohio, in the audio recording accompanying her research team’s poster. The researchers hypothesized that in cases where the pretest risk level is high, a change to very-high status based on the Percepta GSC would result in an earlier decision to recommend surgical resection or other ablative therapy.

The study was a prospective, randomized, decision impact survey involving 37 patients with indeterminate lung nodules. Eligible cases included those in which the patient was undergoing nondiagnostic bronchoscopy of a lung nodule. Eligible nodules had initially been judged to have a 60% or greater risk of malignancy (high risk), which was upclassified by the GSC results as having a greater than 91% risk of malignancy (very high risk).

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The survey was given to 97 licensed US pulmonologists, who were asked to provide recommended management plans for each of 10 patient cases from a set of options. Patient cases were presented with their pre-GSC clinical information, followed by inclusion of the GSC results.

When evaluating patient cases without the GSC results, the most common recommendation was diagnostic positron emission tomography (PET) scan (51%) followed by repeat biopsy (32%) and chest computed tomography (CT) scan (10%). Ablative therapy was recommended in 5.6% of cases.

When very-high risk results were presented, ablative therapy became the most common recommendation (46%), followed by repeat biopsy (31%), diagnostic PET scan (15%), and chest CT scan (5.3%). Use of the Percepta GSC also increased the rate of extremely confident recommendations from 21% to 31% of evaluations.

The researchers concluded that the Percepta GSC had a measurable effect on clinical decision making in the context of this study, and they indicated this approach may improve patient management and outcomes.

Disclosures: This research was supported by Veracyte Inc. Some study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.


Sethi S, Oh S, Chen A, et al. The impact of a genomic sequencing classifier (GSC) on clinical decision making in patients with a high-risk lung nodule. J Clin Oncol. 2021;39(suppl 15; abstr 8549). doi:10.1200/JCO.2021.39.15_suppl.8549